Breastfeeding

(Content revised 02/2025)

Breastmilk is the 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 is the ideal source of nutrients for the baby's growth and development
  • The enzymes in breastmilk help the digestion and absorption of nutrients
  • Breastmilk contains natural antibodies and living immune cells, which help to enhance the baby's immunity and reduce the risk of infection
  • Breastfeeding enhances bonding between mother and baby, makes the baby feel safe and promotes baby's brain development
  • Breastfeeding is convenient and environmentally friendly. It saves time and money

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

  • Responsive feeding

    Breastfeeding responsive to baby's early hunger cues

  • 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 timely

    If you have concerns with breastfeeding, seek help from health professionals as soon as possible

To Mum and Dad of Breastfed Babies:

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

Healthy full term Babies:

  • Feeding:
    • Feed according to baby's needs. Breastfeed at least 3-4 times on the first day
    • From second day onwards, feed baby when early feeding cues are observed. Baby usually needs at least 8-12 feeds a day. No need to restrict feeding frequency
    • 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 (equivalent to around 3 tablespoons or 45ml of water in a dry nappy) with clear or light yellowish urine after the 5th day
  • Soiled nappies：
    • Pass dark green meconium on the first day
    • Change from passing meconium to yellowish stool from the 3rd and 4th day
    • Texture changes from loose or pasty to seedy gradually
    • Pass substantial amount of yellowish stool at least 2 times per day 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
  • Mums:
    • 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)

You should arrange an early appointment with a nearby Maternal and Child Health Centre to follow up baby's feeding and body weight after birth. If you have any problems in breastfeeding, 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 small. Hence, small amount of colostrum produced is enough for your baby. Exclusive breastfeeding will act as if forming a protective film in his intestine to protect the body from bacteria. Unnecessarily supplementing with formula milk or water will, on the contrary, reduce the intestinal protection and thus, increase the risk of infection. The thick colostrum also aids the baby to learn and coordinate his suckling, swallowing and breathing techniques. 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 peadiatrician 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 second 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. If you are in doubt, please seek advice from health professionals or contact nearby Maternal and Child Health Centre.

What can I do if my breasts are engorged?

Your breasts will produce more milk on the third 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. 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 do it repeatedly
  • 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. Expose your baby's chest and bring him close to your breast
    • gently massage your breasts and avoid strong pressure or
    • use warm compress on the breasts. Apply less than 3 minutes because 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?

Jaundice of some breastfed babies may persist longer and usually subside within 2 to 3 months. This is termed "breastmilk jaundice", which is mild and does not harm the baby.

However, there are other sinister causes for prolonged jaundice, like the rare but severe congenital bile duct obstruction. It will dreadfully impair the baby's liver if not treated early. Therefore, your jaundiced baby needs to undergo check-up and blood tests.

On the contrary, if only formula milk is used to bring down bilirubin levels, important medical conditions cannot be ruled out. If the tests return to be normal, you can be assured and continue breastfeeding your baby to provide the optimum nutrition and protection.

You are most welcome to join the Department of Health's breastfeeding peer support programme or the peer support groups in the community.

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...".