Breastfeeding is undoubtedly a natural experience, yet it often turns out to be anything but straightforward, even for highly motivated mothers. Not because there are real obstacles to breastfeeding — the vast majority of new mothers are able to carry it through — but because the physiology of breastfeeding and the mistakes to avoid are not always well understood. Setting aside each mother's perfectly legitimate personal choices, here are the most important things to know about breastfeeding.

The benefits of breastfeeding

Breast milk is the "ideal" food for newborns and young infants. Its composition is not only species-specific (characteristic of the human species and adapted to the particular needs of human young), but unique to each mother-child pair. It changes over time, adapting to the nutritional needs of the infant, and also provides antibodies. Breastfeeding, among other things, limits the incidence and duration of gastroenteritis in newborns, protects against respiratory infections and reduces the risk of developing allergies, while also lowering the mother's risk of developing certain forms of cancer (source: Ministero della Salute). Breast milk is furthermore always available and ready, sterile and at the right temperature, as well as being completely free and environmentally friendly: zero packaging, zero waste, zero environmental impact in terms of storage, transport, waste and production.

Breastfeeding: practical tips

Mothers who wish to breastfeed can follow a number of guidelines to ensure their experience gets off to the best possible start and continues smoothly. First and foremost, the infant should be allowed to feed for as long as they wish, even if they fall asleep, and without worrying about having to alternate between both breasts every time. The composition of breast milk changes throughout a feed, providing a varying supply of essential nutrients for the baby over time (sugars, proteins, lipids, etc.). It is therefore important that feeds last long enough to allow the baby to receive the different "types of milk", so that their meal is complete and balanced. Feeding on demand is also the recommended approach for successful breastfeeding: breast milk should ideally be offered without any fixed meal schedule or predetermined gap between feeds. Especially in the first few months, or during so-called "growth spurts", it is normal for a newborn to ask for the breast very frequently, or in a completely irregular pattern: this does not mean the milk supply is insufficient, or that the baby needs to be supplemented with formula. Nor are there any digestibility issues with breast milk, even when feeds are long and frequent. Feeding "by the clock", on the other hand, risks compromising milk production, which is based on a precise supply-and-demand mechanism.

Is the newborn eating enough?

Ensuring the baby is adequately fed is one of the main concerns for mothers who opt for breastfeeding. Since they cannot measure the amount of milk taken at each feed (and cannot even see it, in practice!), new mothers may find themselves beset by doubts and uncertainty, especially if they do not receive support and reassurance from those around them. Although still relatively widespread, pre- and post-feed weighing is generally an unreliable practice that provides no meaningful information about the baby's intake, and can instead prove to be a source of anxiety and stress for the new mother. When breastfeeding, it is entirely normal for the amount of milk to vary quite considerably from one feed to the next. In the case of very young babies, moreover, a single feed may consist of just a few grams of milk, which are difficult to estimate with a home weighing session that can also be affected by external factors such as urination or a bowel movement by the baby. Far better — unless specific indications or particular situations such as prematurity arise — to rely on weekly or fortnightly weighing at the paediatrician's surgery. To check that a newborn is receiving a sufficient amount of breast milk, it is enough to verify that they wet at least six nappies in the course of 24 hours. Observing the baby during a feed can also help assess its effectiveness: correct suckling involves a "pause" in the movement during which the infant swallows. Finally, there is no point in convincing yourself that the milk is running out or decreasing if the breast feels soft or "empty", or if the nipples are not dripping. The breast does not work like a container but like a tap, which opens and closes according to the baby's demand. The stimulus of suckling triggers the release of milk, which is produced on the spot. Precisely by virtue of this perfect balance between supply and demand, it is entirely normal for the mammary glands, after the first few weeks, to settle into the optimal level of production for the baby, and for there to be no further sensation of tension or "fullness".

If breastfeeding proves problematic, it is important to consult a lactation consultant

How to prevent cracked nipples and mastitis

Another classic mistake to avoid when breastfeeding is underestimating pain during feeds. In the first few weeks after birth, it is possible for nipples to be slightly sore during the first few seconds of a feed. But if the pain is persistent or unbearable, if cracked nipples develop or the breast bleeds, if engorgement, hard and painful areas or fever occur, it is absolutely essential to seek help from a lactation consultant or a midwife (for example through La Leche League or Aicpam) with proven expertise in breastfeeding. The appearance of cracked nipples, severe pain or incomplete breast emptying is usually caused by an incorrect latch on the part of the baby, which can be corrected with the help of an experienced person. As a general rule, the important thing to bear in mind is that the baby should not. The size and shape of the nipples can in turn create some difficulty, which can also usually be overcome with the right measures. In the event of problems, it is also advisable to check the newborn's lingual frenulum which, if too short, can make it difficult for the baby to latch on.

Breastfeeding: when it is contraindicated

There are cases in which breastfeeding is impossible or contraindicated. A genuine absence of breast milk is a possible condition, albeit a very rare one, and may be due to malformations or diseases affecting the mammary gland, such as Sheehan's syndrome or breast hypoplasia. Surgical reduction of the gland (for example to treat a tumour) is not always a condition that makes breastfeeding impossible: the situation can vary considerably from one woman to another, so a case-by-case assessment is always necessary. Certain maternal illnesses or the use of particular medications are also incompatible with breastfeeding. This is the case, for example, with AIDS and chronic nephritis, or with the use of anti-cancer drugs and radioactive substances, but also with other infections, debilitating illnesses and certain drug therapies. From the baby's perspective, cleft lip and palate, often known as a "cleft lip", can be a condition incompatible with suckling from the mother's nipple. According to estimates (source: IBCLC), however, the overall percentage of mother-baby pairs for whom breastfeeding is impracticable for physical reasons does not exceed 5% of the total.