What are the benefits of breastfeeding?

Breastfeeding provides an infant with essential calories, vitamins, minerals, and other nutrients for optimal growth, health, and development. Breastfeeding is beneficial to both a mother and her infant and also offers an important opportunity for the pair to bond. NICHD supports many areas of breastfeeding research, including studies of the benefits of breastfeeding and breast milk, the social and cultural impacts of breastfeeding, and the nutritional components and mechanisms of disease related to breastfeeding and breast milk.

What are the benefits of breastfeeding?

Research shows that breastfeeding offers many health benefits for infants and mothers, as well as potential economic and environmental benefits for communities.

Breastfeeding provides essential nutrition. Among its other known health benefits are some protection against common childhood infections and better survival during a baby’s first year, including a lower risk of Sudden Infant Death Syndrome.1

Research also shows that very early skin-to-skin contact and suckling may have physical and emotional benefits.2

Other studies suggest that breastfeeding may reduce the risk for certain allergic diseases, asthma, obesity, and type 2 diabetes. It also may help improve an infant’s cognitive development. However, more research is needed to confirm these findings.

What are the recommendations for breastfeeding?

In the United States, the American Academy of Pediatrics (AAP) currently recommends:1

  • Infants should be fed breast milk exclusively for the first 6 months after birth. Exclusive breastfeeding means that the infant does not receive any additional foods (except vitamin D) or fluids unless medically recommended.
  • After the first 6 months and until the infant is 1 year old, the AAP recommends that the mother continue breastfeeding while gradually introducing solid foods into the infant’s diet.
  • After 1 year, breastfeeding can be continued if mutually desired by the mother and her infant.

The World Health Organization currently promotes as a global public health recommendation that:2

  • Infants be exclusively breastfed for the first 6 months after birth to achieve optimal growth, development, and health.
  • After the first 6 months, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond.

For the latest information on COVID-19 and breastfeeding, visit CDC at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html.

According to the Centers for Disease Control and Prevention, the majority of new mothers start out breastfeeding, but only a minority still exclusively breastfeed by the time their infants are 6 months old. Many factors influence successful breastfeeding, including support from health care providers, family and community, and the workplace.3

How do I breastfeed?

There are many mothers’ groups, health organizations, and health care provider associations that provide very detailed information and support on how to breastfeed. The following overview is provided for information only—it is not meant to take the place of a health care provider or lactation consultant’s advice or recommendation. Visit the Resources and Publications section to find the names of some breastfeeding organizations.

Infants who are hungry will nuzzle against their mother’s breast and make sucking motions or will put their hands in their mouths. During the first weeks after birth, you may nurse your infant often, perhaps as often as eight to 12 times in 24 hours.1

After your infant is born, follow these tips for getting started:2

  • Breastfeed your infant for the first time as soon as possible after the infant is born.
  • Ask at the hospital whether an on-site lactation consultant is available to assist you.
  • Request that the hospital staff not feed your infant any other foods or formula unless it is medically necessary.
  • Allow your infant to stay with you throughout the day and night at the hospital so that you can breastfeed often. If this is not possible, ask the nurses to bring your infant to you each time for breastfeeding.
  • Avoid giving your infant pacifiers or artificial nipples so that the infant gets used to latching on to just your breast.

Infants will naturally move their head while looking and feeling for a breast to feed. There are many ways to start feeding your infant, and the best approach is the one that works for you and your infant. The steps below can help with getting your infant to “latch” on to the breast for feeding.2

  • Hold your infant against your bare chest. Dress your infant in only a diaper to ensure skin-to-skin contact.
  • Keep your infant upright, with his or her head directly under your chin.
  • Support your infant’s neck and shoulders with one hand and his or her hips with your other hand. Your infant may try to move around to find your breast.
  • Your infant’s head should be slightly tilted back to make nursing and swallowing easier. When his or her head is tilted back and the mouth is open, the tongue will naturally be down in the mouth to allow the breast to go on top of it.
  • At first, allow your breast to hang naturally. Your infant may open his or her mouth when your nipple is near his or her mouth. You also can gently guide the infant to latch on to your nipple.
  • While your infant is feeding, his or her nostrils may flare to breathe in air. Do not panic—this flaring is normal. Your infant can breathe normally while breastfeeding.
  • As your infant tilts backward, support his or her upper back and shoulders with the palm of your hand and gently pull your infant close.

A good latch is important for both effective breastfeeding and your own comfort. Review the following signs to determine whether your infant has a good latch:2

  • The latch feels comfortable and does not hurt or pinch. How it feels is a more important sign of a good latch than how it looks.
  • Your infant does not need to turn his or her head while feeding. His or her chest is close to your body.
  • You see little or no areola (pronounced uh-REE-uh-luh), which is the dark-colored skin on the breast that surrounds the nipple. Depending on the size of your areola and the size of your infant’s mouth, you may see a small amount of areola. If more areola is showing, it should seem that more is above your infant’s lip and less is below.
  • Your infant’s mouth will be filled with breast when in the best latch position.
  • Your infant’s tongue is cupped under the breast, although you might not see it.
  • You can hear or see your infant swallowing. Because some babies swallow so quietly, the only way of knowing that they are swallowing is when you hear or see a pause in their breathing.
  • Your infant’s ears “wiggle” slightly.
  • Your infant’s lips turn outward, similar to fish lips, not inward. You may not even see your infant’s bottom lip.
  • Your infant’s chin touches your breast.

To break the suction and end a breastfeeding session, insert a clean finger between your breast and your infant’s gums. After you hear a soft pop, pull your nipple out of your infant’s mouth.1

You should allow your infant to set his or her own nursing pattern. Many newborns will feed for 10 to 15 minutes on each breast. If your infant wants to nurse for a much longer period—say 30 minutes or longer on each breast—he or she may not be getting enough.

What is weaning and how do I do it?

Weaning is the process of switching an infant’s diet from breast milk or formula to other foods and fluids. In most cases, choosing when to wean is a personal decision. It might be influenced by a return to work, the mother’s or infant’s health, or just a feeling that the time is right.1

Weaning an infant is a gradual process. The American Academy of Pediatrics (AAP) recommends feeding infants only breast milk for the first 6 months after birth. After 6 months, the AAP recommends a combination of solid foods and breast milk until the infant is at least 1 year old.2 The Academy advises against giving cow’s milk to children younger than 1 year old.3

You may have difficulty determining how much to feed your child and when to start introducing solid foods. The general guidance below, as reported by the National Library of Medicine, demonstrates the process of weaning for infants up to 6 months of age.4 You should speak with your infant’s health care provider before attempting to wean your infant to make sure that he or she is ready for weaning and for complete guidance on weaning.

  • Birth to 4 months of age
    • During the first 4 to 6 months, infants need only breast milk or formula to meet their nutritional needs.
      • If breastfeeding, a newborn may need to nurse eight to 12 times per day. By 4 months of age, an infant may need to nurse only four to six times per day.
      • By comparison, formula-fed infants may need to be fed about six to eight times per day, with newborns consuming about 2 to 3 ounces per feeding. The number of feedings will decrease as the infant gets older, similar to breastfeeding.
  • 4 to 6 months of age
    • At 4 to 6 months of age, an infant needs to consume 28 to 45 ounces of breast milk or formula per day and often is ready to start being introduced to solid food.
    • Starting solid foods too soon can be hazardous, so an infant should not be fed solid food until he or she is physically ready.
    • Start solid feedings (1 or 2 tablespoons) of iron-fortified infant rice cereal mixed with breast milk or formula, stirred to a thin consistency.
    • Once the infant is eating rice cereal regularly, you may introduce other iron-fortified instant cereals.
    • Only introduce one new cereal per week so that intolerance or possible allergies can be monitored.

When breastfeeding, how many calories should moms and babies consume?

Many new mothers wonder if they need to consume more calories (also called energy) during breastfeeding, but the answer is no. You can take in the same number of calories that you did before becoming pregnant. This strategy helps with weight loss after birth.1

The Dietary Guidelines for Americans (DGAs) for caloric intake for all women 19 to 50 years old are based on activity level, as follows:2

  • Sedentary: 1,800 to 2,000 calories per day
  • Moderately active: 2,000 to 2,200 calories per day
  • Active: 2,200 to 2,400 calories per day

The increased caloric need for women who are breastfeeding is about 450 to 500 calories per day.3 Women who are not trying to lose weight following pregnancy should supplement the above DGA calories per day by 450 to 500 calories. Often an increase in a normally balanced and varied diet is enough to meet your body’s needs. Whether or not to increase caloric intake during breastfeeding is a decision that should be made with the assistance of a health care provider.

Poorly nourished mothers, those on vegan diets or other special diets, and those with certain health conditions may require a supplement of docosahexaenoic acid (DHA) in addition to multivitamins to ensure complete nutrition for breastfeeding.4

Women who are breastfeeding may have additional requirements for vitamins and minerals. Learn more about your specific nutritional needs during breastfeeding at ChooseMyPlate.gov.

Women also can use the U.S. Department of Agriculture’s (USDA’s) My Plate Daily Checklist for Moms to develop a personalized food plan based on their activity level, amount of breastfeeding, age, and other characteristics.

The estimated energy requirements (in calories per day) for infants are based on their age, size, and sex. Estimated energy requirements developed by the USDA are as follows:5

Males

  • 1 to 3 months: 472 to 572 calories per day
  • 4 to 6 months: 548 to 645 calories per day
  • 7 to 9 months: 668 to 746 calories per day
  • 10 to 12 months: 793 to 844 calories per day

Females

  • 1 to 3 months: 438 to 521 calories per day
  • 4 to 6 months: 508 to 593 calories per day
  • 7 to 9 months: 608 to 678 calories per day
  • 10 to 12 months: 717 to 768 calories per day

 

The above daily calorie ranges are for infants of a specific weight and length. The USDA has information on how to find out the daily calorie needs of your infant based on his or her size (PDF – 237 KB).

The USDA also has determined the daily protein, carbohydrate, and fat requirements for infants (PDF – 237 KB).

Are there any special conditions or situations in which I should not breastfeed?

In special cases, women may be advised not to breastfeed. These instances include when a woman is taking certain medications or drugs, when she has been diagnosed with a specific illness, or when other specific conditions apply.

For the latest information on COVID-19 and breastfeeding, visit CDC at https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html.

Certain medications are known to be dangerous to infants and can be passed to your infant in your breast milk. Women taking the following medicines should speak with their health care providers before considering breastfeeding:

  • Antiretroviral medications (for HIV/AIDS treatment)1
  • Birth-control medications containing estrogen, until breastfeeding has been well established2
  • Cancer chemotherapy agents1
  • Illegal drugs1
  • Certain medications prescribed to treat migraines, such as ergot alkaloids3
  • Mood stabilizers, such as lithium and lamotrigine4
  • Sleep-aid medicines5

In addition, women who are undergoing radiation therapy should not breastfeed, although some therapies may require only a brief interruption of breastfeeding.1

The above list of medications and other drugs is only a guideline. Before breastfeeding, you should speak with your health care provider about all medications that you are taking.5 These include prescribed medications, over-the-counter medicines, vitamins, and herbal therapies.

Medications that are safe during pregnancy may also be safe for you to continue while you are breastfeeding, although you should check with your health care provider to make sure they are safe before you breastfeed.5

Contact your infant’s health care provider if you see any signs of a reaction to your breast milk in your infant, such as diarrhea, excessive crying, or sleepiness.5

Women with certain illnesses and infections may be advised not to breastfeed because of the danger of passing the illness or infection to the breastfed infant.

If you have any of the following conditions, breastfeeding your infant is NOT advised. For more information, speak with your health care provider:1

  • Infection with HIV
  • Infection with human T-cell lymphotropic virus type I or type II
  • Untreated, active tuberculosis

If you are sick with the flu, including the H1N1 flu (also called the swine flu), you should not stop feeding your infant expressed milk. You should avoid being near your infant, however, so that you do not infect him or her. To avoid infecting your infant, someone who is not sick should give your infant your expressed milk.6

For more information on the flu, including the H1N1 flu, visit the following Centers for Disease Control and Prevention (CDC) webpage: http://www.cdc.gov/flu/.

If you have Zika virus or live in areas where Zika virus is found, the CDC recommends you continue to breastfeed your infant. Although Zika virus has been detected in breast milk, there are no reports of transmission of the virus through breastfeeding, and the benefits of breastfeeding are thought to outweigh the risks.7NICHD is partnering with other NIH Institutes and the Brazilian research organization Fundação Oswaldo Cruz (Fiocruz) to study Zika virus transmission in 10,000 pregnant women and their infants. If possible, breast milk will be collected from the mothers. For more information on breastfeeding and Zika virus, visit the CDC’s page on Zika virus transmission and its Q&A for health care providers.

In the United States, the American Academy of Pediatrics and the CDC recommend against breastfeeding if you are HIV positive; the same advice applies in other developed countries.1,8 Without any specific interventions to reduce transmission, infants breastfed by HIV-positive mothers have an increased chance of acquiring HIV through the breast milk. This rate increases if infants are breastfed longer and for mothers with newly-acquired HIV.9

Only HIV-positive mothers living in developing countries should consider breastfeeding their babies, especially if a safe and reliable source of infant formula is unavailable.9 This is because breast milk may protect against malnutrition and diarrhea, which are major causes of infant mortality in some areas of the developing world. If an HIV-positive woman decides to breastfeed her baby, research indicates that the risk of transmitting HIV to her baby is reduced if she exclusively breastfeeds (does not use a combination of formula and breast milk) and if she and her infant take antiretroviral drugs.10,11

In some additional situations, or if women or infants have certain health conditions, women may be advised not to breastfeed or may have difficulty breastfeeding.

  • Women with certain chronic illnesses may be advised not to breastfeed, or will be advised to take steps to ensure their own health while breastfeeding. For example, women who have diabetes should monitor their blood sugar levels regularly, may need to reduce their insulin, and may need a snack containing carbohydrates before or during breastfeeding.12 Also, women who are underweight, including those with thyroid conditions or certain bowel diseases, may need to increase their calories to maintain their own health during breastfeeding.
  • Women who have had breast surgery in the past may face some difficulties with breastfeeding.13
  • Women who actively use drugs or do not control their alcohol intake, or who have a history of these situations, also may be advised not to breastfeed.14
  • Infants who have galactosemia—a rare metabolic disorder in which the body cannot digest the sugar galactose—should not be breastfed. Galactosemia is detected by newborn screening, allowing proper treatment and diet to begin immediately. If not detected, the galactose builds up and becomes toxic for the infant, leading to liver problems, intellectual and developmental disabilities, and shock.5

 

  1. National Institute on Drug Abuse. (2015). Substance use while pregnant and breastfeeding. Retrieved January 29, 2016, from http://www.drugabuse.gov/publications/research-reports/substance-use-in-women/substance-use-while-pregnant-breastfeedingCenters for Disease Control and Prevention (CDC). (2015). Breastfeeding: Diseases and conditions. Retrieved March 21, 2016, from http://www.cdc.gov/breastfeeding/disease/index.htm
  2. American College of Obstetricians and Gynecologists. (2016). Breastfeeding your baby. Retrieved June 1, 2016, from http://www.acog.org/Patients/FAQs/Breastfeeding-Your-Baby
  3. Tepper, D. (2015). Pregnancy and lactation—migraine management. Headache: The Journal of Head and Face Pain, 55, 607–608. Retrieved January 28, 2016, from https://americanheadachesociety.org/wp-content/uploads/2018/05/Pregnancy_and_Lactation_Toolbox.pdf (PDF 209 KB)
  4. Massachusetts General Hospital Center for Women’s Mental Health. (2015). Breastfeeding & psychiatric medications. Retrieved January 29, 2016, from http://www.womensmentalhealth.org/specialty-clinics/breastfeeding-and-psychiatric-medication/
  5. March of Dimes. (2016). Keeping breast milk safe and healthy. Retrieved June 2, 2016, from http://www.marchofdimes.org/baby/keeping-breast-milk-safe-and-healthy.aspx
  6. CDC. (2009, October 23). 2009 H1N1 (swine flu) and feeding your baby: What parents should know. Retrieved April 27, 2012, from http://www.cdc.gov/h1n1flu/infantfeeding.htm
  7. Dupont-Rouzeyrol, M., Biron, A., O’Connor, O., Huguon, E., & Descloux, E. (2016). Infectious Zika viral particles in breastmilk. Lancet, 387(10023), 1051.
  8. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved March 11, 2016 from http://pediatrics.aappublications.org/content/129/3/e827
  9. World Health Organization (WHO). (2008). HIV transmission through breastfeeding: A review of the available evidence. Retrieved March 11, 2016, from http://whqlibdoc.who.int/publications/2008/9789241596596_eng.pdf (PDF – 835 KB)
  10. WHO. (2010). Guidelines on HIV and infant feeding. Retrieved March 11, 2016, from http://whqlibdoc.who.int/publications/2010/9789241599535_eng.pdf (PDF 1.58 MB)
  11. Coovadia, H. M., Rollins, N. C., Bland, R. M., Little, K., Coutsoudis, A., Bennish, M. L., & Newell, M.-L. (2007). Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: An intervention cohort study. Lancet, 369(9567), 1107–1116. Retrieved March 11, 2016, from http://www.thelancet.com/journals/lancet/article/PIIS0140673607602839/fulltext
  12. American Diabetes Association. (2007). Nutrition recommendations and interventions for diabetes. A position statement of the American Diabetes Association. Diabetes Care, 30(Suppl 1), S48–S65. Retrieved January 29, 2016, from http://care.diabetesjournals.org/content/30/suppl_1/S48.full
  13. BFAR. (2009). General frequently asked questions (FAQ) about breastfeeding after breast and nipple surgeries. Retrieved January 29, 2016, from http://www.bfar.org/faq.shtml
  14. U.S. Department of Health and Human Services Office on Women’s Health. (2014).Your guide to breastfeeding. Retrieved June 1, 2016, from http://www.womenshealth.gov/publications/our-publications/breastfeeding-guide/ (PDF 2.2 MB)
  15. U.S. Department of Agriculture (USDA) & U.S. Department of Health and Human Services. (2015). 2015–2020 Dietary Guidelines for Americans (8th ed.). Retrieved January 28, 2016, from https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/appendix-2/#table-a2-1
  16. American College of Obstetricians and Gynecologists. (2016). Breastfeeding your baby. Retrieved June 1, 2016, from http://www.acog.org/Patients/FAQs/Breastfeeding-Your-Baby
  17. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827
  18. USDA. (2009). Nutritional needs for infants. In Infant Nutrition and Feeding: A Guide for Use in the WIC and FSF Programs (11–40). Retrieved October 13, 2016, from https://wicworks.fns.usda.gov/wicworks//Topics/FG/CompleteIFG.pdf (PDF 3.4 MB)
  19. KidsHealth from Nemours. (2014). Weaning your child. Retrieved June 27, 2016, from http://kidshealth.org/en/parents/weaning.html
  20. American Academy of Pediatrics (AAP). (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827
  21. AAP. (2015). Ages & stages: Why formula instead of cow’s milk? Retrieved January 28, 2016, from http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Formula-Instead-of-Cows-Milk.aspx
  22. MedlinePlus. (2016). Feeding patterns and diet—babies and infants. Retrieved June 1, 2016, from https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000712.htm
  23. American College of Obstetricians and Gynecologists. (2016, March). Breastfeeding your baby. Retrieved June 1, 2016, from http://www.acog.org/Patients/FAQs/Breastfeeding-Your-Baby
  24. U.S. Department of Health and Human Services Office on Women’s Health. (2010, August). Breastfeeding: Learning to breastfeed. Retrieved January 28, 2016, from http://www.womenshealth.gov/breastfeeding/learning-to-breastfeed.html
  25. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827
  26. World Health Organization. (2001). The World Health Organization’s infant feeding recommendation. Retrieved January 28, 2016, from http://www.who.int/nutrition/topics/infantfeeding_recommendation/en/index.html
  27. Centers for Disease Control and Prevention. (2017). U.S. Breastfeeding Rates Are Up! More Work Is Needed. Retrieved March 2, 2018, from https://www.cdc.gov/breastfeeding/resources/us-breastfeeding-rates.html
  28. American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. Retrieved April 27, 2012, from https://pediatrics.aappublications.org/content/129/3/e827
  29. Feldman-Winter, L., & Goldsmith, J. P.; Committee on Fetus and Newborn, Task Force on Sudden Infant Death Syndrome. (2016). Safe sleep and skin-to-skin care in the neonatal period for healthy term newborns. Pediatrics, 138(3), e20161889. Retrieved December 20, 2016, from http://pediatrics.aappublications.org/content/early/2016/08/18/peds.2016-1889