By ISMAEL PERDOMO

Physician – Pediatrician | Epidemiologist

The Greatest Gift for a Lifetime

Breastfeeding is the first act of love and nourishment that a mother can offer her child. It is much more than feeding: it is protection, bonding, comfort, and the foundation of lifelong health from the very first moments of life. According to the World Health Organization (WHO), breast milk should be the infant’s only source of nutrition during the first six months of life, without the need for water, formula, or any other food.

A Natural Process… That Still Needs Support

Although breastfeeding is a physiological process, it is not always easy during the first weeks. Many mothers experience uncertainty, pain, or insecurity, especially when they do not receive proper guidance. The most common cause of breastfeeding abandonment is not biological inability, but rather the lack of family, social, and professional support.

Breastfeeding is a learned art that requires practice, patience, and guidance. For this reason, the role of the father, partner, and pediatrician is essential throughout this process.

The Beginning: The Sooner, the Better

The WHO and UNICEF recommend initiating breastfeeding within the first hour of life. This skin-to-skin contact and the first feeding stimulate the release of oxytocin, strengthen mother-child bonding, and promote the production of colostrum — the newborn’s “first natural vaccine,” rich in immunoglobulins, immune cells, and growth factors.

Frequency and Feeding on Demand

Newborns have their own feeding rhythms. In general, they breastfeed every 1.5 to 3 hours, without fixed schedules. Breastfeeding should be “on demand,” meaning whenever the baby requests it and for as long as the baby desires. Some infants feed for 5 minutes, others for 20, and both may receive enough milk if the technique is effective.

Crying is not always a sign of hunger; it may also express a need for comfort, physical contact, or relief from discomfort. It is preferable to offer the breast before the baby begins to cry.

Technique and Positioning: The Key to Success

Proper positioning helps prevent pain, nipple cracks, and frustration. The mother should be comfortable, and the baby should be properly supported, with the body aligned and the abdomen touching the mother’s abdomen (“tummy to tummy”).

The baby should open the mouth wide and latch onto part of the areola, not just the nipple.

During feeding, the baby should remain in a semi-upright position, not lying flat. If clicking sounds are heard during sucking, the latch or technique may be incorrect.

Practical Tip

Begin each feeding with the breast used last during the previous feeding session.

Burping, Air, and Rest

Some babies swallow air while feeding. After each feeding, it is recommended to place the baby over the shoulder and gently massage the back to facilitate burping. If the baby does not burp within two minutes, there is generally no cause for concern and the baby may rest safely.

What About Night Feedings?

Nighttime feedings are extremely important, especially during the first days of life. They stimulate prolactin production, help prevent breast engorgement, and maintain milk supply. Additionally, they promote intimate and comforting contact in a calmer environment.

Maternal Nutrition and Medications

Mothers may follow a varied and balanced diet while breastfeeding. However, alcohol, tobacco, illicit drugs, and certain medications that may pass into breast milk should be avoided. Always consult a pediatrician or healthcare professional before taking any medication or substance during breastfeeding.

Nipple Cracks and Pain

Nipple cracks and pain are common, but they should not be considered normal. They usually indicate that the breastfeeding technique requires correction.

Recommendations for Management
Reduce the duration of each feeding while increasing feeding frequency.
Allow nipples to air dry naturally.
Apply lanolin creams or expressed breast milk to the nipples.
Avoid perfumes, soaps, and scented creams.

Nipple hygiene should be performed using water only.

Breastfeeding: Protection and Prevention

Breast milk protects against multiple diseases and health conditions:

Reduces neonatal mortality by 20% when initiated within the first hour of life.
Decreases the risk of respiratory infections, otitis, diarrhea, and sepsis.
Lowers the risk of childhood obesity and supports neurological development.
Protects mothers against breast and ovarian cancer and strengthens emotional bonding.

“Breastfeeding is the first vaccine, the first food, and the first act of love.” – UNICEF

In Summary
Early initiation: within the first hour of life.
Exclusive breastfeeding until 6 months: no water or additional foods required.
Feeding on demand: without rigid schedules.
Proper technique and positioning are essential.
Avoid medications without medical supervision.
Emotional, family, and professional support are fundamental.
References
World Health Organization (2023). Infant and Young Child Feeding.
UNICEF (2021). Breastfeeding: A Mother’s Gift, for Every Child.
Hale TW. (2023). Medications and Mothers’ Milk. Springer Publishing.
Edmond K, et al. (2006). Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality. Pediatrics, 117(3)–e386.