What I Wish I Knew About Breastfeeding

Updated Oct. 01, 2024

An expert MD serves up the facts on the best practices surrounding breastfeeding.

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Breastfeeding is a nurturing practice that deepens the connection between mother and baby. You might already know about its amazing perks—like boosting your baby’s immune system and helping moms shed that postpartum weight. According to the Centers for Disease Control and Prevention, about 84.1% of infants start off breastfeeding, with 59.8% still at it at six months. However, the number decreases to 27.2% for those who are exclusively breastfed during this period. But remember, just because breastfeeding is natural doesn’t mean it’s always easy. It’s totally normal to face some challenges along the way. Fortunately, there are plenty of resources available to smooth out the rough patches.

Ahead, Kristrun Kristinsdottir, MD, a board-certified OB/GYN at AdventHealth Parker, and Brooke Mayor, a new mom who exclusively breastfed for six months, share their expert advice and personal insights on what you need to know about breastfeeding.

What I Wish I Knew About Breastfeeding
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At what age is breast milk most important?

Dr. Kristinsdottir shares that leading health organizations like the American College of Obstetricians and Gynecologists (ACOG), the World Health Organization (WHO), and the American Academy of Pediatrics (AAP) all recommend exclusive breastfeeding during the first six months of a baby’s life. The organizations also recommend continuing breastfeeding along with suitable complementary foods for up to two years of age or older.

As solid food intake increases, breastfeeding sessions might become shorter and less frequent, but breast milk still provides valuable nutrition and comfort. Brooke originally hoped to breastfeed until her baby was 6 months old. Now, with her child a year old, she cherishes how nursing keeps them bonded and plans to continue as long as possible. “We are down to about four nursing sessions a day—morning, naptime, after dinner, and bedtime,” she says. “It’s less about her being hungry right now, since she’s enjoying all kinds of solids, and more about comfort and our bonding time. Even with her growing independence, these quiet moments keep us connected.”

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What I Wish I Knew About Breastfeeding
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At what age is breastfeeding no longer beneficial?

“There is no specific time at which breastfeeding must be stopped, it can be continued for as long as both mom and baby want to,” according to Dr. Kristinsdottir. She points out that breastmilk is a dynamic source of nutrition that evolves with your baby’s needs. “Breast milk contains the optimal nutrition that babies need and adapts as they grow and change. Babies typically digest breast milk more easily than formula,” she explains.

Beyond nutrition, breast milk is packed with antibodies that help protect infants from common issues like ear infections, diarrhea, allergies, and respiratory illnesses. It’s also linked to a reduced risk of sudden infant death syndrome (SIDS).

But the perks aren’t just for babies. Moms benefit from breastfeeding, too. “Studies have shown that breastfeeding for at least two years can lower mom’s future risk of diabetes, high blood pressure, breast cancer, and ovarian cancer. It also provides optimal nutrition for baby and allows for more bonding time,” Dr. Kristinsdottir adds.

During breastfeeding, the hormone oxytocin is released, which not only helps in milk ejection but may also have a calming effect on the mother and aids the uterus in contracting back to its pre-pregnancy size, reducing postpartum bleeding. Also, considering the high cost of formula, breastfeeding can be a real budget saver.

What I Wish I Knew About Breastfeeding
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What is the hardest stage of breastfeeding?

The initial few weeks are often the hardest stage of breastfeeding for many new mothers. This period involves physical discomfort, challenges with latch and technique, frequent feedings, and emotional adjustments. Mothers and babies often need some time to become accustomed to breastfeeding.

What I Wish I Knew About Breastfeeding
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What are some common challenges of breastfeeding?

“Persistent pain may be a challenge for some and is linked with a higher risk of postpartum depression,” says Dr. Kristinsdottir. Pain can stem from various issues, including breast engorgement, poor latch, mastitis, and thrush. “If the pain during breastfeeding persists beyond the first week of the baby’s life, I recommend consulting a healthcare provider,” she suggests. Often, these challenges can be managed with help from a lactation consultant, and most pediatric and OB/Gyn offices can help women connect with these experts.

Another concern mothers may have is that they aren’t producing enough breast milk to meet their baby’s needs. “It is important to remember that at birth, baby’s stomach is about the size of a marble. As long as baby is feeding at least eight to 12 times per day, steadily gaining weight by age four to five days, and making six to eight wet diapers a day, milk production is adequate,” Dr. Kristinsdottir assures. If there are concerns about milk supply, she always recommends talking to a pediatrician to make sure the baby is well-nourished.

Breastfeeding tends to get easier after the first few months. By then, many of the initial challenges such as sore nipples and latching difficulties decrease as both mom and baby grow more accustomed and comfortable with the process. This was the case for Brooke during her first experience with breastfeeding. She was exhausted, and her baby was struggling with latching. Thankfully, she found great help from a lactation consultant. “She was a godsend. She showed me the most comfortable breastfeeding positions for me and my baby, which really helped ease the soreness,” Brooke explains. “She also suggested I pump for a few minutes before feeding to soften the breast, which made it easier for her to latch on properly. After I started doing that, we didn’t have any more issues.”

Every mother’s breastfeeding journey is unique. Support from healthcare providers, lactation consultants, and support groups can be incredibly helpful during this time.

What I Wish I Knew About Breastfeeding
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What nutritional guidelines should breastfeeding mothers follow?

The demands for energy and nutrition soar when you’re nursing. In most cases, sticking to a balanced diet should cover your bases. “A well-balanced diet consists of meat, fish, dairy, and vitamin and mineral rich fruits and vegetables,” says Dr. Kristinsdottir. “Women should continue taking a prenatal vitamin while breastfeeding and ensure they are adequately hydrated. It’s important to know that exercise is completely safe during breastfeeding.”

If you have concerns about the medications you’re taking while nursing, rest assured that most are safe. However, Dr. Kristinsdottir encourages women to chat with their healthcare provider to address any concerns surrounding medications and review any possible risks.

What I Wish I Knew About Breastfeeding
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When should you not breastfeed?

“There are very few situations where breastfeeding is not encouraged. I advise discussing any of these concerns with your healthcare provider before making a decision,” Dr. Kristinsdottir recommends. However, there are specific instances where breastfeeding is not advised:

  • Infant has classic galactosemia
  • Mother has untreated HIV
  • Mother is using illicit drugs such as cocaine
  • There is an active herpes outbreak on the breast
  • Mother is infected with the Ebola virus

In these scenarios, formula feeding is often the recommended alternative.

For other conditions like active tuberculosis or the varicella virus (chickenpox or shingles), direct breastfeeding might not be advisable temporarily. However, mothers can still nourish their babies with expressed milk. Dr. Kristinsdottir notes, “In these situations, moms can maintain their milk supply with regular pumping.”

What I Wish I Knew About Breastfeeding
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How can mothers manage breastfeeding with demanding schedules?

“While policies are slowly changing to provide more support to breastfeeding moms, there is still much room for improvement,” notes Dr. Kristinsdottir. Legally, employers are required to allot adequate time and privacy for mothers to pump at work. Although breastfeeding offers incredible benefits, sometimes it’s simply not feasible for both mom and baby, and that’s perfectly OK—there’s absolutely no need for shame or guilt. “Ultimately, every situation is unique, but women should always be given the freedom and support to feed their baby however they choose.”

About the Expert

  • Kristrun Kristinsdottir, MD, is a board-certified OB/GYN at AdventHealth Parker. She is a member of the Diversity and Inclusion Council at AdventHealth Parker, the American College of Obstetricians and Gynecologists, and the American Institute of Ultrasound in Medicine.

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