See also The Fourth Trimester and Your Baby Week By Week for more information on breastfeeding in the first three months

Breastfeeding

Human infants are breastfed until natural weaning occurs. This is sometimes called full-term or natural-term breastfeeding. We endorse the World Health Guidelines which state:

“WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life – meaning no other foods or liquids are provided, including water.

Infants should be breastfed on demand – that is as often as the child wants, day and night. No bottles, teats or pacifiers should be used.

From the age of 6 months, children should begin eating safe and adequate complementary foods while continuing to breastfeed for up to 2 years and beyond.”

— https://www.who.int/health-topics/breastfeeding

When direct breastfeeding is not possible, babies should be fed their own mothers expressed breastmilk and/or donor breastmilk. The use of infant formula is considered a last resort. We do not permit any form of brand promotion of infant formula or products used with breastmilk substitutes in accordance with the The International Code of Marketing of Breastmilk Substitutes, informally known as The WHO Code

We support Informal Milk Sharing through online communities including Human Milk For Human Babies and Eats On Feets. We encourage and support the establishment of human milk banking making human milk available to all babies unable to be fully fed their Mothers Own Milk

We support antenatal expression of colostrum and the use of this in the postnatal period in circumstances where babies need supplementation.

We support relactation and induced lactation. We consider the terminology “breast”, “breastmilk” and “breastfeeding” to be biologically accurate at a population level but respect the right of individuals to use terminology like “chestfeeding”.

We recognise the Australian Infant Feeding Guidelines Information for health workers

“In Australia, it is recommended that infants be exclusively breastfed until around 6 months of age when solid foods are introduced. It is further recommended that breastfeeding be continued until 12 months of age
and beyond, for as long as the mother and child desire. ”

— https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n56b_infant_feeding_summary_130808.pdf

We respect child-led weaning from the breast as optimal but recognise that circumstance may led to mother-led weaning after two years.

We do not support night weaning or adult-modification of infant sleep patterns and recognise the normality and benefit of nighttime breastfeeding throughout the early years of life.

While we recognise that the majority of mothers in Australia initiate breastfeeding but only a minority achieve 6 months of exclusive breastfeeding due to circumstances beyond their control, this is not a community for those who choose not to breastfeed for non-medical reasons. This is not a formula feeding support forum. Questions around choosing and using infant formula are not permitted. We choose to describe the risks of infant formula and/or lack of breastfeeding, which may cause distress.

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Breastfeeding In Public Swimming Pools

Australian mothers are protected by anti-discrimination laws and it is prohibited to tell them to cease breastfeeding, move away to private spaces or cover up when breastfeeding in public places. Both State and Federal laws recognise the right to breastfeed anywhere a mother and child may legally be receiving goods and services.

However, some people are under the misunderstanding that these laws do not apply in the case of swimming pools. So lets sort the facts from the fiction.

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Midwives Matter

In Australia, mothers are supported by midwives during labour, birth and the postnatal period. Many women are also in the care of midwives during pregnancy. While we take this arrangement for granted, in countries like the US, midwives are not on staff in hospitals and mothers may not experience this traditional care model.

Midwifery is probably the oldest professional role of women and one which has existed since prehistory. Humans are one of just a couple of species who birth with support (along with bonobos and elephants) and the only species who actively participate in delivering the babies of another woman. Evolution has not been kind to the human female, with the large brain needed for our intelligence not having a correspondingly larger birth canal! The birth process can be long and arduous, with the most critical stage occurring when the mother is most spent. Midwives support and encourage the mother and guide the newborn into the world.

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Every mother is a breastfeeding mother.

In Australia, very few babies are not put to the breast at all. Initiation rates are among the highest in the world, especially compared to countries like the US and UK, who we tend to think of as similar to us. However, the drop-off rate beyond those first attempts is dramatic. Within weeks, a significant number of babies are partly or fully formula fed. In some cases, this is by choice. In the majority, though, it is due to breastfeeding challenges.

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What is breastfeeding support anyway?

It is almost universal for mothers to state a wish for more support during their season of breastfeeding.

From the very early days as they struggle to latch their newborn infant to the final days as they wean their child, support is cited as vital. Yet many are lost when asked to describe the support they crave.

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I asked the right questions … but I asked the wrong people!

These are the words of a mother breastfeeding her second baby, reflecting on her experience of not being supported to do so with her first. 

She’d thought she was well-prepared and in good hands. She trusted the advice she was given about breastfeeding - and when she was told it wouldn't work out. It was only as she prepared for the arrival of her second baby that she discovered how much inaccurate information she had received first time around.

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Frozen Assets: The secret life of expressed breastmilk

Your breasts are capable of producing enough milk for your baby - or babies! Twins, triplets and even quads can be exclusively breastfed. (Perhaps even more but there are only so many hours in a day!)

So why do most women struggle to pump extra milk on a regular basis to donate or store in their freezer?

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We don't talk about not wanting to Breastfeed

Some people are unable to establish or maintain breastfeeding because they don't have the capacity to overcome challenges. It might be due to existing mental health issues, lack of social support, relationship problems, financial barriers or lack of motivation. These mothers might describe themselves as not being able to breastfeed, however this is not really accurate. The problems they experienced could be resolved and are overcome all the time. But these individuals were not in a position to do so.

Not everyone wants to breastfeed. Some have life experiences which mean breastfeeding isn't a good choice for them. Some just don't like the idea. They could breastfeed but they choose not to.

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Paced Bottle Feeding.

Responsive feeding is about allowing the baby to take milk from a bottle more slowly, at a pace which is baby-led, not adult driven. Feeding can take twice as long and is closer to the time a baby would feed at the breast.

If you have chosen to use a bottle to give supplementary or replacement feeds, remember that feeding is an important time for babies to interact with their caregivers. Hold the baby and engage with them before, during and after giving a feed.

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Wondering About Wonder Weeks?

All new parents know there are times when babies are extra unsettled due to development. When parents come together to talk, they find their babies go through these stages at similar ages. “It’s just a phase” is commonly said to reassure them, by experienced mothers, doctors and nurses.

Modern parents have come to know these stages by another name: Wonder Weeks.

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Four Month Monsters

After the unpredictability of the first weeks of a baby’s life, three months is a time when things begin to settle into a more predictable pattern: the circadian rhythm is beginning to develop, your baby is awake and interacting more and sleeping more predictably and life as parents begins to look less chaotic.

It seems cruel that soon after entering this settled period, one of the most challenging periods of an infant’s development kicks in and you feel thrown in the deep end once more.

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Formula is not the same as breastfeeding: in the second year

It can be confronting for parents to be told the differences between #breastfeeding and bottle feeding. Because of the emotional impact of not overcoming challenges to establish or maintain breastfeeding, parents are reassured that f e d I s b e s t and formula feeding is pretty much the same anyway.

Formula feeds babies who do not have access to human milk. Cow or goat milk or soy milk can be modified to make it safer for babies but we do need to acknowledge it cannot make it the same.

The differences really become apparent as babies reach the end of the first year. And sometimes the facts around this can trigger the emotions of the months before all over again. However, information is not judgement and parents can only make informed choices when they have all the facts.

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Breastfeeding to sleep is normal!

Babies fall asleep at the breast. This is not a bad habit, it is part of the package! Breastmilk contains natural sleep-inducing hormones for just This reason!

All that putting baby down "drowsy but awake" has no evidence to support it. Trying to make it happen generally ends up with a cranky baby who would have settled into a nice, deep sleep but is now in a state of distress instead.

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Breastsleeping matters

#breastsleeping is the term coined by Dr James McKenna to describe the biologically-normal practice of breastfed babies sleeping close to their mother during the night attached to or within reach of the breast.

Expectations of infants and breasts to pause for long periods of time overnight make no sense. Babies grow 24/7 and they refuel 24/7. Bressts make milk 24/7.

Removal of milk from the breast stimulates production. Mothers in the light sleep stage of sleep may wake slightly in response to fuller breasts. Babies in light sleep stages might wake slightly seek the breast. Without either fully waking, they make small movements to bring breast and baby together and settle back into a sleepy state. The baby removes milk from the breast and prolactin is released into the bloodstream. This stimulates milk production and the breasts begin to refill.

Mother and baby slip back into sleep, leaving the breasts to do their work. When the cycle starts over, the milk is ready and waiting.

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Breastfeeding isn't all or nothing.

#breastfeeding isn't all or nothing. Exclusive breastfeeding for the first six months is the global guideline but if your journey looks a bit different you can be confident that the effort of providing any breastmilk to your baby is worth it.

Because of the way birth and the postnatal period is managed in our modern world, breastfeeding initiation is sometimes not well-supported by the health care system (public and private) and formula top-ups are prescribed. This might be temporary or an ongoing part of feeding a baby and can range from once a day to every feed. Formula can even become the primary food source for many babies. However introducing formula doesn't have to mean ending breastfeeding. If your baby is still going to the breast, you can continue to offer it. The immune support and bonding continues to be important even if nutrition is not fully met at the breast.

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Bottle caries

The term "nursing caries" was coined by dentists in the 20th century to describe the type of tooth decay they were seeing in toddlers. Unfortunately, their terminology was flawed as Nursing has long been used to describe breastfeeding and the percentage of toddlers still at the breast was negligible in most western societies where the condition was being observed.

Older babies and toddlers who have developed their upper front teeth are at particular risk of decay, caused by milk pooling behind the teeth while sleeping. This is a functional problem created by children falling asleep with a bottle and continuing to hold it in the mouth while sleeping. The design of teats allows a steady drip to be released because of gravity, even when the child is not actively sucking.

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The Piggy Bank Method of Expressing

If you express your breastmilk in the early days after your milk comes in, you will probably get more than your baby needs for a feed – indeed, you might feel you have enough milk for all the babies in the world! You head home confident that expressing is quick and easy and start to plan for the extra freezer you will buy to store all that expressed breast milk in.

So its really disappointing when you try expressing for the first time after the early postnatal period and only get a few mls for your effort. If you are expressing to have a supply of milk for your return to work or a special occasion away from your baby, you will probably start to panic and worry that you need a different (better) breast pump or you have a poor milk supply.

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Responsive Feeding

Back in the day, we had to stress to the midwives in hospital that we wanted to Demand Feed. Otherwise they would presume our babies were on a feeding schedule: 3 hourly feeds until a certain weight, then 4 hourly feeds.

Demand in this context was later reframed as Feeding According to Need. Demand came with some negative connotations and also put too much responsibility onto babies who might be too sleepy to demand very much at all!

Later again we talked about Cue-based Feeding which is now also referred to as Responsive Feeding. Which is what was being talked about all along, it just took several decades to get the language right!

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I’m an individual

Once more for those up the back: nobody is awarding points to the biggest baby! The whole point of a growth chart is to show the range which children at any given age may measure. Height, weight and head circumference are the common measurements.

You can anticipate what a baby aged X months might weigh if they are a particular height but there are lots of reasons why they might not hit that mark on a particular day or even week. Even siblings can be significantly different in how they grow. Detailed studies tracking individual weight gain daily show it is typical for growth to occur in fits and starts.

It is the individual curve over time which matters most, not where a child's curve sits compared to others.

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I am not in a competition

Growth charts are not a league table.

Growth is not a competition. We are all born with a blueprint based on your family genetics.

Some people are born to be tall and lean. Others are destined to be short and stocky. People from parts of the world have generations of typical body types which travel with them through genetics when they migrate.

Plotting the individual changes in infants at different stages is not about comparing their progress against others. Your child is being tracked against themselves and it is their point on their growth curve which matters. If your baby has been tracking along nicely on the 25th percentile for height, you know that 75% of children their age are taller. And the same applies with weight.

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