HOME

TheInfoList




Breastfeeding, also called nursing, is the process of feeding a mother's breast milk to her infant, either directly from the breast or by expressing (pumping out) the milk from the breast and bottle-feeding it to the infant. The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations United Nations Specialized Agencies are autonomous organizations working with the United Nations and each other through the co-ordinating machinery of the Unite ...
(WHO) recommends that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. During the first few weeks of life babies may nurse roughly every two to three hours, and the duration of a feeding is usually ten to fifteen minutes on each breast. Older children feed less often. Mothers may pump milk so that it can be used later when breastfeeding is not possible. Breastfeeding has a number of benefits to both mother and baby, which
infant formula Infant formula, baby formula or just formula (American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of varieties of the English language native to the United S ...

infant formula
lacks. Increased breastfeeding globally could prevent approximately 820,000 deaths of children under the age of five annually. Breastfeeding decreases the risk of
respiratory tract infection Respiratory tract infections (RTIs) are infectious disease An infection is the invasion of an organism's body Tissue (biology), tissues by Pathogen, disease-causing agents, their multiplication, and the reaction of host (biology), host tissues ...
s and
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movement frame, Anatomy of the anus and rectum Defecation is the final act of digestion Digestion is the breakdown of large ins ...
for the baby, both in developing and
developed countries A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state A sovereign state is a political entity that is represented by one centralized governmen ...
. Other benefits include lower risks of
asthma Asthma is a long-term Long-Term Capital Management L.P. (LTCM) was a hedge fund''A financial History of the United States Volume II: 1970–2001'', Jerry W. Markham, Chapter 5: "Bank Consolidation", M. E. Sharpe, Inc., 2002 based in Greenwich, ...

asthma
, food allergies, and
type 1 diabetes Type 1 diabetes (T1D), previously known as juvenile diabetes, is an autoimmune disease An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. There are at least 80 types of autoimmune diseases ...
. Breastfeeding may also improve
cognitive development Cognitive development is a field of study in neuroscience Neuroscience is the science, scientific study of the nervous system. It is a Multidisciplinary approach, multidisciplinary science that combines physiology, anatomy, molecular biology, ...
and decrease the risk of
obesity Obesity is a medical condition A disease is a particular abnormal condition that negatively affects the structure or function (biology), function of all or part of an organism, and that is not due to any immediate external injury. ...

obesity
in adulthood. Mothers may feel pressure to breastfeed, but in the developed world children generally grow up normally when with
formula In , a formula is a concise way of expressing information symbolically, as in a mathematical formula or a . The informal use of the term ''formula'' in science refers to the . The plural of ''formula'' can be either ''formulas'' (from the mos ...

formula
. Benefits for the mother include less
blood loss Bleeding, also known as a hemorrhage, haemorrhage, or simply blood loss, is blood Blood is a body fluid in humans and other animals that delivers necessary substances such as nutrient A nutrient is a substance used by an organism to survi ...

blood loss
following
delivery Delivery may refer to: *Delivery (commerce), of goods, e.g.: **Pizza delivery **Milk delivery Film and television *Delivering (film), ''Delivering'' (film), a 1993 short film by Todd Field *Delivery (film), ''Delivery'' (film), a 2005 animated sho ...

delivery
, better
uterus The uterus (from Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. Through the power of the ...

uterus
contraction, and decreased
postpartum depression Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes. Symptoms may include extreme sadness, Fatigue (medical), low energy, anxiety, crying episodes, irrit ...
. Breastfeeding delays the return of
menstruation Menstruation (also known as a period and many other Colloquialism, colloquial terms) is the regular discharge of blood and Mucous membrane, mucosal tissue from the endometrium, inner lining of the uterus through the vagina. The menstrual cycl ...
and
fertility Fertility is the capability to produce offspring through reproduction following the onset of sexual maturity. The fertility rate is the average number of children born by a female during her lifetime and is quantified Demography, demographicall ...
, a phenomenon known as
lactational amenorrhea Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal The postpartum (or postnatal) period begins immediately after childbirth Childbirth, also known as labour or delivery, is the ending of pregnancy where ...
. Long-term benefits for the mother include decreased risk of
breast cancer Breast cancer is cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumor A benign tumor is a mass of cells Cell most o ...

breast cancer
,
cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart The heart is a cardiac muscle, muscular Organ (biology), organ in most animals, which pumps blood through the blood vessels of the circulatory system. The pumped ...
, and
rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects synovial joint, joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and ...
. Breastfeeding is also less expensive than infant formula. Health organizations, including the
WHO The World Health Organization (WHO) is a specialized agency of the United Nations United Nations Specialized Agencies are autonomous organizations working with the United Nations and each other through the co-ordinating machinery of the Unite ...
, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than possibly
vitamin D Vitamin D is a group of fat-soluble secosteroid 250px, The parent steroid skeleton. The B-ring of the parent steroid is broken between C9 and C10 to yield D vitamins. A secosteroid () is a type of steroid , hypothetical a steroid with ...
, are typically given. After the introduction of foods at six months of age, recommendations include continued breastfeeding until one to two years of age or more. Globally, about 38% of infants are exclusively breastfed during their first six months of life. In the United States in 2015, 83% of women begin breastfeeding, but at 6 months only 58% were still breastfeeding with 25% exclusively breastfeeding. Medical conditions that do not allow breastfeeding are rare. Mothers who take certain
recreational drugs Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for happiness, enjoyment, amusement, o ...

recreational drugs
and
medications A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug Uncoated tablets, consisting of about 90% acetylsalicylic acid, along with a minor amount of inert fillers and binders. Aspir ...

medications
should not breastfeed. In 2020, WHO and UNICEF announced that women should continue to breastfeed during the
COVID-19 pandemic The COVID-19 pandemic is an ongoing global pandemic A pandemic (from , , "all" and , , "local people" the 'crowd') is an of an that has spread across a large region, for instance multiple or worldwide, affecting a substantial numbe ...

COVID-19 pandemic
even if they have confirmed or suspected COVID-19 because current evidence indicates that it is unlikely that COVID-19 can be transmitted through breast milk. Smoking tobacco and consuming limited amounts of alcohol and/or coffee are not reasons to avoid breastfeeding.


Lactation

Changes early in
pregnancy Pregnancy, also known as gestation, is the time during which one or more offspring In biology, offspring are the young creation of living organisms, produced either by a Asexual reproduction, single organism or, in the case of sexual repr ...

pregnancy
prepare the breast for lactation. Before pregnancy the breast is largely composed of
adipose Adipose tissue, body fat, or simply fat is a loose connective tissue Connective tissue is one of the four basic types of animal tissue (biology), tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesod ...
(fat) tissue but under the influence of the hormones
estrogen Estrogens or oestrogens, are a class of natural or synthetic s responsible for the development and regulation of the female and s. There are three major estrogens that have estrogenic hormonal activity: (E1), (E2), and (E3). Estradiol, an ...

estrogen
,
progesterone Progesterone (P4) is an endogenous Endogenous substances and processes are those that originate from within a system such as an organism, Tissue (biology), tissue, or Cell (biology), cell. Endogenous substances and processes contrast with exo ...

progesterone
,
prolactin Prolactin (PRL), also known as lactotropin, is a protein best known for its role in enabling mammals (and birds), usually females, to lactation, produce milk. It is influential in over 300 separate processes in various vertebrates, including hu ...
, and other hormones, the breasts prepare for production of milk for the baby. There is an increase in blood flow to the breasts. Pigmentation of the nipples and
areola The human areola (''areola mammae'', Entry "areola"
in
By the second trimester of pregnancy
colostrum Colostrum (known colloquially as beestings, bisnings or first milk) is the first form of milk Milk is a nutrient A nutrient is a substance Substance may refer to: * Substance (Jainism), a term in Jain ontology to denote the base or owner ...

colostrum
, a thick yellowish fluid, begins to be produced in the alveoli and continues to be produced for the first few days after birth until the milk "comes in", around 30 to 40 hours after delivery.
Oxytocin Oxytocin (Oxt or OT) is a peptide hormone and neuropeptide normally produced in the hypothalamus and released by the posterior pituitary. It plays a role in Human bonding, social bonding, reproduction, childbirth, and the Postpartum period, pe ...

Oxytocin
contracts the
smooth muscle Smooth muscle is an involuntary non-striated muscle Striated muscle tissue is a muscle tissue Muscle tissue is a soft tissue that composes muscles in animal bodies, and gives rise to muscles' ability to contract. It is also referred to as myo ...

smooth muscle
of the
uterus The uterus (from Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. Through the power of the ...

uterus
during birth and following delivery, called the
postpartum The postpartum (or postnatal) period begins immediately after childbirth Childbirth, also known as labour or delivery, is the ending of pregnancy where one or more babies leaves the uterus by passing through the vagina or by Caesarean secti ...
period, while breastfeeding. Oxytocin also contracts the smooth muscle layer of band-like cells surrounding the alveoli to squeeze the newly produced milk into the duct system. Oxytocin is necessary for the ''milk ejection reflex'', or ''let-down'', in response to suckling, to occur.


Breast milk

Not all of breast milk's properties are understood, but its
nutrient A nutrient is a substance Substance may refer to: * Substance (Jainism), a term in Jain ontology to denote the base or owner of attributes * Chemical substance, a material with a definite chemical composition * Matter, anything that has mass and t ...
content is relatively consistent. Breast milk is made from nutrients in the mother's
bloodstream The circulatory system, also called the cardiovascular system or the vascular system, is an organ system An organ system is a biological system A biological system is a complex biological network, network which connects several biologically ...
and bodily stores. It has an optimal balance of fat, sugar, water, and
protein Proteins are large biomolecule , showing alpha helices, represented by ribbons. This poten was the first to have its suckture solved by X-ray crystallography by Max Perutz and Sir John Cowdery Kendrew in 1958, for which they received a No ...

protein
that is needed for a baby's growth and development. Breastfeeding triggers biochemical reactions which allow for the
enzymes Enzymes () are proteins that act as biological catalysts (biocatalysts). Catalysts accelerate chemical reactions. The molecules upon which enzymes may act are called substrate (chemistry), substrates, and the enzyme converts the substrates int ...
,
hormones A hormone (from the Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is approximately 10.7 m ...
, growth factors and immunologic substances to effectively defend against infectious
diseases A disease is a particular abnormal condition that negatively affects the structure or function (biology), function of all or part of an organism, and that is not due to any immediate external injury. Diseases are often known to be medical ...
for the infant. The breast milk also has long-chain
polyunsaturated fatty acidsPolyunsaturated fatty acids (PUFAs) are fatty acids that contain more than one double bond in their backbone. This class includes many important compounds, such as essential fatty acids and those that give drying oil A drying oil is an oil that ...
which help with normal
retina The retina (from la, rete "net") is the innermost, light-sensitive layer of tissue of the eye Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well ...

retina
l and
neural In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemical processes, Molecular biology, molecular interactions, Physiology, physiological mechani ...
development. The composition of breast milk changes depending on how long the baby nurses at each session, as well as on the child's age. The first type, produced during the first days after childbirth, is called ''
colostrum Colostrum (known colloquially as beestings, bisnings or first milk) is the first form of milk Milk is a nutrient A nutrient is a substance Substance may refer to: * Substance (Jainism), a term in Jain ontology to denote the base or owner ...

colostrum
''. Colostrum is easy to digest although it is more concentrated than mature milk. It has a laxative effect that helps the infant to pass early stools, aiding in the excretion of excess
bilirubin Bilirubin (BR) is a yellow compound that occurs in the normal catabolic Catabolism () is the set of metabolic pathways that breaks down molecule File:Pentacene on Ni(111) STM.jpg, A scanning tunneling microscopy image of pentacene molecule ...

bilirubin
, which helps to prevent
jaundice Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and s ...

jaundice
. It also helps to seal the infants gastrointestional tract from foreign substances, which may sensitize the baby to foods that the mother has eaten. Although the baby has received some antibodies through the placenta, colostrum contains a substance which is new to the newborn, secretory
immunoglobulin A File:3D structure of secretory IgA1.png, Two views, one rotated 90 degrees with respect to the other, of the amino acid chains comprising secretory IgA1. Colors are: H-chains (blue and light blue), L-chains (red and light red), J-chain (magenta) an ...
(IgA). IgA works to attack germs in the mucous membranes of the throat, lungs, and intestines, which are most likely to come under attack from germs. Breasts begin producing mature milk around the third or fourth day after birth. Early in a nursing session, the breasts produce ''foremilk'', a thinner milk containing many proteins and vitamins. If the baby keeps nursing, then ''hindmilk'' is produced. Hindmilk has a creamier color and texture because it contains more fat.


Process


Commencement

It is recommended for mothers to initiate breastfeeding within the first hour after birth. Breastfeeding can begin immediately after birth. The baby is placed on the mother and feeding starts as soon as the baby shows interest. According to some authorities the majority of infants do not immediately begin to suckle if placed between the mother's breasts but rather enter a period of rest and quiet alertness. During this time they seem to be more interested in the mother's face, especially her eyes, than beginning to suckle. It has been speculated that this period of infant-mother interaction assists in the mother-child bonding for both mother and baby. There is increasing evidence that suggests that early skin-to-skin contact (also called
kangaroo care Kangaroo care also called skin-to-skin contact, is a technique of newborn care where babies are kept chest-to-chest and skin-to-skin with a parent, typically their mother (occasionally their father). Kangaroo care, named for the similarity to how c ...
) between mother and baby stimulates breastfeeding behavior in the baby. Newborns who are immediately placed on their mother's skin have a natural instinct to latch on to the breast and start nursing, typically within one hour of birth. Immediate skin-to-skin contact may provide a form of imprinting that makes subsequent feeding significantly easier. In addition to more successful breastfeeding and bonding, immediate skin-to-skin contact reduces crying and warms the baby. According to studies cited by
UNICEF UNICEF, also known as the United Nations Children's Fund, is a United Nations agency responsible for providing humanitarian and developmental aid to children worldwide. The agency is among the most widespread and recognizable social welfare or ...

UNICEF
, babies naturally follow a process which leads to a first breastfeed. Initially after birth the baby cries with its first breaths. Shortly after, it relaxes and makes small movements of the arms, shoulders and head. If placed on the mother's abdomen the baby then crawls towards the breast, called the breast crawl and begins to feed. After feeding, it is normal for a baby to remain latched to the breast while resting. This is sometimes mistaken for lack of appetite. Absent interruptions, all babies follow this process. Rushing or interrupting the process, such as removing the baby to weigh him/her, may complicate subsequent feeding. Activities such as weighing, measuring, bathing, needle-sticks, and eye prophylaxis wait until after the first feeding." Current research strongly supports immediate skin-to-skin mother-baby contact even if the baby is born by Cesarean surgery. The baby is placed on the mother in the operating room or the recovery area. If the mother is unable to immediately hold the baby a family member can provide skin-to-skin care until the mother is able. The La Leche League suggests early skin-to-skin care following an unexpected surgical rather than vaginal delivery "may help heal any feelings of sadness or disappointment if birth did not go as planned." Children who are born
preterm Preterm birth, also known as premature birth, is the Childbirth, birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Very early preterm birth is before 32 weeks, early preterm birth ...
have difficulty in initiating breast feeds immediately after birth. By convention, such children are often fed on expressed breast milk or other supplementary feeds through tubes or bottles until they develop satisfactory ability to suck breast milk. Tube feeding, though commonly used, is not supported by scientific evidence as of October 2016. It has also been reported in the same
systematic review Systematic reviews are a type of Literature review, review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or ...
that by avoiding bottles and using cups instead to provide supplementary feeds to preterm children, a greater extent of breast feeding for a longer duration can subsequently be achieved.


Timing

Newborn babies typically express demand for feeding every one to three hours (8–12 times in 24 hours) for the first two to four weeks. A
newborn An infant (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is the more formal or specialised synonym for the common term ''baby'', meaning the of . The term may also be used to refer to of other organisms. A n ...

newborn
has a very small stomach capacity. At one-day old it is 5–7 ml, about the size of a ; at day three it is 22–30 ml, about the size of a ping-pong ball; and at day seven it is 45–60 ml, or about the size of a golf ball. The amount of breast milk that is produced is timed to meet the infant's needs in that the first milk, colostrum, is concentrated but produced in only very small amounts, gradually increasing in volume to meet the expanding size of the infant's stomach capacity. According to
La Leche League International La Leche League International (LLLI) (''La Leche'' is Spanish for "the milk") is a non-governmental, nonprofit organization that organizes advocacy, educational, and training related to breastfeeding Breastfeeding, also called nursing, is ...
, "Experienced breastfeeding mothers learn that the sucking patterns and needs of babies vary. While some infants' sucking needs are met primarily during feedings, other babies may need additional sucking at the breast soon after a feeding even though they are not really hungry. Babies may also nurse when they are lonely, frightened or in pain....Comforting and meeting sucking needs at the breast is nature's original design.
Pacifier A pacifier is a rubber Rubber, also called India rubber, latex, Amazonian rubber, ''caucho'', or ''caoutchouc'', as initially produced, consists of polymer A polymer (; Greek ''poly- Poly, from the Greek :wikt:πολύς, πολύ ...

Pacifier
s (dummies, soothers) are a substitute for the mother when she cannot be available. Other reasons to pacify a baby primarily at the breast include superior oral-facial development, prolonged
lactational amenorrhea Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal The postpartum (or postnatal) period begins immediately after childbirth Childbirth, also known as labour or delivery, is the ending of pregnancy where ...
, avoidance of nipple confusion, and stimulation of an adequate milk supply to ensure higher rates of breastfeeding success." Many newborns will feed for 10 to 15 minutes on each breast. If the infant wants to nurse for a much longer period—say 30 minutes or longer on each breast—they may not be getting enough milk.


Duration and exclusivity

Health organizations recommend breastfeeding exclusively for six months following birth, unless medically contraindicated. Exclusive breastfeeding is defined as "an infant's consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk and no foods) except for vitamins, minerals and medications." In some countries, including the United States, UK, and Canada, daily
vitamin D Vitamin D is a group of fat-soluble secosteroid 250px, The parent steroid skeleton. The B-ring of the parent steroid is broken between C9 and C10 to yield D vitamins. A secosteroid () is a type of steroid , hypothetical a steroid with ...
supplementation is recommended for all breastfed infants. It seems that giving 400 IU vitamin D per day for 6 months to breastfed infants reduces vitamin D insufficiency; this result can also be achieved by providing at least 4000 IU vitamin D per day to the breastfeeding person. Note that it was not possible to determine that these vitamin D supplements were actually improving bone health. After solids are introduced at around six months of age, continued breastfeeding is recommended. The AAP recommends that babies be breastfed at least until 12 months, or longer if both the mother and child wish. WHO's guidelines recommend "continue frequent, on-demand breastfeeding until two years of age or beyond. The vast majority of mothers can produce enough milk to fully meet the nutritional needs of their baby for six months. Breast milk supply augments in response to the baby's demand for milk, and decreases when milk is allowed to remain in the breasts.
Low milk supply In breastfeeding Breastfeeding, also called nursing, is the process of feeding a mother's breast milk to her infant, either directly from the breast or by expressing (pumping out) the milk from the breast and bottle-feeding it to the infant. ...
is usually caused by allowing milk to remain in the breasts for long periods of time, or insufficiently draining the breasts during feeds. It is usually preventable, unless caused by medical conditions that have been estimated to affect up to five percent of women. There is no evidence to support increased fluid intake for breastfeeding mothers will increase their milk production. "Drink when thirsty" is advised. If the baby is latching and swallowing well, but is not gaining weight as expected or is showing signs of dehydration, low milk supply in the mother can be suspected.


Medical contraindications

Medical conditions that do not allow breastfeeding are rare. Infants that are otherwise healthy uniformly benefit from breastfeeding, however, extra precautions should be taken or breastfeeding avoided in circumstances including certain infectious diseases. A breastfeeding child can become infected with HIV. Factors such as the
viral load Viral load, also known as viral burden, is a numerical expression of the quantity of virus in a given volume of fluid, including biological and environmental specimens. It is not to be confused with viral titre or viral titer, which depends on the ...
in the mother's milk complicate breastfeeding recommendations for HIV-positive mothers. In mothers who are treated with
antiretroviral drugs The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs in an attempt to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multip ...
the risk of HIV transmission with breastfeeding is 1–2%. Therefore, breastfeeding is still recommended in areas of the world where death from infectious diseases is common. Infant formula should only be given if this can be safely done. WHO recommends that national authorities in each country decide which infant feeding practice should be promoted by their maternal and child health services to best avoid HIV transmission from mother to child. Other maternal infections of concern include active untreated
tuberculosis Tuberculosis (TB) is an infectious disease An infection is the invasion of an organism's body Tissue (biology), tissues by Pathogen, disease-causing agents, their multiplication, and the reaction of host (biology), host tissues to the in ...

tuberculosis
or
human T-lymphotropic virus The human T-lymphotropic virus, human T-cell lymphotropic virus, or human T-cell leukemia-lymphoma virus (HTLV) family of viruses are a group of human retroviruses that are known to cause a type of cancer called adult T-cell leukemia/lymphoma and ...
. Mothers who take certain
recreational drugs Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for happiness, enjoyment, amusement, o ...

recreational drugs
and medications should not breastfeed. In May 2020, WHO and UNICEF stressed that the ongoing
COVID-19 pandemic The COVID-19 pandemic is an ongoing global pandemic A pandemic (from , , "all" and , , "local people" the 'crowd') is an of an that has spread across a large region, for instance multiple or worldwide, affecting a substantial numbe ...

COVID-19 pandemic
was not a reason to begin or discontinue breastfeeding. They recommend that women should continue to breastfeed during the pandemic even if they have confirmed or suspected COVID-19 because current evidence indicates that it is not likely that COVID-19 can be transmitted through breast milk.


Location

All 50 states, the District of Columbia, Puerto Rico and the Virgin Islands have laws that allow a mother to breastfeed her baby in any public or private location. In the United States, the Friendly Airports for Mothers (FAM) Act was signed into law in 2019 and the requirements went into effects in 2021. This law requires all large and medium hub airports must provide a private, non-bathroom lactation space in each terminal building. In hospitals, rooming-in care permits the baby to stay with the mother and simplifies the process. Some commercial establishments provide breastfeeding rooms, although laws generally specify that mothers may breastfeed anywhere, without requiring a special area. Despite these laws, many women in the United States continue to be publicly shamed or asked to refrain from breastfeeding in public. In the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain,Usage is mixed. The Guardian' and Telegraph' use Britain as a synonym for the United Kingdom. Some prefer to use Britain as shorth ...

United Kingdom
, the
Equality Act 2010 The Equality Act 2010 is an Act of Parliament, Act of Parliament of the United Kingdom passed during the Brown ministry with the primary purpose of consolidating, updating and supplementing the numerous prior Acts and Regulations, that formed the ...
makes the prevention of a woman breastfeeding in any public place
discrimination Discrimination is the act of making unjustified distinctions between people based on the groups, classes, or other categories to which they belong or are perceived to belong. People may be discriminated on the basis of Racial discrimination, r ...
under the law. In
Scotland Scotland ( sco, Scotland, gd, Alba Alba (Scottish Gaelic Scottish Gaelic ( gd, Gàidhlig or Scots Gaelic, sometimes referred to simply as Gaelic) is a Goidelic language (in the Celtic languages, Celtic branch of the Indo-European ...

Scotland
, it is a criminal offense to try to prevent a woman feeding a child under 24 months in public. While laws in the U.S. that passed in 2010 which required that nursing mothers who had returned to work be given a non-bathroom space to express milk and a reasonable break time to do so, as of 2016 the majority of women still did not have access to both accommodations. As of 2019, some establishments have placed small portable nursing "pods" with electrical outlets for nursing pumps to provide their places of business with a comfortable private area to nurse or express milk. The
Minnesota Vikings The Minnesota Vikings are a professional American football American football, referred to simply as football in the United States and Canada and also known as gridiron, is a team sport A team sport includes any sport Sport ...
were the first (2015) NFL franchise to implement the lactation pods. In 2019 it was reported that the pod manufacturer had placed 152 of them in 57 airports. In 2014, newly elected
Pope Francis Pope Francis ( la, Franciscus; it, Francesco; es, link=, Francisco; born Jorge Mario Bergoglio, 17 December 1936) is the head of the Catholic Church and sovereign of the Vatican City State since 2013. Francis is the first pope to be a member ...

Pope Francis
drew worldwide commentary when he encouraged mothers to breastfeed babies in church. During a papal
baptism Baptism (from the Greek language, Greek noun βάπτισμα ''báptisma'') is a Christians, Christian rite of initiation, admission and Adoption (theology), adoption, almost invariably with the use of water, into Christianity. It may be pe ...

baptism
, he said that mothers "should not stand on ceremony" if their children were hungry. "If they are hungry, mothers, feed them, without thinking twice," he said, smiling. "Because they are the most important people here."


Position

Correct positioning and technique for latching on are necessary to prevent nipple soreness and allow the baby to obtain enough milk. Babies can successfully latch on to the breast from multiple positions. Each baby may prefer a particular position. The "football" hold places the baby's legs next to the mother's side with the baby facing the mother. Using the "cradle" or "cross-body" hold, the mother supports the baby's head in the crook of her arm. The "cross-over" hold is similar to the cradle hold, except that the mother supports the baby's head with the opposite hand. The mother may choose a reclining position on her back or side with the baby lying next to her. File:ASC Leiden - Coutinho Collection - 1 12 - Life in Canjambari, Guinea-Bissau - Guinean mother breastfeeding her baby - 1973 (cropped).tiff, Standing mother breastfeeding her baby, Canjambari, Guinea-Bissau, 1973 File:Blausen 0118 Breastfeeding CorrectLatch-On 02.png, Illustration depicting correct latch-on position during breastfeeding. File:Breastfeeding - Cradle Hold.png, Breastfeeding – Cradle hold. File:Breastfeeding - Cross Cradle Position.png, Breastfeeding – Cross cradle position. File:Breastfeeding - Football Hold.png, Breastfeeding – Football hold. File:Breastfeeding - Incorrect vs Correct Latch-On.png, Breastfeeding – Incorrect vs correct latch-on. File:Breastfeeding - Semi-Reclining Position.png, Breastfeeding – Semi-reclining position. File:Breastfeeding - Side-Lying Position.png, Breastfeeding – Side-lying position. File:Breastfeeding - Supine Position.png, Breastfeeding – Supine position. File:Breastfeeding - Tease Lips or Cheek.png, Breastfeeding – Tease lips or cheek. File:Breastfeeding - Twins, Cross Cradle Position I.png, Breastfeeding – Twins, cross cradle position I. File:Blausen 0134 Breastfeeding Twins FootballorClutchHold 02.png, Breastfeeding – Twins, football or clutch hold. File:Breastfeeding - Twins, Parallel Position II.png, Breastfeeding – Twins, parallel position II.


Latching on

Latching on refers to how the baby fastens onto the breast while feeding. The
rooting reflexPrimitive reflexes are reflex actions originating in the central nervous system that are exhibited by normal infants, but not neurologically intact adults, in response to particular stimuli. These reflexes are suppressed by the development of the ...
is the baby's natural tendency to turn towards the breast with the mouth open wide; mothers sometimes make use of this by gently stroking the baby's cheek or lips with their nipple to induce the baby to move into position for a breastfeeding session. Infants also use their sense of smell in finding the nipple. Sebaceous glands called
Glands of Montgomery Areolar glands or Glands of Montgomery are sebaceous glands in the areola surrounding the nipple The nipple is a raised region of tissue on the surface of the breast The breast is one of two prominences located on the upper ventral reg ...
located in the areola secrete an oily fluid that lubricates the nipple. The visible portions of the glands can be seen on the skin's surface as small round bumps. They become more pronounced during pregnancy and it is speculated that the infant is attracted to the odor of the secretions. One study found that when one of the breasts was washed with unscented soap the baby preferred the other one, suggesting that plain water would be the best washing substance while the baby is becoming accustomed to nursing. In a good latch, a large amount of the areola, in addition to the nipple, is in the baby's mouth. The nipple should be angled towards the roof of the mouth, and the baby's lips should be flanged out. In some cases in which a baby seems unable to latch on properly the problem may be related to a medical condition called
ankyloglossia Ankyloglossia, also known as tongue-tie, is a congenital A birth defect, also known as a congenital disorder, is a condition present at birth Birth is the act or process of bearing or bringing forth offspring, also referred to in technical ...
, also referred to as "tongue-tied". In this condition a baby can't get a good latch because their tongue is stuck to the bottom of their mouth by a band of tissue and they can't open their mouth wide enough or keep their tongue over the lower gum while sucking. If an infant is unable to hold their tongue in the correct position they may chew rather than suck, causing both a lack of nutrition for the baby and significant nipple pain for the mother. If it is determined that the inability to latch on properly is related to ankyloglossia, a simple surgical procedure can correct the condition. At one time it was thought that massage of the nipples before the birth of the baby would help to toughen them up and thus avoid possible nipple soreness. It is now known that a good latch is the best prevention of nipple pain. There is also less concern about small, flat, and even "inverted" nipples as it is now believed that a baby can still achieve a good latch with perhaps a little extra effort. In one type of inverted nipple, the nipple easily becomes erect when stimulated, but in a second type, termed a "true inverted nipple," the nipple shrinks back into the breast when the areola is squeezed. According to La Leche League, "There is debate about whether pregnant women should be screened for flat or inverted nipples and whether treatments to draw out the nipple should be routinely recommended. Some experts believe that a baby who is latched on well can draw an inverted nipple far enough back into his mouth to nurse effectively." La Leche League offers several techniques to use during pregnancy or even in the early days following birth that may help to bring a flat or inverted nipple out.


Professional breastfeeding support

Lactation consultants A lactation consultant is a health professional who specializes in the clinical management of breastfeeding. The International Board of Lactation Consultant Examiners (IBLCE) certifies lactation consultants who meet its criteria and have passed its ...
are trained to assist mothers in preventing and solving breastfeeding difficulties such as sore nipples and low milk supply. They commonly work in hospitals, physician or midwife practices, public health programs, and private practice. Exclusive and partial breastfeeding are more common among mothers who gave birth in hospitals that employ International Board-Certified Lactation Consultants (IBCLC), thus the U.S. Surgeon General recommends that all communities have access to IBCLC services.


Newborn jaundice

Approximately 60% of full-term infants develop
jaundice Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and s ...

jaundice
within several days of birth. Jaundice, or yellowing of the skin and eyes, occurs when a normal substance, bilirubin, builds up in the newborn's bloodstream faster than the liver can break it down and excrete it through the baby's stool. By breastfeeding more frequently or for longer periods of time, the infant's body can usually rid itself of the bilirubin excess. However, in some cases, the infant may need additional treatments to keep the condition from progressing into more severe problems. There are two types of newborn jaundice. Breast milk jaundice occurs in about 1 in 200 babies. Here the jaundice isn't usually visible until the baby is a week old. It often reaches its peak during the second or third week. Breast milk jaundice can be caused by substances in mother's milk that decrease the infant's liver's ability to deal with bilirubin. Breast milk jaundice rarely causes any problems, whether it is treated or not. It is usually not a reason to stop nursing. A different type of jaundice, Breastfeeding jaundice, may occur in the first week of life in more than 1 in 10 breastfed infants. The cause is thought to be inadequate milk intake, leading to dehydration or low caloric intake. When the baby is not getting enough milk bowel movements are small and infrequent so that the bilirubin that was in the baby's gut gets reabsorbed into the blood instead of being passed in bowel movements. Inadequate intake may be because the mother's milk is taking longer than average to "come in" or because the baby is poorly latched while nursing. If the baby is properly latching the mother should offer more frequent nursing sessions to increase hydration for the baby and encourage her breasts to produce more milk. If poor latch is thought to be the problem, a lactation expert should assess and advise.


Weaning

Weaning is the process of replacing breast milk with other foods; the infant is fully weaned after the replacement is complete. Psychological factors affect the weaning process for both mother and infant, as issues of closeness and separation are very prominent. If the baby is less than a year old, substitute bottles are necessary; an older baby may accept milk from a cup. Unless a medical emergency necessitates abruptly stopping breastfeeding, it is best to gradually cut back on feedings to allow the breasts to adjust to the decreased demands without becoming engorged. La Leche League advises: "The nighttime feeding is usually the last to go. Make a bedtime routine not centered around breastfeeding. A good book or two will eventually become more important than a long session at the breast." If breastfeeding is suddenly stopped a woman's breasts are likely to become engorged with milk. Pumping small amounts to relieve discomfort helps to gradually train the breasts to produce less milk. There is presently no safe medication to prevent engorgement, but cold compresses and
ibuprofen Ibuprofen is a medication in the nonsteroidal anti-inflammatory drug (NSAID) class that is used for treating pain, fever, and inflammation. This includes dysmenorrhea, painful menstrual periods, migraines, and rheumatoid arthritis. It may also ...

ibuprofen
may help to relieve pain and swelling. Pain should go away in one to five days. If symptoms continue and comfort measures are not helpful a woman should consider the possibility that a blocked milk duct or infection may be present and seek medical intervention. When weaning is complete the mother's breasts return to their previous size after several menstrual cycles. If the mother was experiencing
lactational amenorrhea Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal The postpartum (or postnatal) period begins immediately after childbirth Childbirth, also known as labour or delivery, is the ending of pregnancy where ...
her periods will return along with the return of her fertility. When no longer breastfeeding she will need to adjust her diet to avoid weight gain.


Drugs

Almost all medicines pass into breastmilk in small amounts. Some have no effect on the baby and can be used while breastfeeding. Many medications are known to significantly suppress milk production, including
pseudoephedrine Pseudoephedrine (PSE) is a sympathomimetic Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of endogenous Endogenous substances and processes are those that originat ...

pseudoephedrine
,
diuretic A diuretic () is any substance that promotes diuresis Diuresis () is increased urination Urination is the release of urine from the urinary bladder through the urethra to the outside of the body. It is the urinary system's form of excretio ...
s, and
contraceptive Birth control, also known as contraception, anticonception, and fertility control, is a method or device used to prevent pregnancy Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman ...
s that contain
estrogen Estrogens or oestrogens, are a class of natural or synthetic s responsible for the development and regulation of the female and s. There are three major estrogens that have estrogenic hormonal activity: (E1), (E2), and (E3). Estradiol, an ...

estrogen
. The
American Academy of Pediatrics The American Academy of Pediatrics (AAP) is an American professional association A professional association (also called a professional body, professional organization, or professional society) usually seeks to further Further or Furthur ma ...
(AAP) states that "tobacco smoking by mothers is not a contraindication to breastfeeding." Breastfeeding is actually ''especially'' recommended for mothers who smoke, because of its protective effects against SIDS. With respect to alcohol, the AAP states that when breastfeeding, "moderation is definitely advised" and recommends waiting for 2 hours after drinking before nursing or pumping. A 2014 review found that "even in a theoretical case of binge drinking, the children would not be subjected to clinically relevant amounts of alcohol hrough breastmilk, and would have no adverse effects on children as long as drinking is "occasional". The
Centers for Disease Control The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services The United States Department of Heal ...
says "pumping and dumping", or getting rid of milk expressed or pumped, would not reduce the amount of alcohol.


Methods


Expressed milk

A mother can ''express'' (produce) her milk for storage and later use. Expression occurs with
massage Massage is the manipulation of the body's soft tissues. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device. The purpose of massage is generally for the treatment of body stress or pain. A per ...

massage
or a
breast pump A breast pump is a mechanical device that lactating women use to extract milk from their breast The breast is one of two prominences located on the upper region of the of s. In females, it serves as the , which produces and secrete ...

breast pump
. It can be stored in freezer storage bags, containers made specifically for breastmilk, a supplemental nursing system, or a
bottle A bottle is a narrow-necked container made of an impermeable material (clay, glass, plastic, aluminium etc.) in various shapes and sizes to store and transport liquids (water, milk, beer, wine, ink, cooking oil, medicine, soft drinks, shampoo ...

bottle
ready for use. Using someone other than the mother/wet nurse to deliver the bottle maintains the baby's association of nursing with the mother/wet nurse and bottle feeding with other people. Breast milk may be kept at
room temperature Colloquially, room temperature is the range of air temperatures that most people prefer for indoor settings, which feel comfortable when wearing typical indoor clothing. Human comfort can extend beyond this range depending on humidity, air circu ...
for up to six hours, refrigerated for up to eight days or frozen for six to twelve months. Research suggests that the
antioxidant Antioxidants are compounds Compound may refer to: Architecture and built environments * Compound (enclosure), a cluster of buildings having a shared purpose, usually inside a fence or wall ** Compound (fortification), a version of the above ...

antioxidant
activity in expressed breast milk decreases over time, but remains at higher levels than in
infant formula Infant formula, baby formula or just formula (American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of varieties of the English language native to the United S ...

infant formula
. Mothers express milk for multiple reasons. Expressing breast milk can maintain a mother's milk supply when she and her child are apart. A sick baby who is unable to nurse can take expressed milk through a
nasogastric tube Nasogastric intubation is a medical process involving the insertion of a plastic tube (nasogastric tube or NG tube) through the nose A nose is a protuberance in vertebrate Vertebrates () comprise all species of animal Animals (also ...
. Some babies are unable or unwilling to nurse. Expressed milk is the feeding method of choice for premature babies.
Viral disease A viral disease (or viral infection) occurs when an organism's body is invaded by pathogen In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism that can produc ...
transmission can be prevented by expressing breast milk and subjecting it to Holder
pasteurisation Pasteurization or pasteurisation is a process in which packaged and non-packaged foods (such as milk Milk is a nutrient-rich liquid food produced by the mammary gland A mammary gland is an exocrine gland in humans and other mammal ...
. Some women donate expressed breast milk (EBM) to others, either directly or through a
milk bank A human milk bank or breast milk bank is a service which collects, screens, processes, and dispenses by prescription human milk donated by nursing mothers who are not biologically related to the recipient infant. The optimum nutrition for newborn i ...
. This allows mothers who cannot breastfeed to give their baby the benefits of breast milk. Babies feed differently with artificial nipples than from a breast. With the breast, the infant's tongue massages the milk out rather than sucking, and the nipple does not go as far into the mouth. Drinking from a bottle takes less effort and the milk may come more rapidly, potentially causing the baby to lose desire for the breast. This is called ''nursing strike, nipple strike'' or ''nipple confusion''. To avoid this, expressed milk can be given by means such as spoons or cups. "Exclusively expressing", "exclusively pumping", and "EPing" are terms for a mother who exclusively feeds her baby expressed milk. With good pumping habits, particularly in the first 12 weeks while establishing the milk supply, it is possible to express enough milk to feed the baby indefinitely. With the improvements in breast pumps, many women exclusively feed expressed milk, expressing milk at work in
lactation room Lactation room (or Lactorium) is an American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of varieties of the English language native to the United States. Curren ...

lactation room
s. Women can leave their infants in the care of others while traveling, while maintaining a supply of breast milk.


Shared nursing

It is not only the mother who may breastfeed her child. She may hire another woman to do so (a
wet nurse A wet nurse is a woman who breast feeds and cares for another's child. Wet nurses are employed if the mother dies, or if she is unable or chooses not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cu ...
), or she may share childcare with another mother (cross-nursing). Both of these were common throughout history. It remains popular in some
developing nation Image:Imf-advanced-un-least-developed-2008.svg, 450px, Example of Older Classifications by the International Monetary Fund, IMF and the United Nations, UN from 2008 A developing country is a country with a less developed Industrial sector, i ...
s, including those in Africa, for more than one woman to breastfeed a child. Shared breastfeeding is a risk factor for
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus ''Lentivirus'' is a genus Genus (plural genera) is a taxonomic rank Taxonomy (general) is the practice and science of classification of things or concepts, inc ...

HIV
infection in infants. Shared nursing can sometimes provoke negative social reactions in the
English-speaking world Speakers of English English usually refers to: * English language English is a West Germanic languages, West Germanic language first spoken in History of Anglo-Saxon England, early medieval England, which has eventually become the Wo ...
.


Tandem nursing

It is possible for a mother to continue breastfeeding an older sibling while also breastfeeding a new baby; this is called ''tandem nursing''. During the late stages of pregnancy, the milk changes to colostrum. While some children continue to breastfeed even with this change, others may
wean Weaning is the process of gradually introducing an infant 222x222px, Eight-month-old sororal twin sisters An infant (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is the more formal or specialised synonym ...
. Most mothers can produce enough milk for tandem nursing, but the new baby should be nursed first for at least the first few days after delivery to ensure that it receives enough colostrum. Breastfeeding triplets or larger broods is a challenge given babies' varying appetites. Breasts can respond to the demand and produce larger milk quantities; mothers have breastfed triplets successfully. File:Breastfeeding newborn twins.jpg, Newborn twins being breastfed File:Breastfeeding 2 year old twins.jpg, Woman breastfeeds 2 year old twins whilst reading them a book. File:Tandem breastfeeding toddler and baby.jpg, Woman tandem nurses an infant and a toddler.


Induced lactation

Induced lactation, also called ''adoptive lactation'', is the process of starting breastfeeding in a woman who did not give birth. This usually requires the adoptive mother to take hormones and other drugs to stimulate breast development and promote milk production. In some cultures, breastfeeding an adoptive child creates
milk kinship Milk kinship, formed during nursing by a non-biological mother, was a form of fostering allegiance with fellow community members. This particular form of kinship In anthropology, kinship is the web of social relationships that form an impo ...
that built community bonds across class and other hierarchal bonds.


Re-lactation

Re-lactation is the process of restarting breastfeeding. In developing countries, mothers may restart breastfeeding after a weaning as part of an oral rehydration treatment for
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movement frame, Anatomy of the anus and rectum Defecation is the final act of digestion Digestion is the breakdown of large ins ...
. In developed countries, re-lactation is common after early medical problems are resolved, or because a mother changes her mind about breastfeeding. Re-lactation is most easily accomplished with a newborn or with a baby that was previously breastfeeding; if the baby was initially bottle-fed, the baby may refuse to suckle. If the mother has recently stopped breastfeeding, she is more likely to be able to re-establish her milk supply, and more likely to have an adequate supply. Although some women successfully re-lactate after months-long interruptions, success is higher for shorter interruptions. Techniques to promote lactation use frequent attempts to breastfeed, extensive skin-to-skin contact with the baby, and frequent, long pumping sessions. Suckling may be encouraged with a tube filled with infant formula, so that the baby associates suckling at the breast with food. A dropper or syringe without the needle may be used to place milk onto the breast while the baby suckles. The mother should allow the infant to suckle at least ten times during 24 hours, and more times if he or she is interested. These times can include every two hours, whenever the baby seems interested, longer at each breast, and when the baby is sleepy when he or she might suckle more readily. In keeping with increasing contact between mother and child, including increasing skin-to-skin contact, grandmothers should pull back and help in other ways. Later on, grandmothers can again provide more direct care for the infant. These techniques require the mother's commitment over a period of weeks or months. However, even when lactation is established, the supply may not be large enough to breastfeed exclusively. A supportive social environment improves the likelihood of success. As the mother's milk production increases, other feeding can decrease. Parents and other family members should watch the baby's weight gain and urine output to assess nutritional adequacy. A WHO manual for physicians and senior health workers citing a 1992 source states: "If a baby has been breastfeeding sometimes, the breastmilk supply increases in a few days. If a baby has stopped breastfeeding, it may take 1-2 weeks or more before much breastmilk comes."


Extended

Extended breastfeeding means breastfeeding after the age of 12 or 24 months, depending on the source. In Western countries such as the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...

United States
,
Canada Canada is a country in the northern part of North America North America is a continent A continent is any of several large landmasses. Generally identified by convention (norm), convention rather than any strict criteria, ...

Canada
, and
Great Britain Great Britain is an island An island (or isle) is an isolated piece of habitat that is surrounded by a dramatically different habitat, such as water. Very small islands such as emergent land features on atoll An atoll (), ...

Great Britain
, extended breastfeeding is relatively uncommon and can provoke criticism. In the United States, 22.4% of babies are breastfed for 12 months, the minimum amount of time advised by the
American Academy of Pediatrics The American Academy of Pediatrics (AAP) is an American professional association A professional association (also called a professional body, professional organization, or professional society) usually seeks to further Further or Furthur ma ...
. In
India India, officially the Republic of India (Hindi Hindi (Devanagari: , हिंदी, ISO 15919, ISO: ), or more precisely Modern Standard Hindi (Devanagari: , ISO 15919, ISO: ), is an Indo-Aryan language spoken chiefly in Hindi Belt, ...

India
, mothers commonly breastfeed for 2 to 3 years.


Health effects

Support for breastfeeding is universal among major health and children's organizations. WHO states, "Breast milk is the ideal food for the healthy growth and development of infants; breastfeeding is also an integral part of the reproductive process with important implications for the health of mothers.". Breastfeeding decreases the risk of a number of diseases in both mothers and babies. The US Preventive Services Task Force recommends efforts to promote breastfeeding. A
United Nations The United Nations (UN) is an intergovernmental organization aiming to maintain international peace and international security, security, develop friendly relations among nations, achieve international cooperation, and be a centre for harm ...

United Nations
resolution promoting breast feeding was passed despite opposition from the Trump administration. Lucy Sullivan of 1,000 Days, an international group seeking to improve baby and infant nutrition, stated this was "public health versus private profit. What is at stake: breastfeeding saves women and children’s lives. It is also bad for the multibillion-dollar global infant formula (and dairy) business."


Baby

Early breastfeeding is associated with fewer nighttime feeding problems. Early skin-to-skin contact between mother and baby improves breastfeeding outcomes and increases cardio-respiratory stability. Reviews from 2007 found numerous benefits. Breastfeeding aids general health, growth and development in the infant. Infants who are not breastfed are at mildly increased risk of developing acute and chronic diseases, including lower
respiratory infection Respiratory tract infections (RTIs) are infectious diseases involving the respiratory tract. An infection of this type usually is further classified as an upper respiratory tract infection (URI or URTI) or a lower respiratory tract infection (LRI ...
, ear infections,
bacteremia Bloodstream infections (BSIs), which include bacteremias when the infections are bacterial and fungemia Fungemia is the presence of fungi or yeasts in the blood. The most common type, also known as candidemia, candedemia, or systemic candi ...
,
bacterial meningitis Meningitis is an acute Acute may refer to: Science and technology * Acute angle ** Acute triangle ** Acute, a leaf shape in the glossary of leaf morphology#acute, glossary of leaf morphology * Acute (medicine), a disease that it is of short dur ...
,
botulism Botulism is a rare and potentially fatal illness A disease is a particular abnormal condition that negatively affects the structure A structure is an arrangement and organization of interrelated elements in a material object or syste ...
,
urinary tract infection A urinary tract infection (UTI) is an infection An infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host A host is a person responsible for guests at an e ...
and
necrotizing enterocolitis Necrotizing enterocolitis (NEC) is a devastating intestinal disease that affects premature infants. Symptoms may include poor feeding, bloating, decreased activity, blood in the stool, vomiting of bile, bowel death, multiorgan failure and even dea ...
. Breastfeeding may protect against
sudden infant death syndrome Sudden infant death syndrome (SIDS), also known as cot death or crib death, is the sudden unexplained death (1906) Death is the permanent, Irreversible process, irreversible cessation of all biological process, biological functions that ...
, insulin-dependent diabetes mellitus,
Crohn's disease Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension, ...

Crohn's disease
,
ulcerative colitis Ulcerative colitis (UC) is a long-term condition that results in inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogen In biology Biology i ...

ulcerative colitis
, childhood
lymphoma Lymphoma is a group of blood cancer, blood malignancies that develop from lymphocytes (a type of white blood cell). The name often refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include Lymphadenopathy, ...

lymphoma
, allergic diseases, digestive diseases, obesity, develop diabetes, or childhood leukemia later in life. and may enhance
cognitive development Cognitive development is a field of study in neuroscience Neuroscience is the science, scientific study of the nervous system. It is a Multidisciplinary approach, multidisciplinary science that combines physiology, anatomy, molecular biology, ...
. Babies that are breastfed are able to recognize being full quicker than infants who are bottle fed. Breastmilk also makes a child resistant to insulin, which is why they are less likely to be hypoglycemic. Infants are more likely to have a normal neural and retinal development if they are breastfed.


Growth

The average breastfed baby doubles its birth weight in 5–6 months. By one year, a typical breastfed baby weighs about 2-1/2 times its birth weight. At one year, breastfed babies tend to be leaner than formula-fed babies, which improves long-run health. The Davis Area Research on Lactation, Infant Nutrition and Growth (DARLING) study reported that breastfed and formula-fed groups had similar weight gain during the first 3 months, but the breastfed babies began to drop below the median beginning at 6 to 8 months and were significantly lower weight than the formula-fed group between 6 and 18 months. Length gain and head circumference values were similar between groups, suggesting that the breastfed babies were leaner.


Infections

Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against infections) and
lactoferrin Lactoferrin (LF), also known as lactotransferrin (LTF), is a multifunctional protein Proteins are large biomolecule , showing alpha helices, represented by ribbons. This poten was the first to have its suckture solved by X-ray crystallog ...

lactoferrin
(which binds to iron and inhibits the growth of intestinal bacteria). Exclusive breastfeeding till six months of age helps to protect an infant from gastrointestinal infections in both developing and industrialized countries. The risk of death due to diarrhea and other infections increases when babies are either partially breastfed or not breastfed at all. Infants who are exclusively breastfed for the first six months are less likely to die of
gastrointestinal The gastrointestinal tract, (GI tract, GIT, digestive tract, digestion tract, alimentary canal) is the tract from the mouth to the anus which includes all the organs of the digestive system The human digestive system consists of the human ...
infections than infants who switched from exclusive to partial breastfeeding at three to four months. During breastfeeding, approximately 0.25–0.5 grams per day of secretory IgA antibodies pass to the baby via milk. This is one of the important features of colostrum. The main target for these antibodies are probably microorganisms in the baby's
intestine The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system The human digestive system consists of the gastrointestinal tract The gastrointestinal tract, (GI tract, GIT, d ...

intestine
. The rest of the body displays some uptake of IgA, but this amount is relatively small. Maternal vaccinations while breastfeeding is safe for almost all vaccines. Additionally, the mother's immunity obtained by vaccination against
tetanus Tetanus, also known as lockjaw, is a bacterial infection Pathogenic bacteria are bacteria Bacteria (; common noun bacteria, singular bacterium) are a type of Cell (biology), biological cell. They constitute a large domain (biology), do ...
,
diphtheria Diphtheria is an infection caused by the bacteria, bacterium ''Corynebacterium diphtheriae''. Most infections are asymptomatic or have a mild Course (medicine), clinical course, but in some outbreaks more than 10% of those diagnosed with the di ...

diphtheria
,
whooping cough Whooping cough, also known as pertussis or the 100-day cough, is a highly contagious bacterial disease. Initial symptoms are usually similar to those of the common cold The common cold, also known simply as a cold, is a viral infectious d ...
and
influenza Influenza, commonly known as "the flu", is an infectious disease An infection is the invasion of an organism's body Tissue (biology), tissues by Pathogen, disease-causing agents, their multiplication, and the reaction of host (biology), ...

influenza
can protect the baby from these diseases, and breastfeeding can reduce fever rate after infant immunization. However,
smallpox Smallpox was an infectious disease An infection is the invasion of an organism's body Tissue (biology), tissues by Pathogen, disease-causing agents, their multiplication, and the reaction of host (biology), host tissues to the infectious ...

smallpox
and
yellow fever Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever Fever, also referred to as pyrexia, is defined as having a above the due to an increase in the body's temperature . There is not a singl ...
vaccines increase the risk of infants developing
vaccinia ''Vaccinia virus'' (VACV or VV) is a large, complex, enveloped virus A virus is a submicroscopic infectious agent In biology Biology is the natural science that studies life and living organisms, including their anatomy, physi ...
and
encephalitis Encephalitis is inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogen In biology Biology is the natural science that studies life and living ...
.


Mortality

Babies who receive no breast milk are almost six times more likely to die by the age of one month than those who are partially or fully breastfed.


Childhood obesity

The protective effect of breastfeeding against obesity is consistent, though small, across many studies. A 2013
longitudinal study A longitudinal study (or longitudinal survey, or panel study) is a research design Research design refers to the overall strategy utilized to carry out research Research is "creativity, creative and systematic work undertaken to increase ...
reported less obesity at ages two and four years among infants who were breastfed for at least four months.


Allergic diseases

In children who are at risk for developing allergic diseases (defined as at least one parent or sibling having
atopy Atopy is the tendency to produce an exaggerated immunoglobulin E Immunoglobulin E (IgE) is a type of (or (Ig) "") that has been found only in s. IgE is synthesised by s. Monomers of IgE consist of two heavy chains (ε chain) and two light ...
), atopic syndrome can be prevented or delayed through 4-month exclusive breastfeeding, though these benefits may not persist.


Other health effects

Breastfeeding may reduce the risk of necrotizing enterocolitis (NEC). Breastfeeding or introduction of gluten while breastfeeding don't protect against
celiac disease Coeliac disease or celiac disease is a long-term autoimmune disorder An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. There are at least 80 types of autoimmune diseases. Nearly any bo ...
among at-risk children. Breast milk of healthy human mothers who eat
gluten Gluten is a protein naturally found in some grains including wheat, barley, and rye. Although, strictly speaking, "gluten" pertains only to wheat proteins, in the medical literature it refers to the combination of prolamin Prolamins are a group ...

gluten
-containing foods presents high levels of non-degraded
gliadin Gliadin (a type of prolamin) is a class of proteins present in wheat and several other cereals within the grass genus ''Triticum''. Gliadins, which are a component of gluten, are essential for giving bread the ability to rise properly during bak ...

gliadin
(the main gluten protein). Early introduction of traces of gluten in babies to potentially induce tolerance doesn't reduce the risk of developing celiac disease. Delaying the introduction of gluten does not prevent, but is associated with a delayed onset of the disease. About 14 to 19 percent of leukemia cases may be prevented by breastfeeding for six months or longer. However, breastfeeding is also the primary cause of
adult T-cell leukemia/lymphoma Adult T-cell leukemia/lymphoma (ATL or ATLL) is a rare cancer of the immune system's T-cells caused by human T cell leukemia/lymphotropic virus type 1 (HTLV-1). All ATL cells contain integrated HTLV-1 provirus further supporting that causal role ...
, as the
HTLV-1 Human T-cell lymphotropic virus type 1 or human T-lymphotropic virus (HTLV-I), also called the adult T-cell lymphoma virus type 1, is a retrovirus A retrovirus is a type of virus that inserts a copy of its RNA genome into the DNA of a host ce ...
virus is transmitted through breastmilk. Breastfeeding may decrease the risk of
cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart The heart is a cardiac muscle, muscular Organ (biology), organ in most animals, which pumps blood through the blood vessels of the circulatory system. The pumped ...
in later life, as indicated by lower
cholesterol Cholesterol is any of a class of certain organic compound, organic molecules. A cholesterol is a sterol (or chemical modification, modified steroid), a type of lipid. Cholesterol is biosynthesis, biosynthesized by all animal Cell (biology)#Euk ...

cholesterol
and
C-reactive protein C-reactive protein (CRP) is an annular (ring-shaped) pentameric protein found in blood plasma, whose circulating concentrations rise in response to inflammation. It is an acute-phase protein of hepatic origin that increases following interleukin-6 s ...

C-reactive protein
levels in breastfed adult women. Breastfed infants have somewhat lower blood pressure later in life, but it is unclear how much practical benefit this provides. A 1998 study suggested that breastfed babies have a better chance of good dental health than formula-fed infants because of the developmental effects of breastfeeding on the
oral cavity In animal anatomy Anatomy (Greek ''anatomē'', 'dissection') is the branch of concerned with the study of the structure of s and their parts. Anatomy is a branch of natural science which deals with the structural organization of living thin ...
and
airway The respiratory tract is the subdivision of the respiratory system The respiratory system (also respiratory apparatus, ventilatory system) is a biological system A biological system is a complex network Network and networking may refer to: ...
. It was thought that with fewer
malocclusion In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855-1930), ...
s, breastfed children may have a reduced need for
orthodontic Orthodontics is a specialty of dentistry that deals with the diagnosis, prevention, and correction of malpositioned teeth and jaws, and misaligned bite patterns. It can also focus on modifying facial growth, known as dentofacial orthopedics. Abnor ...
intervention. The report suggested that children with a well rounded, "U-shaped"
dental arch The dental arches are the two arches (crescent arrangements) of teeth A tooth (plural teeth) is a hard, calcified Calcification is the accumulation of calcium salts in a Tissue (biology), body tissue. It normally occurs in the formation of ...
, which is found more commonly in breastfed children, may have fewer problems with snoring and
sleep apnea Sleep apnea, also spelled sleep apnoea, is a sleep disorder A sleep disorder, or somnipathy, is a medical disorder of an individual's sleep patterns. Some sleep disorders are severe enough to interfere with normal physical, mental, social and ...
in later life. A 2016 review found that breastfeeding protected against malocclusions. Breastfeeding duration has been correlated with child maltreatment outcomes, including neglect and sexual abuse.


Intelligence

It is unclear whether breastfeeding improves
intelligence Intelligence has been defined in many ways: the capacity for abstraction, logic, understanding, self-awareness, learning, emotional knowledge, reasoning, planning, creativity, critical thinking, and problem-solving. More generally, it can be des ...
later in life. Several studies found no relationship after controlling for
confounding In statistics, a confounder (also confounding variable, confounding factor, extraneous determinant or lurking variable) is a variable that influences both the dependent variable and independent variable, causing a spurious association. Co ...

confounding
factors like maternal intelligence (smarter mothers were more likely to breastfeed their babies). However, other studies concluded that breastfeeding was associated with increased cognitive development in childhood, although the cause may be increased mother–child interaction rather than nutrition.


Mother


Maternal bond

Hormones released during breastfeeding help to strengthen the
maternal bond A maternal bond is the personal relationship, relationship between a mother and her child. While typically associated with pregnancy and childbirth, a maternal bond may also develop in cases where the child is unrelated, such as an adoption. B ...
. Teaching partners how to manage common difficulties is associated with higher breastfeeding rates. Support for a breastfeeding mother can strengthen familial bonds and help build a paternal bond.


Fertility

Exclusive breastfeeding usually delays the return of fertility through
lactational amenorrhea Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal The postpartum (or postnatal) period begins immediately after childbirth Childbirth, also known as labour or delivery, is the ending of pregnancy where ...
, although it does not provide reliable
birth control Birth control, also known as contraception, anticonception, and fertility control, is a method or device used to prevent pregnancy Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woma ...
. Breastfeeding may delay the return to fertility for some women by suppressing ovulation. Mothers may not
ovulate Ovulation is the release of egg An egg is the organic vessel containing the in which an develops until it can survive on its own, at which point the animal hatches. An egg results from of an . Most s, (excluding s), and lay eggs, alth ...
, or have regular periods, during the entire lactation period. The non-ovulating period varies by individual. This has been used as natural contraception, with greater than 98% effectiveness during the first six months after birth if specific nursing behaviors are followed.


Postpartal Bleeding

While breastfeeding soon after birth is believed to increase
uterus The uterus (from Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. Through the power of the ...

uterus
contraction and reduce bleeding. This effect is most likely causally linked to the increase in Oxytocin levels in the bloodstream. Purified Oxytocin is commonly administered in hospitals for the reduction of postpartal bleeding.


Other

It is unclear whether breastfeeding causes mothers to lose weight after giving birth. The National Institutes of Health states that it may help with weight loss. For breastfeeding women, long-term health benefits include reduced risk of
breast cancer Breast cancer is cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumor A benign tumor is a mass of cells Cell most o ...

breast cancer
,
ovarian cancer Ovarian cancer is a cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumor A benign tumor is a mass of cells Cell most ...
, and
endometrial cancer Endometrial cancer is a cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumor A benign tumor is a mass of cells Cell ...
. A 2011 review found it unclear whether breastfeeding affects the risk of
postpartum depression Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes. Symptoms may include extreme sadness, Fatigue (medical), low energy, anxiety, crying episodes, irrit ...
. Later reviews have found tentative evidence of a lower risk among mothers who successfully breastfeed.


Diabetes

Breastfeeding of babies is associated with a lower chance of developing
diabetes mellitus type 1 Type 1 diabetes (T1D), previously known as juvenile diabetes, is an autoimmune disease An autoimmune disease is a condition arising from an abnormal immune response An immune response is a reaction which occurs within an organism for the purp ...
. Breastfed babies also appear to have a lower likelihood of developing
diabetes mellitus type 2 Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is a form of diabetes Diabetes mellitus, commonly known as just diabetes, is a group of metabolic disorders characterized by a hyperglycemia, high blood sugar level over a pro ...
later in life. Breastfeeding is also associated with a lower risk of type 2 diabetes among mothers who practice it.


Social factors

The majority of mothers intend to breastfeed at birth. Many factors can disrupt this intent. Research done in the US shows that information about breastfeeding is rarely provided by a women's obstetricians during their prenatal visits and some health professionals incorrectly believe that commercially prepared formula is nutritionally equivalent to breast milk. Many hospitals have instituted practices that encourage breastfeeding, however a 2012 survey in the US found that 24% of maternity services were still providing supplements of commercial infant formula as a general practice in the first 48 hours after birth. ''The Surgeon General’s Call to Action to Support Breastfeeding'' attempts to educate practitioners.


Social support

A review found that when effective forms of support are offered to women, exclusive breastfeeding and duration of breastfeeding are increased. Characteristics of effective support includes ongoing, face-to-face support tailored to fit their needs. It may be offered by lay/peer supporters, professional supporters, or a combination of both. This review contrasts with another large review that looked at education programs alone, which found no conclusive evidence of initiation of breastfeeding or the proportion of women breastfeeding either exclusively or partially at 3 months and 6 months. Positive social support in essential relationships of new mothers plays a central role in the promotion of breastfeeding outside of the confines of medical centers. Social support can come in many incarnations, including tangible, affectionate, social interaction, and emotional and informational support. An increase in these capacities of support has shown to greatly positively effect breastfeeding rates, especially among women with education below a high school level. Some mothers that have used lactation rooms have taken to leaving sticky notes to not only thank the businesses that have provided them but to support, encourage, and praise the nursing moms who use them. In the social circles surrounding the mother, support is most crucial from the male partner, the mother's mother, and her family and friends. Research has shown that the closest relationships to the mother have the strongest impact on breastfeeding rates, while negative perspectives on breastfeeding from close relatives hinder its prevalence. * Mother – Adolescence is a risk factor for low breastfeeding rates, although classes, books and personal counseling (professional or lay) can help compensate. Some women fear that breastfeeding will negatively impact the look of their breasts. However, a 2008 study found that breastfeeding had no effect on a woman's breasts; other factors did contribute to "drooping" of the breasts, such as advanced age, number of pregnancies and smoking behavior. * Partner – Partners may lack knowledge of breastfeeding and their role in the practice. *
Wet nursing A wet nurse is a woman who breast feeds and cares for another's child. Wet nurses are employed if the mother dies, or if she is unable or chooses not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cu ...
– Social and cultural attitudes towards breastfeeding in the African-American community are also influenced by the legacy of forced wet-nursing during slavery.


Maternity leave

Work is the most commonly cited reason for not breastfeeding. In 2012
Save the Children The Save the Children Fund, commonly known as Save the Children, was established in the United Kingdom in 1919 to improve the lives of children through better education, health care, and economic opportunities, as well as providing emergency ...
examined
maternity leave Parental leave, or family leave, is an employee benefit available in almost all countries. The term "parental leave" may include maternity, Paternity (law), paternity, and adoption leave; or may be used distinctively from "maternity leave" and " ...
laws, ranking 36 industrialized countries according to their support for breastfeeding. Norway ranked first, while the United States came in last. Maternity leave in the US varies widely, including by state. The United States does not mandate paid maternity leave for any employee however the
Family Medical Leave Act The Family and Medical Leave Act of 1993 (FMLA) is a United States labor law United States labor law sets the rights and duties for employees, Labor unions in the United States, labor unions, and employers in the United States. Labor law's basic a ...
(FMLA) guarantees qualifying mothers up to 12 weeks unpaid leave although the majority of US mothers resume work earlier. A large 2011 study found that women who returned to work at or after 13 weeks after childbirth were more likely to predominantly breastfeed beyond three months.


Healthcare


Caesarean Section

Women are less likely to start breastfeeding after caesarean delivery compared with vaginal delivery.


Breast surgery

Breastfeeding can generally be attempted after breast augmentation or reduction surgery, however prior breast surgery is a risk factor for
low milk supply In breastfeeding Breastfeeding, also called nursing, is the process of feeding a mother's breast milk to her infant, either directly from the breast or by expressing (pumping out) the milk from the breast and bottle-feeding it to the infant. ...
. A 2014 review found that women who have
breast implant A breast implant is a prosthesis In medicine Medicine is the science Science (from the Latin word ''scientia'', meaning "knowledge") is a systematic enterprise that Scientific method, builds and Taxonomy (general), organizes knowl ...
surgery were less likely to exclusively breast feed, however it was based on only three small studies and the reasons for the correlation were not clear. A large follow-up study done in 2014 found a reduced rate of breastfeeding in women who had undergone breast augmentation surgery, however again the reasons were unclear. The authors suggested that women contemplating augmentation should be provided with information related to the rates of successful breastfeeding as part of informed decision making when contemplating surgery. Prior
breast reduction surgery Reduction mammoplasty (also breast reduction and reduction mammaplasty) is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery for re-establishing a functional Cleavage (breasts), bust that is propo ...
is strongly associated with an increased probability of
low milk supply In breastfeeding Breastfeeding, also called nursing, is the process of feeding a mother's breast milk to her infant, either directly from the breast or by expressing (pumping out) the milk from the breast and bottle-feeding it to the infant. ...
due to disruption to tissues and nerves. Some surgical techniques for breast reduction appear to be more successful than others in preserving the tissues that generate and channel milk to the nipple. A 2017 review found that women were more likely to have success with breastfeeding with these techniques.


Medications

Breastfeeding mothers should inform their healthcare provider about all of the medications they are taking, including herbal products. Nursing mothers may be immunized and may take most
over-the-counter drugs Over-the-counter (OTC) drugs are medication, medicines sold directly to a consumer without a requirement for a medical prescription, prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to co ...
and
prescription drugs A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug Uncoated tablets, con ...

prescription drugs
without risk to the baby but certain drugs, including some
painkillers An analgesic or painkiller is any member of the group of drugs used to achieve analgesia, relief from pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines p ...
and some
psychiatric drugs A psychiatric or psychotropic medication is a psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. Thus, these medications are used to treat Mental disorder, mental illnesses. Usually prescribed in ps ...
, may pose a risk. The
US National Library of Medicine The United States National Library of Medicine (NLM), operated by the United States federal government The federal government of the United States (U.S. federal government) is the national government of the United States The Unit ...
publishes "LactMed", an up-to-date online database of information on drugs and lactation. Geared to both healthcare practitioners and nursing mothers, LactMed contains over 450 drug records with information such as potential drug effects and alternate drugs to consider. Some substances in the mother's food and drink are passed to the baby through breast milk, including
mercury Mercury usually refers to: * Mercury (planet) Mercury is the smallest planet in the Solar System and the closest to the Sun. Its orbit around the Sun takes 87.97 Earth days, the shortest of all the Sun's planets. It is named after the Roman g ...

mercury
(found in some
carnivorous A carnivore , meaning "meat eater" (Latin, ''caro'', genitive ''carnis'', meaning "meat" or "flesh" and ''vorare'' meaning "to devour"), is an organism, animal whose food and energy requirements derive solely from animal Tissue (biology), tissu ...
fish),
caffeine Caffeine is a central nervous system The central nervous system (CNS) is the part of the nervous system In biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structu ...

caffeine
, and
bisphenol A Bisphenol A (BPA) is an organic synthetic compound with the chemical formula A chemical formula is a way of presenting information about the chemical proportions of atom An atom is the smallest unit of ordinary matter In classi ...

bisphenol A
.


Medical conditions

Undiagnosed maternal
celiac disease Coeliac disease or celiac disease is a long-term autoimmune disorder An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. There are at least 80 types of autoimmune diseases. Nearly any bo ...
may cause a short duration of the breastfeeding period. Treatment with the
gluten-free diet A gluten-free diet (GFD) is a nutritional plan that strictly excludes gluten Gluten is a protein naturally found in some grains including wheat, barley, and rye. Although, strictly speaking, "gluten" pertains only to wheat proteins, in the ...
can increase its duration and restore it to the average value of the healthy women. Mothers with all types of
diabetes mellitus Diabetes mellitus, commonly known as just diabetes, is a group of metabolic disorders characterized by a hyperglycemia, high blood sugar level over a prolonged period of time. Symptoms often include frequent urination, Polydipsia, increased th ...
normally use insulin to control their blood sugar, as the safety of other
antidiabetic drugs Drugs used in diabetes treat diabetes mellitus by altering the blood sugar level, glucose level in the blood. With the exceptions of Insulin (medication), insulin, exenatide, liraglutide and pramlintide, all are administered orally and are thus als ...
while breastfeeding is unknown. Women with
polycystic ovary syndrome Polycystic ovary syndrome, or PCOS, is the most common endocrine The endocrine system is a messenger system comprising feedback loops of the hormone A hormone (from the Greek Greek may refer to: Greece Anything of, from, or related to G ...
, which is associated with some hormonal differences and obesity, may have greater difficulty with producing a sufficient supply to support exclusive breastfeeding, especially during the first weeks.


Socioeconomic status

Race, ethnicity and socioeconomic status affect choice and duration in the United States. A 2011 study found that on average, US women who breastfed had higher levels of education, were older and were more likely to be white. The rates of breastfeeding in the African-American community remain much lower than any other race, for a variety of proposed reasons. These include the legacy of
Wet nursing A wet nurse is a woman who breast feeds and cares for another's child. Wet nurses are employed if the mother dies, or if she is unable or chooses not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cu ...
during slavery, higher rates of poor perinatal health, higher stress levels, less access to support, and less flexibility in the workplace. While for other races as socio-economic class raises rates of breastfeeding also go up, for the African-American community breastfeeding rates remain consistently low regardless of socio-economic class. There are also racial disparities in access to maternity care practices that support breastfeeding. In the US, primarily African-American neighborhoods are more likely to have facilities (such as hospitals and female healthcare clinics) that do not support breastfeeding, contributing to the low rate of breastfeeding in the African-American community. Comparing facilities in primarily African American neighborhoods to ones in primarily White neighborhoods, the rates of practices that support or discourage breastfeeding were: limited use of supplements (13.1% compared with 25.8%) and rooming-in (27.7–39.4%) Low-income mothers are more likely to have unintended pregnancies. Mothers whose pregnancies are unintended are less likely to breastfeed. Especially the combination of powdered formula with unclean water can be very harmful to the health of babies. In the late 1970s, there was a boycott against Nestle due to the great number of baby deaths due to formula. Dr. Michele Barry explains that breastfeeding is most imperative in poverty environments due to the lack of access of clean water for the formula. The Lancet study in 2016 discovered that universal breastfeeding would prevent the deaths of 800,000 children as well as save .


Social acceptance

Some women feel discomfort when breastfeeding in public. Public breastfeeding may be forbidden in some
places Place may refer to: Geography * Place (United States Census Bureau) The United States Census Bureau The United States Census Bureau (USCB), officially the Bureau of the Census, is a principal agency of the U.S. Federal Statistical System ...
, not addressed by law in others, and a legal right in others. Even given a legal right, some mothers are reluctant to breastfeed, while others may object to the practice. The use of infant formula was thought to be a way for western culture to adapt to negative perceptions of breastfeeding. The breast pump offered a way for mothers to supply breast milk with most of formula feeding's convenience and without enduring possible disapproval of nursing. Some may object to breastfeeding because of the implicit association between infant feeding and sex. These negative cultural connotations may reduce breastfeeding duration. Maternal guilt and shame is often affected by how a mother feeds her infant. These emotions occur in both bottle- and breast- feeding mothers, although for different reasons. Bottle feeding mothers may feel that they should be breastfeeding. Conversely, breastfeeding mothers may feel forced to feed in uncomfortable circumstances. Some may see breastfeeding as, "indecent, disgusting, animalistic, sexual, and even possibly a perverse act." Advocates (known by the
neologism A neologism (; from Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is appro ...
"lactivists") use " nurse-ins" to show support for breastfeeding in public. One study that approached the subject from a feminist viewpoint suggested that both nursing and non-nursing mothers often feel maternal guilt and shame with formula feeding mothers feeling that they are not living up to the ideals of woman and motherhood and nursing mothers concerned that they are transgressing "cultural expectations regarding feminine modesty." The authors advocate that women be provided with education on breastfeeding's benefits as well as problem-solving skills, however there is no conclusive evidence that breastfeeding education alone improves initiation of breastfeeding or the proportion of women breastfeeding either exclusively or partially at 3 months and 6 months.


Prevalence

Globally about 38% of babies are exclusively breastfed during their first six months of life. In the United States the rate of women beginning to breastfeed was 76% in 2009 increasing to 83% in 2015 with 58% still breastfeeding at 6 months, although only 25% were still breastfeeding exclusively. African-American women have persistently low rates of breastfeeding compared to White and Hispanic American women. In 2014, 58.1% of African-American women breastfeed in the early postpartum period, compared to 77.7% of White women and 80.6% of Hispanic women. Breastfeeding rates in different parts of China vary considerably. Rates in the United Kingdom were the lowest in the world in 2015 with only 0.5% of mothers still breastfeeding at a year, while in Germany 23% are doing so, 56% in Brazil and 99% in Senegal. In Australia for children born in 2004, more than 90% were initially breastfed. In Canada for children born in 2005–06, more than 50% were only breastfed and more than 15% received both breastmilk and other liquids, by the age of 3 months.


History

In the
Egyptian Egyptian describes something of, from, or related to Egypt. Egyptian or Egyptians may refer to: Nations and ethnic groups * Egyptians, a national group in North Africa ** Egyptian culture, a complex and stable culture with thousands of years of r ...

Egyptian
,
Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is approximately 10.7 million as of ...
and
Roman empire The Roman Empire ( la, Imperium Rōmānum ; grc-gre, Βασιλεία τῶν Ῥωμαίων, Basileía tôn Rhōmaíōn) was the post-Republican Republican can refer to: Political ideology * An advocate of a republic, a type of governme ...

Roman empire
s, women usually fed only their own children. However, breastfeeding began to be seen as something too common to be done by royalty, and wet nurses were employed to breastfeed the children of the royal families. This extended over time, particularly in western Europe, where noble women often made use of wet nurses. Lower-class women breastfed their infants and used a wet nurse only if they were unable to feed their own infant. Attempts were made in 15th-century Europe to use cow or goat milk, but these attempts were not successful. In the 18th century, flour or cereal mixed with broth were introduced as substitutes for breastfeeding, but this provided inadequate nutrition. The appearance of improved infant formulas in the mid 19th century and its increased use caused a decrease in breastfeeding rates, which accelerated after
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a global war A world war is "a war War is an intense armed conflict between states State may refer to: Arts, entertainment, and media Literatur ...
, and for some in the US, Canada, and UK, breastfeeding was seen as uncultured. From the 1960s onwards, breastfeeding experienced a revival which continued into the 2000s, though negative attitudes towards the practice were still entrenched in some countries up to 1990s.


Society and culture


Language

In languages around the world, the word for "mother" is something like " mama". The linguist
Roman Jakobson Roman Osipovich Jakobson (russian: Рома́н О́сипович Якобсо́н; October 11, 1896Kucera, Henry. 1983. "Roman Jakobson." ''Language: Journal of the Linguistic Society of America'' 59(4): 871–883. – July 18,
hypothesized that the nasal sound in "mama" comes from the nasal murmur that babies produce when breastfeeding.


Financial considerations

Breastfeeding is less costly than alternatives, but the mother generally must eat more food than she would otherwise. In the US, the extra money spent on food (about US$ each week) is usually about half as much money as the cost of infant formula. Breastfeeding reduces health care costs and the cost of caring for sick babies. Parents of breastfed babies are less likely to miss work and lose income because their babies are sick. Looking at three of the most common infant illnesses, lower respiratory tract illnesses,
otitis media Otitis media is a group of inflammatory Inflammatory may refer to: * Inflammation, a biological response to harmful stimuli * The word ''inflammatory'' is also used to refer literally to fire and flammability, and figuratively in relation to com ...
, and gastrointestinal illness, one study compared infants that had been exclusively breastfed for at least three months to those who had not. It found that in the first year of life there were 2033 excess office visits, 212 excess days of hospitalization, and 609 excess prescriptions for these three illnesses per 1000 never-breastfed infants compared with 1000 infants exclusively breastfed for at least 3 months.


Mobile apps

Dozens of
mobile apps A mobile application, also referred to as a mobile app or simply an app, is a computer program In imperative programming, a computer program is a sequence of instructions in a programming language that a computer can execute or interpret. In d ...

mobile apps
exist for tracking the habits of breastfeeding mothers.


Criticism of breastfeeding advocacy

There are controversies and ethical considerations surrounding the means used by public campaigns which attempt to increase breastfeeding rates, relating to pressure put on women, and potential feeling of guilt and shame of women who fail to breastfeed; and social condemnation of women who use formula. In addition to this, there is also the moral question as to what degree the state or medical community can interfere with the self-determination of a woman: for example in the
United Arab Emirates The United Arab Emirates (UAE; ar, الإمارات العربية المتحدة ) or the Emirates ( ar, الإمارات ), is a country in Western Asia Western Asia, West Asia, or Southwest Asia, is the westernmost subregion A subregio ...

United Arab Emirates
the law requires a woman to breastfeed her baby for at least 2 years and allows her husband to sue her if she does not do so. It is widely assumed that if women's healthcare providers encourage them to breastfeed, those who choose not to will experience more guilt. Evidence does not support this assumption. On the contrary, a study on the effects of prenatal breastfeeding counselling found that those who had received such counselling and chosen to formula-feed denied experiencing feelings of guilt. Women were equally comfortable with their subsequent choices for feeding their infant regardless of whether they had received encouragement to breastfeed. Preventing a situation where women are denied agency and/or stigmatized for formula use is also seen as important. In 2018, in the UK, a policy statement from the
Royal College of Midwives The Royal College of Midwives (RCM) is a British midwives organisation founded in 1881 by Louisa Hubbard and Zepherina Veitch. It has existed under its present name since 1947, and is the United Kingdom's only trade union or professional organisatio ...
said that women should be supported and not stigmatized, if after being given advice and information, they choose to formula feed.


Social marketing

Social marketing is a marketing approach intended to change people's behavior to benefit both individuals and society. When applied to breastfeeding promotion, social marketing works to provide positive messages and images of breastfeeding to increase visibility. Social marketing in the context of breastfeeding has shown efficacy in media campaigns. Some oppose the marketing of infant formula, especially in developing countries. They are concerned that mothers who use formula will stop breastfeeding and become dependent upon substitutes that are unaffordable or less safe. Through efforts including the
Nestlé boycott A boycott was launched in the United States on July 4, 1977, against the Swiss-based Nestlé corporation. The boycott expanded into Europe in the early 1980s and was prompted by concern about Nestlé's "aggressive marketing" of breast milk substitut ...
, they have advocated for bans on free samples of infant formula and for the adoption of pro-breastfeeding codes such as the
International Code of Marketing of Breast-milk SubstitutesThe International Code of Marketing of Breast-milk Substitutes (also known as the WHO Code) is an international health policy framework for breastfeeding promotion adopted by the World Health Assembly (WHA) of the World Health Organization Th ...
by the
World Health Assembly The World Health Assembly (WHA) is the forum through which the World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations United Nations Specialized Agencies are autonomous organizations wo ...
in 1981 and the Innocenti Declaration by WHO and UNICEF policy-makers in August 1990. Additionally, formula companies have spent millions internationally on campaigns to promote the use of formula as an alternative to mother's milk.


Baby Friendly Hospital Initiative

The Baby Friendly Hospital Initiative (BFHI) is a program launched by the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations United Nations Specialized Agencies are autonomous organizations working with the United Nations and each other through the co-ordinating machinery of the Unite ...
(WHO) in conjunction with
UNICEF UNICEF, also known as the United Nations Children's Fund, is a United Nations agency responsible for providing humanitarian and developmental aid to children worldwide. The agency is among the most widespread and recognizable social welfare or ...
in order to promote infant feeding and maternal bonding through certified hospitals and birthing centers. BFHI was developed as a response to the influence held by formula companies in private and public maternal health care.The initiative has two core tenets: the Ten Steps to Successful Breastfeeding and the
International Code of Marketing of Breast-milk SubstitutesThe International Code of Marketing of Breast-milk Substitutes (also known as the WHO Code) is an international health policy framework for breastfeeding promotion adopted by the World Health Assembly (WHA) of the World Health Organization Th ...
. The BFHI has especially targeted hospitals and birthing centers in the developing world, as these facilities are most at risk to the detrimental effects of reduced breastfeeding rates. As of 2018, 530 hospitals in the United States hold the "Baby-Friendly" title in all 50 states. Globally, there are more than 20,000 "Baby-Friendly" hospitals worldwide in over 150 countries.


Representation on television

The first depiction of breastfeeding on television was in the children's program ''
Sesame Street ''Sesame Street'' is an American educational Education is the process of facilitating learning Learning is the process of acquiring new understanding, knowledge, behaviors, skills, value (personal and cultural), values, attitudes ...
'', in 1977. With few exceptions since that time breastfeeding on television has either been portrayed as strange, disgusting, or a source of comedy, or it has been omitted entirely in favor of bottle feeding.


Religion

In some cultures, people who have been breastfed by the same woman are milk-siblings who are equal in legal and social standing to a consanguineous sibling. Islam has a complex system of rules regarding this, known as ''
Rada (fiqh) Breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recomm ...
''. Like the Christian practice of
godparent A godparent (also known as a sponsor, or '' gossiprede''), in Catholicism The Catholic Church, also known as the Roman Catholic Church, is the largest Christian church, with 1.3 billion baptised Baptism (from the Greek ...
ing, milk kinship established a second family that could take responsibility for a child whose biological parents came to harm. "Milk kinship in Islam thus appears to be a culturally distinctive, but by no means unique, institutional form of adoptive kinship." In
Western Western may refer to: Places *Western, Nebraska, a village in the US *Western, New York, a town in the US *Western Creek, Tasmania, a locality in Australia *Western Junction, Tasmania, a locality in Australia *Western world, countries that ide ...

Western
countries, differences in breastfeeding practices have also been observed according to the affiliation or practice of
Christian Christians () are people who follow or adhere to Christianity, a monotheistic Abrahamic religion based on the life and teachings of Jesus in Christianity, Jesus Christ. The words ''Christ (title), Christ'' and ''Christian'' derive from the Koi ...

Christian
religions; unaffiliated and
Protestant Protestantism is a form of that originated with the 16th-century , a movement against what its followers perceived to be in the . Protestants originating in the Reformation reject the Roman Catholic doctrine of , but disagree among themselves ...
women exhibit higher rates of breastfeeding.


Workplace

Many mothers have to return to work a short time after their babies have been born. In the U.S. about 70% of mothers with children younger than three years old work full-time with 1/3 of the mothers returning to work within 3 months and 2/3 returning within 6 months. Working outside of the home and full-time work are significantly associated with lower rates of breastfeeding and breastfeeding for a shorter duration of time. According to the
CDC CDC may refer to: Organizations Government * Centers for Disease Control and Prevention The United States The United States of America (USA), commonly known as the United States (U.S. or US), or America, is a country Contiguous Unite ...
"support for breastfeeding in the workplace includes several types of employee benefits and services, including writing corporate policies to support breastfeeding women; teaching employees about breastfeeding; providing designated private space for breastfeeding or expressing milk; allowing flexible scheduling to support milk expression during work; giving mothers options for returning to work, such as teleworking, part-time work, and extended maternity leave; providing on-site or near-site child care; providing high-quality breast pumps; and offering professional lactation management services." Programs to promote and assist nursing mothers have been found to help maintain breastfeeding. In the United States the CDC reports on a study that "examined the effect of corporate lactation programs on breastfeeding behavior among employed women in California
hich Ij ( fa, ايج, also Romanize Romanization or romanisation, in linguistics Linguistics is the scientific study of language A language is a structured system of communication used by humans, including speech (spoken language), ge ...

hich
included prenatal classes, perinatal counseling, and lactation management after the return to work". They found that "about 75% of mothers in the lactation programs continued breastfeeding at least 6 months, although nationally only 10% of mothers employed full-time who initiated breastfeeding were still breastfeeding at 6 months." The U.S.
Patient Protection and Affordable Care Act The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act, and colloquially known as Obamacare, is a United States U.S. federal law, federal statute enacted by the 111th United States Congress and signed ...
which was passed in 2010 requires that all nursing mothers be given a non-bathroom space to express milk and a reasonable break time to do so, however as of 2016 the majority of women still do not have access to both accommodations. A 2016 study found: "1) federal law does not address lactation space functionality and accessibility, 2) federal law only protects a subset of employees, and 3) enforcement of the federal law requires women to file a complaint with the United States Department of Labor. To address each of these issues, we recommend the following modifications to current law: 1) additional requirements surrounding lactation space and functionality, 2) mandated coverage of exempt employees, and 3) requirement that employers develop company-specific lactation policies." In
Canada Canada is a country in the northern part of North America North America is a continent A continent is any of several large landmasses. Generally identified by convention (norm), convention rather than any strict criteria, ...

Canada
,
British Columbia ( en, Splendour without diminishment) , image_map = British Columbia in Canada 2.svg , Label_map = yes , coordinates = , official_lang = None , Slogan = Beautiful British C ...

British Columbia
and
Ontario ("Loyal she began, loyal she remains") , Label_map = yes , image_map = Ontario in Canada 2.svg , map_alt = Map showing Ontario's location east/central of Canada. , coordinates = , cap ...

Ontario
, provincial Human Rights Codes prevent against workplace discrimination due to breastfeeding. In British Columbia, employers are required to provide accommodation to employees who breastfeed or express breast milk. Although no specific requirements are mandated, under the Human Rights Code, accommodations suggested include paid breaks (not including meal breaks), private facilities that include clean running water, comfortable seating areas, and refrigeration equipment, as well as flexibility in terms of work-related conflicts. In Ontario, employers are encouraged to accommodate breastfeeding employees by providing additional breaks without fear of discrimination. Unlike in British Columbia, the Ontario Code does not include specific recommendations, and therefore leaves significant flexibility for employers.


Research

Breastfeeding research continues to assess prevalence, HIV transmission, pharmacology, costs, benefits, immunology, contraindications, and comparisons to synthetic breast milk substitutes. Factors related to the mental health of the nursing mother in the perinatal period have been studied. While cognitive behavior therapy may be the treatment of choice, medications are sometimes used. The use of therapy rather than medication reduces the infant's exposure to medication that may be transmitted through the milk. In coordination with institutional organisms, researchers are also studying the social impact of breastfeeding throughout history. Accordingly, strategies have been developed to foster the increase of the breastfeeding rates in the different countries.


See also

*
Baby-led weaning Baby-led weaning (often also referred to as BLW) is a method of adding complementary foods to a baby's diet of breast milk or formula. A method of food progression, BLW facilitates the development of age appropriate oral motor control while maint ...
* Breast shell *
Breastfeeding in public The social attitudes to and legal status of breastfeeding in public vary widely in cultures around the world. In many countries, both in the Global South and in a number of Western countries, breastfeeding Breastfeeding, also called nursing, ...

Breastfeeding in public
*
Breastfeeding promotion Breastfeeding promotion refers to coordinated activities and policies A policy is a deliberate system of principle A principle is a proposition or value that is a guide for behavior or evaluation. In law, it is a rule Rule or ruling may r ...
*
Child development Child development involves the biological Biology is the natural science Natural science is a branch of science Science (from the Latin word ''scientia'', meaning "knowledge") is a systematic enterprise that Scientific method, b ...
*
Dairy allergy Milk allergy is an adverse immune reaction to one or more protein Proteins are large biomolecules or macromolecules that are comprised of one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array ...
* Breastfeeding and fertility * Lactation failure *
Lactation room Lactation room (or Lactorium) is an American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of varieties of the English language native to the United States. Curren ...

Lactation room
*
Milk line The mammary ridge or mammary crest is a primordium specific for the development of the mammary gland A mammary gland is an exocrine gland in humans and other mammals that produces milk to feed young offspring. Mammals get their name from the L ...
* Nursing chair *
Public health Public health has been defined as "the science and art of preventing disease", prolonging life and improving quality of life Quality of life (QOL) is defined by the World Health Organization The World Health Organization (WHO) is a s ...

Public health
*
World Alliance for Breastfeeding Action The World Alliance for Breastfeeding Action (WABA) is a network of people working on a global scale to eliminate obstacles to breastfeeding Breastfeeding, also called nursing, is the process of feeding a mother's breast milk to her infant, e ...
*
Breastfeeding and mental health Breastfeeding and mental health is the relationship between postpartum The postpartum (or postnatal) period begins immediately after childbirth Childbirth, also known as labour or delivery, is the ending of pregnancy where one or more babie ...


References


Bibliography

* * * *


Further reading

* * Scholarly essays on a variety of topics such as networks of milk sharing through Facebook, public-health guidelines on infant feeding and HIV in Malawi, and dilemmas involving breastfeeding and bonding for babies born from surrogate mothers. * *


External links

*
Breastfeeding Resources
La Leche League International
Breast-Feeding Content Resources
WHO reports on Breast Feeding
Breastfeeding and Breast Milk
US National Institute of Health
The World Alliance for Breastfeeding Action
(WABA) is a global network of individuals and organisations concerned with the protection, promotion and support of breastfeeding worldwide

CDC
Academy of Breastfeeding Medicine
Worldwide organization dedicated to the promotion, protection, and support of breastfeeding
LactMed
a database of the safety of drugs to which breastfeeding mothers may be exposed, by the
US National Library of Medicine The United States National Library of Medicine (NLM), operated by the United States federal government The federal government of the United States (U.S. federal government) is the national government of the United States The Unit ...
{{Authority control Wikipedia medicine articles ready to translate Infant feeding