Breastfeeding and Breast Milk

Breastfeeding provides an infant with essential calories, vitamins, minerals, and other nutrients for optimal growth, health, and development. Breastfeeding is beneficial to both a mother and her infant and also offers an important opportunity for the pair to bond. NICHD supports many areas of breastfeeding research, including studies of the benefits of breastfeeding and breast milk, the social and cultural impacts of breastfeeding, and the nutritional components and mechanisms of disease related to breastfeeding and breast milk.

About Breastfeeding and Breast Milk

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. Breastfeeding and breast milk provide an infant with calories and nutrients, including macronutrients (fat, protein, and carbohydrates) and micronutrients (vitamins and minerals).1

According to the American Academy of Pediatrics (AAP) Policy Statement on Breastfeeding, women who don't have health problems should exclusively breastfeed their infants for at least the first 6 months after birth.2

The AAP suggests that, if possible, a woman should try to continue breastfeeding her infant for up to 12 months, while adding other foods, because of the benefits to both the mother and the infant.2

Although breastfeeding is the recommended method for feeding infants, and breast milk provides most of the nutrients an infant needs, it does not provide infants with adequate vitamin D.3 The current recommended daily vitamin D intake for infants and children is available on the American Academy of Pediatrics website  .

Citations

  1. Ballard, O., & Morrow, A. L. (2013). Human milk composition: Nutrients and bioactive factors. Pediatric Clinics of North America, 60(1), 49–74. Retrieved June 21, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586783
  2. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827 
  3. Centers for Disease Control and Prevention. (2009, October 20). Breastfeeding: Vitamin D supplementation. Retrieved June 1, 2016, from http://www.cdc.gov/breastfeeding/recommendations/vitamin_D.htm
  4. Wagner, C. L., Greer, F. R., & American Academy of Pediatrics Section on Breastfeeding and Committee on Nutrition. (2008). Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics, 122(5), 1142–1152. Retrieved November 4, 2016, from http://pediatrics.aappublications.org/content/122/5/1142 

What are the benefits of breastfeeding?

Research shows that breastfeeding offers many health benefits for infants and mothers, as well as potential economic and environmental benefits for communities.

Breastfeeding provides essential nutrition. Among its other known health benefits are some protection against common childhood infections and better survival during a baby's first year, including a lower risk of Sudden Infant Death Syndrome.1

Research also shows that very early skin-to-skin contact and suckling may have physical and emotional benefits.2

Other studies suggest that breastfeeding may reduce the risk for certain allergic diseases, asthma, obesity, and type 2 diabetes. It also may help improve an infant's cognitive development. However, more research is needed to confirm these findings.

For more specific information about the health benefits of breastfeeding, visit one of the following resources:

Citations

  1. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827 
  2. Feldman-Winter, L., & Goldsmith, J. P.; Committee on Fetus and Newborn, Task Force on Sudden Infant Death Syndrome. (2016). Safe sleep and skin-to-skin care in the neonatal period for healthy term newborns. Pediatrics, 138(3), e20161889. Retrieved December 20, 2016, from http://pediatrics.aappublications.org/content/early/2016/08/18/peds.2016-1889 

What are the recommendations for breastfeeding?

In the United States, the American Academy of Pediatrics (AAP) currently recommends:1

  • Infants should be fed breast milk exclusively for the first 6 months after birth. Exclusive breastfeeding means that the infant does not receive any additional foods (except vitamin D) or fluids unless medically recommended.
  • After the first 6 months and until the infant is 1 year old, the AAP recommends that the mother continue breastfeeding while gradually introducing solid foods into the infant's diet.
  • After 1 year, breastfeeding can be continued if mutually desired by the mother and her infant.

The World Health Organization currently promotes as a global public health recommendation that:2

  • Infants be exclusively breastfed for the first 6 months after birth to achieve optimal growth, development, and health.
  • After the first 6 months, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond.

For the latest information on COVID-19 and breastfeeding, visit CDC at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html.

 

Citations

  1. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827 
  2. World Health Organization. (2001). The World Health Organization's infant feeding recommendation. Retrieved January 28, 2016, from http://www.who.int/nutrition/topics/infantfeeding_recommendation/en/index.html 
  3. Centers for Disease Control and Prevention. (2017). U.S. Breastfeeding Rates Are Up! More Work Is Needed. Retrieved March 2, 2018, from https://www.cdc.gov/breastfeeding/resources/us-breastfeeding-rates.html

How do I breastfeed?

There are many mothers' groups, health organizations, and health care provider associations that provide very detailed information and support on how to breastfeed. The following overview is provided for information only—it is not meant to take the place of a health care provider or lactation consultant's advice or recommendation. Visit the Resources and Publications section to find the names of some breastfeeding organizations.

Citations

  1. American College of Obstetricians and Gynecologists. (2016, March). Breastfeeding your baby. Retrieved June 1, 2016, from http://www.acog.org/Patients/FAQs/Breastfeeding-Your-Baby 
  2. U.S. Department of Health and Human Services Office on Women's Health. (2010, August). Breastfeeding: Learning to breastfeed. Retrieved January 28, 2016, from http://www.womenshealth.gov/breastfeeding/learning-to-breastfeed.html

What is weaning and how do I do it?

Weaning is the process of switching an infant's diet from breast milk or formula to other foods and fluids. In most cases, choosing when to wean is a personal decision. It might be influenced by a return to work, the mother's or infant's health, or just a feeling that the time is right.1

Weaning an infant is a gradual process. The American Academy of Pediatrics (AAP) recommends feeding infants only breast milk for the first 6 months after birth. After 6 months, the AAP recommends a combination of solid foods and breast milk until the infant is at least 1 year old.2 The Academy advises against giving cow's milk to children younger than 1 year old.3

You may have difficulty determining how much to feed your child and when to start introducing solid foods. The general guidance below, as reported by the National Library of Medicine, demonstrates the process of weaning for infants up to 6 months of age.4 You should speak with your infant's health care provider before attempting to wean your infant to make sure that he or she is ready for weaning and for complete guidance on weaning.

  • Birth to 4 months of age
    • During the first 4 to 6 months, infants need only breast milk or formula to meet their nutritional needs.
      • If breastfeeding, a newborn may need to nurse eight to 12 times per day. By 4 months of age, an infant may need to nurse only four to six times per day.
      • By comparison, formula-fed infants may need to be fed about six to eight times per day, with newborns consuming about 2 to 3 ounces per feeding. The number of feedings will decrease as the infant gets older, similar to breastfeeding.
  • 4 to 6 months of age
    • At 4 to 6 months of age, an infant needs to consume 28 to 45 ounces of breast milk or formula per day and often is ready to start being introduced to solid food.
    • Starting solid foods too soon can be hazardous, so an infant should not be fed solid food until he or she is physically ready.
    • Start solid feedings (1 or 2 tablespoons) of iron-fortified infant rice cereal mixed with breast milk or formula, stirred to a thin consistency.
    • Once the infant is eating rice cereal regularly, you may introduce other iron-fortified instant cereals.
    • Only introduce one new cereal per week so that intolerance or possible allergies can be monitored.

For more information on weaning your infant, visit MedLinePlus: Feeding Patterns and Diet—Children 6 Months to 2 Years.

Citations

  1. KidsHealth from Nemours. (2014). Weaning your child. Retrieved June 27, 2016, from http://kidshealth.org/en/parents/weaning.html 
  2. American Academy of Pediatrics (AAP). (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827 
  3. AAP. (2015). Ages & stages: Why formula instead of cow's milk? Retrieved January 28, 2016, from http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Formula-Instead-of-Cows-Milk.aspx 
  4. MedlinePlus. (2016). Feeding patterns and diet—babies and infants. Retrieved June 1, 2016, from https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000712.htm

When breastfeeding, how many calories should moms and babies consume?

Citations

  1. U.S. Department of Health and Human Services Office on Women's Health. (2014).Your guide to breastfeeding. Retrieved June 1, 2016, from http://www.womenshealth.gov/publications/our-publications/breastfeeding-guide/ (PDF 2.2 MB)
  2. U.S. Department of Agriculture (USDA) & U.S. Department of Health and Human Services. (2015). 2015–2020 Dietary Guidelines for Americans (8th ed.). Retrieved January 28, 2016, from https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/appendix-2/#table-a2-1
  3. American College of Obstetricians and Gynecologists. (2016). Breastfeeding your baby. Retrieved June 1, 2016, from http://www.acog.org/Patients/FAQs/Breastfeeding-Your-Baby 
  4. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827 
  5. USDA. (2009). Nutritional needs for infants. In Infant Nutrition and Feeding: A Guide for Use in the WIC and FSF Programs (11–40). Retrieved October 13, 2016, from https://wicworks.fns.usda.gov/wicworks//Topics/FG/CompleteIFG.pdf (PDF 3.4 MB)

Are there any special conditions or situations in which I should not breastfeed?

In special cases, women may be advised not to breastfeed. These instances include when a woman is taking certain medications or drugs, when she has been diagnosed with a specific illness, or when other specific conditions apply.

For the latest information on COVID-19 and breastfeeding, visit CDC at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html.

Citations

  1. Centers for Disease Control and Prevention (CDC). (2015). Breastfeeding: Diseases and conditions. Retrieved March 21, 2016, from http://www.cdc.gov/breastfeeding/disease/index.htm
  2. American College of Obstetricians and Gynecologists. (2016). Breastfeeding your baby. Retrieved June 1, 2016, from http://www.acog.org/Patients/FAQs/Breastfeeding-Your-Baby 
  3. Tepper, D. (2015). Pregnancy and lactation—migraine management. Headache: The Journal of Head and Face Pain, 55, 607–608. Retrieved January 28, 2016, from https://americanheadachesociety.org/wp-content/uploads/2018/05/Pregnancy_and_Lactation_Toolbox.pdf  (PDF 209 KB)
  4. Massachusetts General Hospital Center for Women's Mental Health. (2015). Breastfeeding & psychiatric medications. Retrieved January 29, 2016, from http://www.womensmentalhealth.org/specialty-clinics/breastfeeding-and-psychiatric-medication/ 
  5. March of Dimes. (2016). Keeping breast milk safe and healthy. Retrieved June 2, 2016, from http://www.marchofdimes.org/baby/keeping-breast-milk-safe-and-healthy.aspx 
  6. CDC. (2009, October 23). 2009 H1N1 (swine flu) and feeding your baby: What parents should know. Retrieved April 27, 2012, from http://www.cdc.gov/h1n1flu/infantfeeding.htm
  7. Dupont-Rouzeyrol, M., Biron, A., O'Connor, O., Huguon, E., & Descloux, E. (2016). Infectious Zika viral particles in breastmilk. Lancet, 387(10023), 1051.
  8. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved March 11, 2016 from http://pediatrics.aappublications.org/content/129/3/e827 
  9. World Health Organization (WHO). (2008). HIV transmission through breastfeeding: A review of the available evidence. Retrieved March 11, 2016, from http://whqlibdoc.who.int/publications/2008/9789241596596_eng.pdf  (PDF - 835 KB)
  10. WHO. (2010). Guidelines on HIV and infant feeding. Retrieved March 11, 2016, from http://whqlibdoc.who.int/publications/2010/9789241599535_eng.pdf  (PDF 1.58 MB)
  11. Coovadia, H. M., Rollins, N. C., Bland, R. M., Little, K., Coutsoudis, A., Bennish, M. L., & Newell, M.-L. (2007). Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: An intervention cohort study. Lancet, 369(9567), 1107–1116. Retrieved March 11, 2016, from http://www.thelancet.com/journals/lancet/article/PIIS0140673607602839/fulltext 
  12. American Diabetes Association. (2007). Nutrition recommendations and interventions for diabetes. A position statement of the American Diabetes Association. Diabetes Care, 30(Suppl 1), S48–S65. Retrieved January 29, 2016, from http://care.diabetesjournals.org/content/30/suppl_1/S48.full 
  13. BFAR. (2009). General frequently asked questions (FAQ) about breastfeeding after breast and nipple surgeries. Retrieved January 29, 2016, from http://www.bfar.org/faq.shtml 
  14. National Institute on Drug Abuse. (2015). Substance use while pregnant and breastfeeding. Retrieved January 29, 2016, from http://www.drugabuse.gov/publications/research-reports/substance-use-in-women/substance-use-while-pregnant-breastfeeding

 

How do I pump and store breast milk?

Citations

  1. U.S. Department of Health and Human Services Office on Women's Health. (2015). Breastfeeding: Pumping and milk storage. Retrieved January 29, 2016, from http://womenshealth.gov/breastfeeding/pumping-and-breastmilk-storage.html
  2. American Academy of Pediatrics. (n.d.). Breastfeeding initiatives: FAQs. Retrieved April 27, 2012, from https://www.womenshealth.gov/breastfeeding/pumping-and-storing-breastmilk 
  3. Centers for Disease Control and Prevention. (2010). Breastfeeding: Proper handling and storage of human milk. Retrieved April 27, 2012, from http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm

Do breastfed infants need other nutrition?

Citations

  1. Centers for Disease Control and Prevention. (2015). Vitamin D supplementation. Retrieved January 29, 2016, from http://www.cdc.gov/breastfeeding/recommendations/vitamin_D.htm
  2. Wagner, C. L., Greer, F. R., & American Academy of Pediatrics Section on Breastfeeding and Committee on Nutrition. (2008). Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics, 122(5), 1142–1152. Retrieved November 4, 2016, from http://pediatrics.aappublications.org/content/122/5/1142 
  3. Kellams, A., et al. (2017). Academy of Breastfeeding Medicine, Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate. Breastfeeding Medicine, 12(3): 1-11. Retrieved from https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/3-supplementation-protocol-english.pdf May 12, 2020.   (PDF 380 KB)
  4. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827 
  5. U.S. Department of Agriculture Food and Nutrition Service. (2009). Infant Nutrition and Feeding: A Guide for Use in the WIC and CSF Programs. Retrieved October 13, 2016, from https://wicworks.fns.usda.gov/wicworks/Topics/FG/CompleteIFG.pdf (PDF 3.4 MB)
  6. World Health Organization. (n.d.) Complementary feeding. Retrieved October 12, 2016, from http://www.who.int/nutrition/topics/complementary_feeding/en/ 

NICHD Breastfeeding and Breast Milk Research Goals

NICHD seeks to understand the aspects of breastfeeding and breast milk that lead to optimal health for mothers and infants and optimal development for infants. To meet its goals, NICHD supports and conducts research that addresses breastfeeding practices and initiatives throughout the nation and abroad.

Some of the projects related to breastfeeding and breast milk include (but are not limited to):

  • Understanding the full range of benefits from breastfeeding and breast milk for mother and infant and their short-, medium-, and long-term influences on health and disease
  • Examining the social, cultural, and economic impacts of breastfeeding in the U.S. and worldwide, as well as the factors that positively and negatively influence breastfeeding decisions
  • Elucidating the nutritional and biochemical components of breast milk and how they might prevent, treat, or reduce the severity of various diseases
  • Identifying nutritional and other components of breast milk that might be lacking and creating and evaluating strategies to ensure that infants receive these components in various settings
  • Understanding the effects of diseases such as malaria, and of chronic conditions such as HIV/AIDS, on breast milk, breastfeeding practices, and treatments for diseases
  • Collaborating with agencies and organizations to raise awareness of the scientific evidence that underlies breastfeeding recommendations

The Institute also supports efforts to meet the public health goals outlined by the U.S. Department of Health and Human Services (HHS) Healthy People 2020 initiative, such as increasing the number of infants who are breastfed, through various awareness and outreach efforts. For more information on the Healthy People 2020 goals for breastfeeding, visit
https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives.

Breastfeeding and Breast Milk Research Activities and Advances

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