Breastfeeding

**Breastfeeding**, or **nursing**, is the process by which human breast milk is fed to an infant. Human breast milk may be fed to infants directly from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of life. The baby should be given the opportunity to breastfeed as early as possible within the first hour of life, termed the Golden Hour, and breastfeeding should occur at least 8-12 times per day, or more frequently as desired by the infant. Feedings may last as long as 30–45 minutes each as milk supply develops and the infant learns the Suck-Swallow-Breathe pattern. However, as milk supply increases and the infant becomes more efficient at feeding, duration of feeds may shorten. Older children may feed less often. Mothers should hand express or pump breastmilk when breastfeeding is not possible for many reasons, including emptying the breasts to prevent plugged milk ducts and breast infection, maintaining milk supply, resolving engorgement and so milk can be fed to infant at a later time.

Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D, are typically given. After the introduction of foods at six months of age, recommendations include continued breastfeeding until one to two years of age or more. Globally, about 38% of infants are exclusively breastfed during their first six months of life. In the United States in 2015, 83% of women begin breastfeeding, but at 6 months only 58% were still breastfeeding with 25% exclusively breastfeeding. Medical conditions that do not allow breastfeeding are rare. Mothers who take certain recreational drugs should not breastfeed, however in general, reasons to "pump-and-dump" are rare. Most medications are compatible with breastfeeding. In 2020, WHO and UNICEF announced that women should continue to breastfeed during the COVID-19 pandemic even if they have confirmed or suspected COVID-19 because current evidence indicates that it is unlikely that COVID-19 can be transmitted through breast milk. Smoking tobacco and consuming limited amounts of alcohol and/or coffee are not reasons to avoid breastfeeding.

Breastfeeding has a number of benefits to both mother and baby, which infant formula lacks. Increased breastfeeding to near-universal levels in low and medium income countries could prevent approximately 820,000 deaths of children under the age of five annually. Breastfeeding decreases the risk of respiratory tract infections, ear infections, and diarrhea for the baby, both in developing and developed countries. Breastfeeding also decreases the risk of Sudden Infant Death Syndrome (SIDS) compared to formula-fed infants. Other benefits have been proposed to include lower risks of asthma, food allergies, and diabetes, although more recent results from meta-analyses did not find significant effects. Breastfeeding may also improve cognitive development and decrease the risk of obesity in adulthood. Mothers may feel pressure to breastfeed, but in the developed world children generally grow up normally when bottle fed with formula.

Benefits for the mother include less blood loss following delivery, better contraction of the uterus, and decreased postpartum depression. Breastfeeding delays the return of menstruation, and in very specific circumstances, fertility, a phenomenon known as lactational amenorrhea. Mothers who hope to use lactational amenorrhea as birth control should consult with a healthcare provider. Long-term benefits for the mother include decreased risk of breast cancer, cardiovascular disease, diabetes, metabolic syndrome, and rheumatoid arthritis. Breastfeeding is also less expensive than infant formula.