- ATHENS OFFICE MED4WOMAN ATHENS
- VOLOS OFFICE MED4WOMAN VOLOS
Obstetrician-Gynecologist
PhD, University of Athens Medical School
Obstetrician-gynecologist Panagiotis Polyzos practices at the Institute of Life, the IVF Unit of IASO Maternity Hospital.
Life can become easier when you breastfeed. Breastfeeding may require a little more effort at first compared to feeding with formula.
However, once you and your baby settle into a good routine at home, life can become much easier. When you breastfeed, there are no bottles or nipples to sterilize. You don’t need to buy, measure, or mix anything. There are no bottles to warm up in the middle of the night!
You can satisfy your baby’s hunger immediately when breastfeeding. Physical contact is important for newborns: it can help them feel more secure, warm, and comforted.
Mothers can also benefit from this closeness, as breastfeeding has a calming effect and offers relaxing bonding time. Skin-to-skin contact with the baby can boost the mother’s oxytocin levels. Oxytocin is a hormone that supports milk flow and provides a sense of calm to the mother.
Breastfeeding may have beneficial effects on the mother’s health and reduce the risk of the following health issues:
Breast milk is not just food. It contains antibodies, enzymes and living cells that no infant formula can replicate, and its composition changes according to the baby's age and needs.
In the first days the breast produces colostrum, a thick, yellowish fluid that starts forming during pregnancy. It comes in small amounts but is extremely rich in antibodies and proteins. The small volume matches the size of the newborn's stomach, which on the first day holds just 5 to 7 ml.
Between the third and fifth day the milk “comes in.” The breasts fill up and feel heavier, and the milk becomes whiter and more plentiful. Mature milk has the right balance of water, fat, lactose and protein. At the start of each feed it is more watery to quench the baby's thirst, and at the end it is richer in fat to fill the baby up. That is why you let the baby finish the first breast before offering the second.
The first hours matter a lot. What helps most:
Correct positioning: tummy to tummy, with the baby's nose opposite the nipple. Wait for the mouth to open wide and bring the baby to the breast, not the breast to the baby. The mouth should take in a large part of the areola, not just the nipple. The chin rests against the breast and the lips turn outward. If breastfeeding hurts beyond the first few seconds, the latch is probably shallow: gently break the suction with your finger and try again.
A newborn feeds 8 to 12 times in 24 hours, that is, every two to three hours, including at night. Breastfeeding is “on demand”: offer the breast at the first signs of hunger, when the baby turns their head, sucks on their hands or opens their mouth. Crying is a late sign. Feeds last anywhere from 10 to 40 minutes and get shorter as the baby grows.
How to tell the baby is getting enough milk:
Whatever the difficulty, early help from a midwife or lactation consultant makes a difference. Most problems are solved when they are addressed in the first days.
You do not need a special diet. You need roughly 400 to 500 extra calories a day, a variety of foods and plenty of fluids. The same nutritious foods recommended during pregnancy apply here too. There are no “forbidden” foods, unless you notice that a particular food consistently bothers your baby.
The World Health Organization recommends exclusive breastfeeding for the first six months and continued breastfeeding, along with solid foods, up to two years or for as long as mother and child wish. Every week of breastfeeding counts, even if you do not reach this goal.
After a cesarean section: breastfeeding is entirely possible. The side-lying position and the “football hold” protect the incision. The milk may come in a day later.
Returning to work: you can pump and store milk. It keeps for up to 4 hours at room temperature, up to 4 days in the refrigerator and about 6 months in the freezer.
In emergencies, such as natural disasters or water supply cuts, breastfeeding protects the baby from contaminated water, respiratory infections and diarrhea. The milk is always available, at the right temperature, with no supplies needed.
There are a few situations where breastfeeding is not recommended, such as certain maternal treatments or rare metabolic disorders in the infant. If you cannot or do not want to breastfeed, infant formula is a safe option and the decision is yours.
The benefits of breastfeeding add up the longer it continues. As a guide, month by month:
Exclusive breastfeeding delays the return of ovulation, but it is not guaranteed protection. The so-called lactational amenorrhea method (LAM) is about 98% effective only when three conditions are met at the same time:
As soon as one of these no longer applies, you need another method. Ovulation comes before the first period, so you can get pregnant before you even see a period. Methods compatible with breastfeeding include condoms, the copper or hormonal IUD, the progestin-only pill, the implant and the injection. The combined birth control pills containing estrogen are avoided for at least the first six weeks after childbirth, and often longer, because they increase the risk of blood clots and may reduce milk supply. Discuss the method with your doctor at your postpartum checkup.
As long as you breastfeed often, your period may not return for months. In women who do not breastfeed, it usually returns within 6 to 8 weeks. The first cycles are often irregular, lighter or heavier, and this is expected. However, if your period is late and you have already resumed unprotected intercourse, a pregnancy test will clarify things. For other possible causes, see the guide on a late period.
If you become pregnant while breastfeeding, in most normal pregnancies breastfeeding can continue. Your milk may decrease or change taste, and your nipples may become more sensitive. Tell your doctor if you have a history of preterm labor, bleeding or abdominal pain.
Many women continue their pregnancy vitamins for as long as they breastfeed. Avoid herbal “galactagogue” (milk-boosting) products without medical advice: most lack clear evidence.
A lump during lactation is usually a blocked duct or a galactocele. However, breastfeeding does not rule out other breast conditions, and an ultrasound can be done as usual while you breastfeed.
Usually between the third and fifth day. Until then, colostrum fully covers the baby's needs. After a cesarean section it may be delayed by a day.
Some tenderness in the first few seconds is common in the first days. Pain that lasts throughout the feed or sore, cracked nipples usually point to poor positioning, which can be corrected.
The baby has at least six wet diapers a day, yellow soft stools, is calm after feeds and gains weight as expected by the pediatrician.
Most common medications, such as acetaminophen (paracetamol) and many antibiotics, are compatible with breastfeeding. Always consult your doctor before any treatment.
Exclusive breastfeeding for six months and continued breastfeeding alongside solid foods up to two years, or for as long as you and your child wish.
From the first days it protects against infections and helps the uterus recover. At 3 months it reduces ear infections and hospitalizations, at 6 months it reduces the risk of sudden infant death and obesity, and after the first year it also protects the mother against breast and ovarian cancer.
Yes. Ovulation can return before the first period, especially when feeds become less frequent or solid foods are introduced. If you do not want a new pregnancy, use a contraceptive method that is compatible with breastfeeding.
Usually yes after silicone implants, especially when the incision was not made around the nipple. After breast reduction, milk supply may be lower because ducts and nerves are cut. Let your midwife or lactation consultant know early, so the baby's weight can be monitored closely.
Gradually. Drop one feed every two to three days, starting with the one the baby is least interested in. If your breasts fill up, express just a little milk for relief. Stopping abruptly increases the risk of engorgement and mastitis.
