Breast milk is uniquely made to meet your baby’s nutritional needs. When your baby is first born, he or she is in the process of developing an immune system to help fight diseases. A mother’s early milk, called colostrum, contains antibodies or proteins that help babies fight infections while their own immune system is maturing. This colostrum changes to mature milk when a baby is 3–5 days old. The protein in breast milk is also easier for babies to digest than the protein in formulas.
How long should infants be breastfed?
The recommendation is that that babies eat only breast milk for the first six months of their lives. After six months, food and other liquids can be added into their diet. Babies should get breast milk for at least 12 months. The American Academy of Pediatrics (AAP), American Academy of Family Physicians, American College of Obstetricians and Gynecologists (ACOG), American College of Nurse-Midwives, Academy of Nutrition and Dietetics, World Health Organization, and American Public Health Association all support these recommendations.
Medical benefits of breast milk
Breastfed infants have a lower risk of many common conditions, including:
- Common colds (upper respiratory infections)
- Ear infections
- Urinary tract infections
- Celiac disease
- Sudden unexplained infant death syndrome (SUIDS or SIDS)
- Diabetes (types 1 and 2)
- Inflammatory bowel disease (Ulcerative Colitis, Crohns)
- Food allergies
In the first year of life, breastfed babies are hospitalized less often and require fewer doctors’ visits than formula-fed babies. Infants receiving even just some breast milk can gain these health benefits, even if they receive some formula as well.
Benefits of breast milk for premature babies
Breast milk is especially important for premature babies, who are at an increased risk of many serious conditions. Premature babies who receive breast milk have lower rates of a life-threatening gut infection called necrotizing enterocolitis. Premature babies who receive breast milk also have a lower rate of sepsis (a serious bloodstream infection) than formula-fed premature babies. Breast milk in premature babies also quickens the development of hearing and improves vision. Premature infants who receive breast milk are less likely to get readmitted to the hospital after leaving the neonatal intensive care unit.
Benefits of breastfeeding for mothers
Both pediatricians and OB/GYN physicians recommend providing breast milk for your infant. This can be through breastfeeding, providing expressed milk in a bottle, or a combination of both. Here are some of the benefits of breastfeeding that are supported by the AAP and ACOG.
- Emotional benefits – Breastfeeding can be a wonderful time for bonding between new mother and infant. Breastfeeding releases hormones in the mother’s body called prolactin and oxytocin. These hormones help promote peaceful sensations and a sense of attachment that can be soothing for both mother and baby. The breastfeeding experience can be very powerful and connect mom and baby in a unique physical and emotional way.
- Physical benefits – Oxytocin also has other effects on the body, including helping the uterus contract and return to its regular size more quickly, which can reduce postpartum bleeding. Breastfeeding may also increase post-partum weight loss and help with the return to pre-pregnancy weight. Expressing milk or breastfeeding also have long-term benefits for women. Medical studies have shown that women who have breastfed have lower rates of breast and ovarian cancer. Some studies have also found that women who have breastfed have lower rates of rheumatoid arthritis, type 2 diabetes, high blood pressure, high cholesterol, and heart disease.
- Practical benefits – Breastfeeding can be a less expensive option than formula. The cost savings depends on many factors but can be considerable, although it does require more time investment from the mother. It is also easier to travel with a breastfed baby as you don’t need to carry bottles and formula.
Reasons not to breastfeed
There are only a few medical reasons why your doctor would not recommend breastfeeding your infant:
- Your infant has galactosemia (a rare genetic metabolic disorder)
- You have HIV infection or human T-cell lymphotropic virus infection
- You are receiving chemotherapy or radiation
- You have untreated tuberculosis
- You have active varicella (chicken pox) or a herpes simplex virus lesion on a breast
- It is OK to breastfeed using the other breast if it is clear of lesions
- It is OK to breastfeed if lesions are elsewhere on the body
- You are using drugs of abuse or “illicit drugs”
- This should be a discussion with your pediatrician as it can vary from situation to situation. Some women on stable treatment doses of methadone should be encouraged to breastfeed.
- We do not have enough scientific data to know what the effects of maternal marijuana use are on breastfeeding infants, so we recommend against marijuana use.
While you may worry about the following reasons, you are actually safe for breastfeeding if:
- You have hepatitis B or C
- You have a fever/mild illness
- You are a carrier of cytomegalovirus (CMV)
- If your baby weighed less than 1500g at birth, then the risk of CMV transmission should be discussed with your doctor.
- You are taking medication
- Most medications are OK to take while breastfeeding but there some are worth discussing with your pediatrician or OB/GYN. If you have questions about the safety of the medications you are taking, please discuss with your doctor.
- You are using tobacco/smoking/e-cigs
- Although tobacco use is not an absolute reason to not breastfeed, all nursing mothers should avoid smoking in their house or car and attempt to quit smoking if possible to decrease exposure of their baby to second hand smoke.
- You have had one small alcoholic beverage
- You should limit alcohol exposure and you should not breastfeed while intoxicated.
- Breastfeeding Support & Resources (U-M Mott Children’s Hospital)
- Why Breastfeed (AAP)
- Benefits of Breastfeeding for Mom (AAP)
- Optimizing Support for Breastfeeding as Part of Obstetric Practice (ACOG)
- Breastfeeding and the Use of Human Milk (AAP)
Written by Megan Quist, MD, and Alyssa Wojciechowski, MD
Updated September 2018