Breastfeeding: benefits, difficulties and warnings
Breastfeeding is more than just feeding a baby. It is a process that releases oxytocin, which in turn pushes the milk out and creates a very special and unique bond between mother and child, creating an instinctive, warm protection that words cannot quite capture. Breast milk acts as a shield that provides antibodies, anti-inflammatory factors and digestive enzymes. Its composition changes throughout the day and the weeks, adjusting to the baby—more fat at night to satiate them and more antibodies if they catch a virus.
Shortly after birth comes colostrum, the first milk, which is thicker, yellowish, and lower in quantity—exactly the amount the newborn's stomach needs, as it is very small. Days later, mature milk comes in, which is associated with fuller, tenser and sometimes painful breasts. It is a beautiful process, but one that can bring accumulated fatigue, difficult nights and pain.
Benefits for the baby
Breast milk reduces common everyday infections by 50-70%: less diarrhea, pneumonia, ear infections, and urinary tract infections. In the long term, it can reduce the risk of obesity, asthma, type 2 diabetes, and allergies by 20-30%, due to better regulation of hunger and the gut microbiota.
Premature babies are less prone to necrotizing enterocolitis (up to 50% less), sepsis, chronic lung disease, and retinopathy. Suction helps shape the face: high palate, aligned teeth, fewer early cavities (though an oral hygiene routine should be established over time).
Benefits for the mother
Postpartum recovery accelerates because by breastfeeding, the mother releases a hormone called oxytocin, which contracts the uterus in minutes and cuts hemorrhaging by 20-30%. Weight is regulated over time because breastfeeding involves a daily calorie burn (500-700 kcal).
There is also a lower risk of breast/ovarian cancer (4-20% less per year), type 2 diabetes, hypertension and cardiovascular diseases, due to anti-inflammatory and hormonal effects. It is also a good way to regulate stress; cortisol levels drop with each breastfeed and blood pressure stabilizes.
Until what age should you breastfeed?
Recommendations suggest breastfeeding be exclusive until about 6 months and then gradually adding complementary feeding from there. This process of introduction and adaptation can last until the age of 2 or more, depending heavily on several factors. This journey should be made up of variety and good nutrients, and breastfeeding ends up being a source of nutritional and emotional support.
Breastfeeding for longer does not spoil the milk. Its composition changes with age and continues to provide immune components and nutritional value. In parallel, the longer the total duration of breastfeeding over a lifetime, the more consistent some benefits appear for the mother, such as a reduction in the risk of breast and ovarian cancer.
It happens more often than people think—mothers breastfeeding their children until age 4/5, especially in some cultural contexts. There is no good evidence of negative effects on children who breastfeed until late. The only warning appears to be factors related to oral health. Systematic reviews find an association between breastfeeding beyond 24 months and a higher risk of early childhood caries, particularly when there is frequent nighttime breastfeeding and/or sugar consumption throughout the day. However, this is not so much about breastfeeding itself, but rather about oral hygiene, which should exist from the moment the baby gets teeth, even if their only food is breast milk.
Breast milk contains lactose, which is not sugar, but it remains a carbohydrate that can feed plaque bacteria and lower the pH around the tooth. The risk usually rises with higher nighttime frequency because there is less saliva at night and the mouth’s natural cleaning process is weaker.
On the other hand, stopping early or breastfeeding very little does not determine anyone's future, but population data associates this with more childhood infections and worse outcomes in various health markers over time.
Nipple pain
Slight discomfort at the start may occur. Pain that makes you clench your teeth, that repeats with every breastfeeding session, or cracked nipples, may mean the latch is shallow or the position is unstable.
What helps:
- Align the baby (belly to belly), with their body very close, without twisting their neck;
- Wait for a wide-open mouth and bring the baby to the breast (do not pull the breast to the baby);
- Aim for a deeper latch, with more areola in the baby's mouth, not just the nipple.
If there is constant pain, fissures, blood, or fear of putting the baby to the breast, specialized help should be sought.
Engorgement
Engorgement is when the breast becomes very full, tense and swollen, usually in the first few days as the milk supply increases, or when there is a delay in removing milk (e.g., long intervals, ineffective latch, changes in routine).
The breast can become hard, hot and painful, and the areola can become so stretched that the baby has difficulty latching well. This can mean accumulation and swelling of the tissues.
What usually helps:
- Softening the areola before breastfeeding, with manual expression just enough to facilitate the latch.
- Cold after, to reduce swelling and relieve pain.
- Avoid aggressive massages and attempts to empty everything by force, as they can further irritate the area.
- Cold after, to relieve swelling and pain.
If it comes with fever, increasing redness, chills, or if it does not improve within 24–48 hours, medical evaluation should be sought, as it may progress to more intense inflammation or mastitis.
Mastitis
Mastitis is an inflammation of the breast that usually happens during breastfeeding, often after a period of very full breasts, ineffective drainage, or local irritation. It can remain just inflammation or progress to a bacterial infection.
Most commonly, an area of the breast becomes sore, hot, swollen and red, and the mother feels unwell, has body aches and sometimes even fever. It can resemble a flu that appears suddenly, but is localized in the breast. The following factors can be helpful in the initial stages:
- Rest and hydration;
- Local cold to reduce inflammation;
- Compatible analgesic/anti-inflammatory, when necessary and advised;
- Maintain breastfeeding comfortably and effectively.
When to request medical evaluation on the same day:
- High or persistent fever;
- Clear worsening after 24 hours;
- Very intense pain or a nodule that does not recede;
- Suspected abscess (very marked, painful area, sometimes with fluctuation).
Milk production
Milk production responds primarily to effective and frequent removal. The following factors should be kept in mind:
- Introducing supplements just as a precaution without a plan (the baby breastfeeds less, the body produces less).
- Long intervals due to attempting to train the baby.
- Excessive pumping right at the beginning, which creates production beyond what is necessary and paves the way for engorgement and inflammation.
However, there may also be cases of naturally low production. Causes can include, for example, maternal illness, prior breast surgery, complicated birth, prematurity, or the baby's anatomical difficulties. When there is such a suspicion, necessary support can be sought through medical recommendations.
Return to work and pumping
If you need to pump milk, the focus is on creating a minimally stable routine and safe storage. The following storage rules are essential:
- Up to about 4 hours at room temperature.
- Up to about 4 days in the refrigerator.
- In the freezer, it can be kept for months; many references use 12 months as the upper limit.
A tip: avoid storing milk in the door of the refrigerator/freezer due to temperature variations.
Warning signs
For the mother:
- Fever, chills, strong malaise.
- Intense localized breast pain, increasing redness, or suspected abscess.
- Nipple pain that does not improve with adjustments and support, or deep fissures.
For the baby:
- Too few wet diapers for their age, very dark urine, or unusual sleepiness.
- Clear difficulty breastfeeding, persistent refusal, marked weight loss, or failure to regain weight despite follow-up.
Breastfeeding support
Support makes sense when it solves a specific problem, such as: pain that prevents latching, a baby having difficulty grabbing the breast, very flat nipples, engorgement that leaves the areola tense, or the need for pumping due to separation/routine.
Silicone nipple shields can help for short periods when the baby cannot latch well or when the pain is so strong that it prevents direct breastfeeding, but ideally with guidance, because in some cases they can reduce milk transfer and affect production. In the first few days, with colostrum, many guidelines advise caution. If they are used, it is advisable to monitor signs of intake and, in some cases, combine with pumping to protect production.
Breast pump is useful for maintaining production when there is separation, for relieving tension and facilitating latch, or when there is low transfer. Using it just as a safety measure can create overproduction and increase the risk of engorgement and inflammation.
Cold/heat work as quick aids: cold afterwards to reduce swelling and pain; warm heat for a short time before can facilitate flow, without overdoing it.
Breastfeeding pillow reduces tension in the shoulders and back and helps keep the baby well-aligned, especially during a more sensitive postpartum period.
Absorbent nursing pads and comfortable clothing prevent moisture and friction, which aggravate irritation.
Caring for the details today is investing in tomorrow's well-being.
