The World Health Organization has included measures to promote successful breastfeeding, such as supporting mothers to initiate breastfeeding within one hour after delivery, implementing 24-hour rooming-in for mothers and infants, exclusive breastfeeding for six months, and encouraging breastfeeding for two years or longer.
Benefits of Breastfeeding for Mothers and Infants
Breastfeeding offers numerous health benefits for both mothers and infants. For infants, it provides all the nutrients required for growth and development during the first six months of life, and even beyond this period, breast milk remains an essential source of energy and high-quality nutrients. Breastfeeding enhances the infant's immune system, supports dental and facial development, and strengthens the emotional bond between mother and child. For mothers, breastfeeding promotes uterine involution, reduces postpartum bleeding, accelerates postpartum recovery, and lowers the risk of breast and ovarian cancers. Successful breastfeeding can also boost maternal confidence while reducing the risk of postpartum anxiety and depression.
Breastfeeding Duration and Methods
Breastfeeding is a natural behavior and is recommended to be done on demand. Each session generally lasts 20–30 minutes. Depending on the environment, various breastfeeding positions can be used, such as cradle hold, football hold, cross-cradle hold, reclining position, or side-lying position, ensuring a comfortable posture for both mother and infant.
Before breastfeeding, mothers should clean their hands and gently cleanse the breasts and nipples with warm water. During breastfeeding, both mother and infant should be positioned comfortably. The mother should place her thumb on top of the breast and the other four fingers underneath, guiding the nipple and most of the areola into the infant's mouth. The breast should be supported to prevent it from obstructing the infant's nose. After one breast has been emptied, feeding can continue on the other side. Post-breastfeeding, wearing a breathable cotton bra may help maintain comfort. The infant should be held upright and gently patted on the back for 1–2 minutes after nursing to release trapped air and prevent spitting up. If breast milk supply is confirmed to be insufficient, formula milk may be supplemented as required.
Common breastfeeding-related issues and their management include the following:
Engorgement
Physiological breast engorgement occurs 3–5 days postpartum and is considered normal. Symptoms include a feeling of fullness, mild warmth, and tenderness, which are primarily caused by the accumulation of blood and lymph rather than milk. These changes are necessary for the initiation of milk production. Frequent and effective infant suckling helps alleviate engorgement. Warm compresses before breastfeeding and cold compresses between sessions can relieve discomfort. Avoid aggressive techniques such as forceful breast massage.
Milk Production
Regular suckling and the complete emptying of breasts are essential for continuous milk production. Milk supply is influenced by factors such as maternal nutrition, sleep, emotional well-being, and overall health. In cases of insufficient milk supply, providing emotional support, guiding proper breastfeeding techniques, ensuring adequate rest, sufficient sleep, and a nutrient-rich diet can be beneficial. Stress should be minimized as much as possible to avoid its negative impact on lactation.
Lactation Suppression
For mothers unable to breastfeed, early lactation suppression is recommended. The simplest approach involves ceasing breastfeeding. When necessary, medication can be used as an adjunct. Common methods for lactation suppression include the following:
- Steeping 60–90 g of malt in water to prepare a tea, consumed once daily for 3–5 days.
- Preparing two gauze bags filled with 250 g of Glauber’s salt (sodium sulfate) and applying them to the breasts, replacing them when they become moist and hardened.
- Taking vitamin B6 at a dosage of 200 mg three times daily for 3–5 days.
Steroidal hormones or bromocriptine are not recommended as first-line medications for lactation suppression.
Nipple Cracking
Mild nipple cracks may not prevent breastfeeding. Adjusting the breastfeeding position to achieve better nipple latch can reduce pain. Expressing a small amount of breast milk to apply to the nipple and areola, followed by brief air exposure, can promote healing. For severe nipple cracks, breastfeeding may be temporarily discontinued. Milk can be expressed manually or using a breast pump and fed to the infant until the wounds heal, after which breastfeeding may be resumed.
Assessing Milk Supply
Indicators of adequate milk supply include the following:
- The infant is breastfed approximately 8 times per day.
- The infant urinates 5–6 times and defecates 2–4 times daily.
- The infant demonstrates good weight gain and has satisfactory sleep patterns.
Conditions for Breast Milk Storage
When direct breastfeeding is not possible, expressed milk can be stored in milk storage bags. At a temperature of 20–30°C, breast milk remains safe for up to 4 hours. At 4°C, it can be stored for up to 48 hours, and at -15 to -5°C, it can be stored for up to 6 months.
Contraindications or Temporary Suspension of Breastfeeding
Breastfeeding may not be suitable in certain circumstances, such as when the mother has acute infectious diseases, severe organ dysfunction, serious postpartum psychological or mental disorders, or is taking medications that may harm the infant. Neonatal conditions such as lactose intolerance may also require the cessation of breastfeeding. Additionally, breastfeeding may be inadvisable in cases of alcohol abuse, extreme emotional disturbance, or other situations where substances consumed by the mother may adversely affect the infant.