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Breast Milk |
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Breast Milk |
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The process starts during pregnancy:
If you're pregnant, you have no doubt noticed the huge metamorphosis occurring in your bra cups. Those physical changes — tender, swollen breasts, and darkened nipples and areolas (the circle of skin surrounding your nipple) — may be one of your earliest clues that you've conceived. Experts believe the colour change may also be a helpful aid to breastfeeding. It's nature's way of providing a visual guide that helps newborns feed successfully (hey, dinner's over here!). Another pregnancy signal: the appearance of tiny bumps around your areola called the glands of Montgomery (named after the British obstetrician who first described them), which also play a role in breastfeeding. These bumps produce an oily substance that cleanses, lubricates, and protects the nipple from infection during breastfeeding.
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Learning how to pump and store breast milk can make returning to work easier and less stressful. It does require some work, but if you have a plan, it can be done.
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Alternative names
Milk - human; Human milk
Function:
Breast milk is the perfect source of nutrition for infants. Breast milk contains appropriate amounts of carbohydrate, protein, and fat. It also provides digestive enzymes, minerals, vitamins, and hormones that all infants require. Breast milk contains valuable antibodies from the mother that may help the baby resist infections.
Healthy infants have adequate iron stores to last until 8 months of age. Iron-rich foods can be started at this age. (See diet for age.) Your pediatrician or dietitian may recommend fluoride supplementation in communities where water is not fluoridated (areas with less than 0.25 p.p.m. fluoride).
Cow's milk by itself is inappropriate for infants less than 1 year old. The infant may develop an allergy to dairy products if given cow's milk too early in life. Although cow's milk contains most of the same components as breast milk, these components are not in the same amounts. Cow's milk also lacks the immune factors (antibodies) that help protect infants until their own immune system fully develops.
Commercially prepared formulas may be based on non-fat cow's milk, whey protein, or soy protein. In order to provide a balanced diet for an infant, formulas must be fortified with carbohydrates, fats, minerals, and vitamins. The antibodies found in breast milk, however, can never be added to formulas.
BREAST MILK PRODUCTION:
Milk is produced in small sac-like glands in the breast. These sacs develop after specific hormones (such as estrogen, progesterone, pituitary prolactin, and placental lactogen) stimulate them, beginning during the second trimester of pregnancy.
The human breast does not store a large volume of milk, as cows do. Suckling stimulates the release of a hormone (prolactin) which stimulates milk production and the release of another hormone (oxytocin). Oxytocin, in turn, stimulates contraction (or the "let-down reflex") of the milk glands. The milk is squeezed out of the milk gland, into the milk ducts, and into the nipple.
At the beginning of the feeding, the milk is bluish and contains lactose and proteins, but little fat; it is called foremilk. The end of the feeding produces hindmilk. The hindmilk contains more fat, the main source of energy for your baby. If breast milk is allowed to sit for half-an-hour after being expressed, the "cream" separates and settles on top of the watery part. This is because human milk isn't homogenized, the process that makes the water and fat portion in milk stay blended.
MILK EJECTION REFLEX:
Some mothers feel a tingling sensation as the milk begins to eject from the breast due to the let-down reflex. The best way to monitor whether this milk-ejection reflex has begun is by watching the sucking and breathing patterns of your baby.
At the start of a feeding, you will notice a pattern: suck, suck, suck, swallow, suck, suck, suck, swallow. This pattern may last up to 30 seconds, but could be longer. As the milk ejection reflex takes over, the pattern may be described as gulping: one swallow, one deep breath, one swallow, one deep breath. This pattern may last for 2 - 4 minutes.
Your baby may want to nurse longer (maybe 15 or 20 minutes) on this breast in order to get more fat from the hindmilk or because your baby needs to fill a need for sucking. Rather than watching the clock to let him nurse 10 minutes on each side, you may want to allow your baby to pull away from the first breast naturally before switching to the other breast.
Recommendations:
Your milk supply will be established during the first few days and weeks after the birth of your baby. Nursing early (within the first half-hour), and frequently (on demand, or 8 - 12 times per day), allows you to nurse comfortably and efficiently. It usually takes less than 1 minute for an infant to stimulate the milk ejection reflex. You should feel little discomfort or pain when breast feeding appropriately.
Within 6 - 8 weeks, your milk supply will adjust to your baby's needs. Before that time, your breasts may feel either too full or empty. Frequent, comfortable feedings will maintain your milk supply. Your milk supply will increase or decrease based on your baby's hunger and energetic sucking (milk demand or use). Changes in your milk supply will occur within 1 - 3 days after changes in milk demand or use.
MILK HANDLING AND STORAGE:
When storing milk for home use, wash your hands before expressing (pumping). Use containers that have been washed in hot, soapy water and rinsed well. Always date the milk before storing it.
Fresh breast milk can be kept at room temperature up to 10 hours, and refrigerated up to 1 week. Frozen milk can be kept in a freezer compartment inside the refrigerator for 2 weeks; in a separate door refrigerator/freezer up to 3 or 4 months; and in a deep freezer at constant 0 degrees for 6 months. Frozen and thawed milk can be refrigerated for up to 9 hours, but it should not be refrozen.
Plastic containers are the best for storing breast milk. For freezing, use small (2 or 3 ounce) containers to avoid the waste of unused portions at the end of the day. Refrigerated milk and frozen milk should be warmed under a stream of warm tap water. Never microwave breast milk -- overheating destroys valuable nutrients and "hot spots" can scald your baby
Feeding Baby With Breast Milk or Formula
The Food and Drug Administration, or FDA, is part of the United States Government. It is the FDA's job to make sure infant formulas have important nutrients such as fat, protein, and vitamins.
Feed Your New Baby Breast Milk, If Possible
Both breast milk and infant formula will help your baby grow.
But breast milk is the best first food for babies.
Either way, mealtime is more than feeding your baby. It's a time to cuddle and comfort your baby, too.
Breast-Feeding Is Best For Your Baby
Breast milk provides sugars, fats and protein that are just right for your baby.
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Sucking on the breast is good for your baby's jaw. It helps future teeth grow straight.
Breast-Feeding Is Best For You
When you breast-feed, you don't have to sterilize bottles. You don't have to buy, measure and mix formula.
Breast-feeding lets you rest every few hours while you feed your baby.
Feedings at night are easy. You don't have to get a bottle and warm it up. You can breast-feed while lying down.
Breast-feeding helps you recover from childbirth and appears to improve your long-term health.
Follow These Tips For Breast-Feeding Success
If you can, breast-feed within an hour after your baby's birth.
Put your nipple as far back in your baby's mouth as possible. This will make you more comfortable.
Breast-feed your baby regularly and frequently, even as often as every two hours and at least 8 times in a 24-hour period.
Your baby should have at least 8 wet diapers a day.
Don't give your baby sugar water or formula unless your doctor or nurse tells you to do so. Your baby usually will not need extra sugar water or formula.
Air dry your nipples to prevent cracking and soreness.
Eat a healthy diet. Rest as much as you can. Drink plenty of fluids, including water.
Ask for help with other children, housework and
cooking. Your most important job is taking care of your new baby and you.
Be patient. It will take time for you and your baby to learn how to breast-feed.
Warning: Women who are HIV positive should not breast-feed! Your breast milk could pass the HIV infection to your baby.
If You Choose Infant Formula
FDA makes sure that the infant formula you buy at the store is safe and contains all the things your baby needs.
Babies can drink formula made from cow's milk or soybeans. Ask the doctor what formula to give your baby.
Formula comes three ways: powder, liquid concentrate, and ready-to-feed. Powder costs the least. Ready-to-feed costs the most.
Prepare Formula Safely
Sterilize bottles and nipples in a dishwasher or in a pot of boiling water for five minutes.
Boil the water before adding it to powder formula or liquid concentrate. Bring it to a very bubbly boil. Keep boiling it for a minute or two, then let it cool.
Mix powder formula and liquid concentrate with the exact amount of water stated on the label. Too little water can upset your baby's stomach or hurt the kidneys. Too much water keeps your baby from getting enough to eat.
Warning: Only use approved infant formulas. Homemade formula may not have all the things your baby needs to be healthy.
Store Formula Safely
Keep the prepared formula in the refrigerator until you use it.
Keep an opened can of ready-to- feed or liquid concentrate formula in the refrigerator. Use it within 48 hours after opening.
To warm a bottle of formula, place it in a pot of water and heat the pot on the stove.
Warning: Don't heat bottles in a microwave oven! Microwaves make hot spots that could burn your baby's mouth.
When Can You Switch to Whole Milk?
You can stop feeding formula and start whole milk around your baby's first birthday. But do not give your 1-year-old any reduced-fat or no-fat milk. These milks don't have enough fat and calories for your growing toddler.
Or, you can continue feeding your child breast milk for as long as you want.
Warning: Don't give your 1-year-old reduced-fat or no-fat milk!
Do You Have More Questions About Breast-Feeding or Infant Formula?
Ask your doctor or breast-feeding consultant. And ask FDA. There may be an office near you. Look for their number in the blue pages of the phone book.
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How long should I pump each time?
Pumping your breasts takes about the same time as breastfeeding, but with practice and a good pump, you can pump your breasts in as little as 10 to 15 minutes. While you are at work, try to pump as often as your baby usually feeds. To keep up your milk supply, give your baby extra feedings when you are together.
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Soy Milk
