Breastfeeding

Breastmilk is the best natural food for your baby. The longer the babies are fed on breastmilk, the greater the benefits for the health of mothers and babies. According to the World Health Organization’s (WHO’s) recommendation, babies should be breastfed exclusively in the first six months and continue to have breastmilk together with solid food in their diet until two years old or above.

The Benefits of Breastfeeding:

  • Breastmilk provides all the essential nutrients that meet the baby’s needs in the first 6 months of life
  • The proteins in breastmilk are easily digested and absorbed
  • Breastmilk contains many antibodies and immunoglobulins, which help to enhance the immunity of the baby, and reduce the chance of having allergic conditions and infections
  • During breastfeeding, the close and intimate contact between the mother and baby greatly enhances mother-infant bonding
  • Breastfeeding is more hygienic, convenient, economical and environmentally friendly than bottle feeding

Tips of Success:

  • Rooming in

    Let your baby sleeps in a cot by your bed so you can observe his needs easily and respond readily

  • Feeding on demand

    Let your baby take the lead in feeding. Most newborns require frequent feeding of up to 8-12 times a day in the first month

  • Family Support

    Research showed women with support from their partners and families being able to continue breastfeeding for six weeks is 8.5 times that of those without support

  • Seek medical help

    Seek help from health professionals when you are in doubt

To Mum and Dad:

“How do you know your baby is getting enough milk?”

Healthy full term Babies:

  • Feeding:
    • Feed at least 3 to 4 times on the first day
    • Feed frequently for 8 to 12 times a day according to their needs from 2nd day onwards. They appear contented and satisfied after feeds
    • However, every baby has his own feeding pattern. Some of them may need to be fed more frequently at certain time of the day. Therefore feed them according to their needs
  • Wet nappies:
    • Have 1 to 2 wet nappies for exclusively breastfed babies on the first 2 days
    • Have at least 3 heavier nappies per day on the 3rd and 4th day
    • Have 5 to 6 heavy nappies (equals to 3 tablespoons of water in a nappy) with clear or light yellowish urine after the 5th day
  • Soiled nappies:
    • Pass black or dark green meconium on the first day
    • Change from passing meconium to yellowish stool in the first 5 days
    • Texture changes from loose or pasty to seedy gradually
    • Pass at least 2 times yellowish stool per day (size of a $1 coin at least) in the first month
  • Body weight:
    • It is normal for your baby to lose a bit of weight in the first few days after birth
    • By the first to second week, your baby will regain the birth weight and then put on weight steadily
    • He will gain at least 0.5 kg at the first month
  • Mums:
    • Breastfeed exclusively and no need to add formula milk or water
    • Be free from breasts and nipples sore, see or hear your babies swallowing while breastfeeding
    • The fullness feeling in the breast become relieved after feeds in the first few weeks (may not notice the changes in the first few days as your milk hasn’t come in)

If your baby has the above signs of getting enough milk, please take him/her to a nearby Maternal and Child Health Centre for regular follow up within 7 days after birth. If you have any problems in breastfeeding or your baby does not have any one of the above signs, please seek advice from:

  • Family Health Service, Department of Health
    • A Maternal and Child Health Centre nearby
    • Breastfeeding Hotline 3618 7450
  • Hotline services provided by public hospitals (for newborn born in that hospital only, please refer to the hospital for details)
  • Baby Friendly Hospital Initiative Hong Kong Association 2838 7727 (9:00a.m. to 9:00p.m.)
  • Hong Kong Breastfeeding Mothers’ Association 2540 3282 (24-hour Voice Mail)
  • Your paediatricians/obstetricians/family doctors

Common Breastfeeding Concerns:

My baby only takes very small amount of breastmilk in the first 2 days. Do I need to give my baby formula milk as supplement?

Most healthy and full term babies are born with sufficient reserve of water and nutrients. Also, the sizes of their stomachs are just like the size of a marble. Hence, small amount of colostrum produced is enough for your baby. The thick colostrum also aids the baby to learn and coordinate his suckling, swallowing and breathing techniques. Exclusive breastfeeding will act as if forming a protective film in his intestine to protect the body from bacteria and allergens. Unnecessarily supplementing with formula milk or water will, on the contrary, reduce the intestinal protection and thus, increase the risk of infection and allergy. During the first two days, if your baby have at least one to two wet diapers a day with colourless or pale yellow urine, and have bowel movement at least twice a day. Don't you worry! Just keep up with the good work, breastfeed according to your baby's demand. You should also bring your baby to the Maternal and Child Health Centres or your family doctor as soon as possible so to monitor your baby’s condition more closely.

My baby is 2 to 3 days old already. I still don't have breast fullness, am I producing enough milk? Is formula milk supplement needed?

Colostrum or the first milk is produced and stored in your breasts since your third trimester of pregnancy. It is prepared for the baby to use upon birth. A newborn baby with his tiny stomach capacity; therefore, his intake is small in the first few days. You may not notice when he suckles. Therefore, it is normal if you don't have breast fullness in the first few days. Just continue to breastfeed your baby according to his needs and observe closely on the frequency and colour of the urine and stool. If all are normal, you don't need to supplement with formula milk, water or glucose water. Supplements will reduce the chance of suckling and thus affect your milk production. In fact, most mothers experience breast fullness in the third day onwards. After the breastmilk comes-in, more milk will be produced in response to frequent suckling from the baby. With patience and practice, the skills of both you and your baby will improve, the feeding pattern becomes more regular, and you will again experience breast fullness less.

What can I do if my breasts are engorged?

Your breasts will produce more milk on the third or fourth day after you give birth; this is usually known as “milk come-in”. If your baby is not suckling well, your milk will stay and the milk ducts of your breasts may get stuck. If the situation persists, your breast will engorge and become very painful, which will obstruct the milk flow. With an engorged breast your nipple will also become flattened which makes your baby even harder to suckle effectively. Again without proper suckling and milk removal, your breasts will engorge further and results in a vicious cycle. In order to relieve the breast engorgement after your milk “comes-in", you should establish breastfeeding early. Have skin-to-skin contact with the baby and breastfeed your baby straight after birth, thereafter, breastfeed your baby according to his needs. Let the baby be fed on one breast first, if he is satisfied with one side you do not need to feed him on the other. If the other breast is engorged, apply cold compress to relieve the discomfort.

When your breasts are engorged:

  • Do not wear tight or underwire bras, they will impede your milk flow
  • You can take painkiller regularly. Take it 45 minutes before breastfeeding to allow time for it to work. Paracetamol is the common use of drug for breastfeeding mothers
  • After and in between feeds, apply cold compress on your breasts to relieve pain and swelling. You can apply repeatedly, but remember to avoid contacting your areola with the cold compress
  • You can also apply chilled or room temperature raw green cabbage leaves to your breasts, yet avoid the areola. Dispose the leaves after 20 minutes or when the leaves soften. Before application, you can use a bottle to flatten the cabbage leaves
  • Continue breastfeeding, and ensure your baby is suckling well
  • You can stimulate the milk let-down reflex before breastfeeding to enhance milk flow by:
    • make skin-to-skin contact with your baby
    • gently massage your breasts and avoid strong pressure or
    • use warm compress on the breasts. However, only apply warm compress to your breasts for 2 minutes or less, prolonged application or overheating will scald the skin and increase swelling
  • You can express small amount of breastmilk by hand so as to soften your areola, your baby can grasp more areola easily and suckle well
  • You can try other nursing positions

If the situation does not improve and you still have questions, please consult Maternal and Child Health Centres or other healthcare professional for advice.

If my baby has jaundice, should I continue breastfeeding?

Newborn jaundice is the yellow discoloration in the skin and eyes of newborn babies in the first month. It is caused by increased levels of a pigment called bilirubin in the blood. Most cases of newborn jaundice are physiological where the jaundice will disappear without treatment in 1 to 2 weeks. Bilirubin, after processing in the liver, it will be excreted in the faeces and urine. If your baby is getting enough breastmilk, the laxatives effect of breastmilk, will alleviate newborn jaundice. If your baby have jaundice or requires phototherapy, you should still continue breastfeeding exclusively. Although some breastfed babies may have mild prolonged jaundice, as long as your baby is eating and growing well, the jaundice will gradually subside itself and will not affect your baby’s health. If you have any question, consult healthcare professionals for advice.

You are most welcome to join the breastfeeding support groups organized by the Maternal and Child Health Centres.

If you have any queries on breastfeeding, please contact the medical and nursing staff of Maternal and Child Health Centres or call the Department of Health’s Breastfeeding Hotline: 3618 7450

For more information about breastfeeding, please visit Family Health Service website www.fhs.gov.hk for the booklet ”Love , starts from breastfeeding...”, or call Family Health Service 24-hour Information Hotline 2112 9900.

(Content revised 02/2015)