DEAR DOCTOR K: What are the benefits of breast-feeding? And if I do decide to breast-feed, how will I know if my baby is getting enough milk?
DEAR READER: Breast milk provides all the calories and nutrients that a baby needs for the first six months of life. It also helps protect babies from illnesses such as ear infections, lung infections, vomiting and diarrhea. That's because for the first months of life, a baby's immune system is not fully developed. Breast milk contains antibodies that the mother has made, plus several other infection-fighting substances and cells.
There is some evidence that breast milk may also help protect against sudden infant death syndrome, although why that might be so is not clear.
Babies of mothers who breast-feed are somewhat less likely to develop obesity, cancer, heart disease and Type 1 diabetes when they become adults.
Please don't misunderstand: I'm not saying that babies who bottle-feed will get these diseases, just that breast-feeding may slightly reduce the risk that babies will develop these diseases when they become adults.
Breast milk is easier for babies to digest than formula. Exclusively breast-feeding for the first six months may help prevent food allergies. Breast-feeding also may help with brain development and learning.
There are also practical advantages to breast-feeding. It's convenient, costs less than formula and does not need to be prepared.
That being said, some women choose not to breast-feed for medical or personal reasons. Infant formula does contain all the nutrients a baby needs for normal growth. Millions of perfectly healthy babies have been raised on bottled infant formula.
If you do decide to breast-feed, it can be hard to judge how much milk your baby takes in at each feeding. But there are several signs that your baby is getting enough milk:
— Wet diapers. Your baby should have at least one to two wet diapers for the first two days. After that, your baby should have four to six wet diapers per day.
— Stools. During the first week, your baby should have two or more stools per day. After that, the number of stools should increase to four or more per day.
— Milk supply. Two to four days after delivery, your milk should "come in." Your breasts will feel larger, firmer and warmer as they fill with milk before each feeding. They'll get smaller and softer after your baby has nursed.
— Feedings. Your baby should feed at least eight times every 24 hours. Most newborns nurse every one and a half to three hours. After feeding, your baby should seem satisfied and will probably fall asleep.
— Weight. After the first week of life, your newborn should steadily gain weight.
If one or more of these signs indicate that your baby might not be getting enough milk, talk to your pediatrician.
Dr. Anthony L. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.