Breastfeeding: benefits, getting started and common problems

Breast milk gives a baby balanced nutrition, and many mothers need support to get breastfeeding going. This article summarises what the World Health Organization (WHO), the NHS and MedlinePlus say about the recommendations, the benefits, common problems and when to ask for help.

1. Introduction

The WHO recommends starting breastfeeding within an hour of birth and feeding only breast milk for the first six months. After that, breastfeeding should continue up to two years or beyond, together with suitable foods that are added from about six months ^[1]. The WHO reports that about 47% of infants under 6 months were exclusively breastfed between 2018 and 2025, and it has set a target of at least 60% by 2030 ^[1]. The NHS also recommends exclusive breast milk for about the first 6 months (26 weeks), after which breastfeeding can continue alongside solid foods for as long as mother and baby wish ^[2]. MedlinePlus describes breast milk as a balanced mix of nutrients for healthy growth, and says some of its nutrients help protect infants against common childhood illnesses and infections ^[3].

2. Benefits for the baby

The NHS says breastfed babies have fewer infections and fewer hospital visits for them, and a lower risk of diarrhoea and vomiting. It also links breastfeeding with a lower risk of sudden infant death syndrome (SIDS) and of obesity. It adds that any amount of breast milk helps, and that breast milk changes as the baby grows to meet developing needs ^[2]. The WHO says breastfeeding helps prevent pneumonia and diarrhoea, and that breastfed children are less likely to be overweight or obese and perform better on intelligence tests. It estimates that nearly 400,000 deaths in children under 5 could be prevented every year with optimal breastfeeding ^[1].

3. Benefits for the mother

The NHS reports that mothers who breastfeed have a lower risk of breast cancer, ovarian cancer, osteoporosis (thinning of the bones), cardiovascular disease, obesity and diabetes, and that the benefits grow the longer a mother breastfeeds ^[2]. The WHO also says longer breastfeeding lowers the risk of ovarian and breast cancer, and that exclusive breastfeeding in the first 6 months can delay the return of fertility ^[1]. MedlinePlus likewise says certain cancers may occur less often in mothers who have breastfed ^[3].

4. Getting started

Good support in the first days helps. The WHO lists these measures that help mothers breastfeed ^[1]:

• Skin-to-skin contact straight after birth
• Keeping mother and baby together (rooming-in)
• Responsive feeding, which means feeding in response to the baby's cues
• Counselling and community support groups

MedlinePlus lists useful topics to learn about, including colostrum (the baby's first milk), how often and how much to feed, and nursing positions ^[3]. A nurse or lactation consultant can show you how to position and attach your baby.

5. Common problems

MedlinePlus points to guides on common breastfeeding challenges, including low milk supply, mastitis (a breast infection) and nipple skin irritation ^[3]. Many problems have practical answers when help is found early. MedlinePlus advises contacting a lactation consultant if you are having breastfeeding problems ^[3].

6. Medicines, illness and special situations

MedlinePlus says most women with health problems can still breastfeed, and only rare illnesses lead to advice not to. Some medicines, illegal drugs and alcohol can pass into breast milk and may harm the baby ^[3]. MedlinePlus advises checking with a health care provider if you have concerns about whether you should breastfeed, and it links to a drug information database for medicines. The WHO explains that babies of mothers living with HIV who take lifelong antiretroviral therapy can breastfeed with very little risk of passing on HIV ^[1]. It also states that breastfeeding remains the preferred way to feed a baby in almost all difficult situations, including for low-birth-weight or premature babies ^[1]. Always discuss your own situation with your doctor.

7. Feeding from about six months

From about six months, the WHO advises adding safe foods and gradually increasing their consistency and variety, with good hygiene and proper food handling. It suggests 2 to 3 meals a day at 6 to 8 months and 3 to 4 meals a day from 9 to 23 months, with snacks as needed, and more fluids including more frequent breastfeeding during illness. It adds that breast milk still provides half or more of a child's energy needs at 6 to 12 months and about one third at 12 to 24 months ^[1]. Your child's doctor can advise what suits your child.

8. When to see a doctor

Talk to a doctor, nurse or lactation consultant if:

• Feeding is painful, or you cannot get the baby to attach.
• You think your milk supply is low or your baby does not seem to feed well.
• You have a red, hot or painful area on the breast, or feel unwell.
• You take any medicine and wonder whether it is safe while breastfeeding.
• Your baby seems unusually sleepy, has few wet nappies, or is not gaining weight.

A baby who is very sleepy, not feeding, breathing with difficulty or unwell needs urgent care.

In an emergency, call your local emergency number (112 in India, 911 in the United States).

9. Conclusion

The WHO recommends breastfeeding within an hour of birth, only breast milk for six months and continued breastfeeding with other foods to two years or beyond. It benefits both baby and mother. Problems are common, and skilled support helps. Your doctor or lactation consultant can help with your own situation.