When your baby is born, an amazing process steps up a few gears.
It's one which began not long after your new baby was conceived: lactation.
Everything your baby needs to eat – with very few medical exceptions – is ready and waiting for her.
Colostrum has been produced by your breasts from as early as 16 weeks, as your breasts prepared for the arrival of your baby.
In fact, your breasts begin the process every month, as part of your menstrual cycle.
Maturation and rapid growth of milk ducts and alveolar buds take place during the follicular and ovulatory phases – which you might notice as tender breasts and nipples.
When pregnancy doesn’t occur, this is reversed. But when fertilisation is successful, your breasts continue their steady progress to lactation.
What Is Colostrum?
Colostrum is your baby’s first food, and the most important she will ever have.
Colostrum is more than just nutrition. It helps establish the bacteria in the gut, and works as a laxative to clear the bowel of meconium. It also begins the immune support that your newborn urgently needs once outside of the womb.
Dairy farmers and other animal breeders will go to great lengths to feed colostrum to newborn animals — even finding another new mother to take on an orphan. Yet, too often, human mothers are urged to provide the milk of another animal (often those very dairy cows) in the form of formula supplements.
Why is colostrum so important? And how can we give our babies a better chance of achieving the World Health Organization’s recommended 6 months of exclusive breastfeeding?
Here are 6 reasons why your breastfed newborn doesn’t need formula:
#1: Your Colostrum is Exactly What Nature Intended
Colostrum is thick, specifically to coat the lining of the gut. This cleverly prevents pathogens passing through into the bloodstream. Colostrum is full of immune factors, and breastfeeding is the baby's external immune support, until the baby fully develops their own.
There are good reasons why breast milk is low volume. It's highly concentrated, and designed to gradually introduce the infant’s digestive system to its life-long work. Initially, the stomach has very little ability to stretch, and large volumes of fluid cannot be accommodated. And after nine months absorbing amniotic fluid in your womb, your baby will be over-hydrated and shedding excess water. Some of this water came onboard via his mother’s bloodstream, due to IV drips in labour, or during and after c-sections. This is the main reason why newborns lose weight in the first week of life, as they need to expel this excess fluid.
#2: Colostrum Is What Your Baby Wants
Babies are born to suckle. Some people misinterpret this behaviour as unsatisfied hunger, but often all they need is popping back on the breast.
Colostrum is what babies were designed to have, exactly in the quantities that is delivered.
The fact that a fussy newborn can be given a 90ml bottle of formula, and his insatiable desire to suckle means he will drink it all does not prove that he was hungry. Just because a stomach can be over-filled, it's not a reason to do so. Babies find sucking pleasurable and comforting, yet it's often confused with hunger.
#3: Colostrum Is What Your Baby Needs
By the second or third day of life, your baby begins an almost-marathon period of breastfeeding. She will come out of a sleepy period after birth, and will be seeking the breast more frequently.
As well as gradually stretching her stomach towards its full capacity, your baby’s constant removal of milk from your breasts is stimulating the next stage of lactation: often referred to as your milk “coming in”.
In the recent past, most mothers experienced massive swelling of their breasts (known as engorgement) when the mature milk began to mix with the colostrum. Still thought to be a normal part of the process by many, what engorgement really means is that your baby is not feeding often enough or effectively enough to keep the breast emptying as rapidly as it's filling.
During this time, other things responsible for engorgement include:
- Restricted feeding due to schedules
- Misinterpretations of baby’s feeding cues
- Sleepy babies affected by drugs in labour, or the common condition known as newborn jaundice
- Other interruptions to the natural peak of feeding demand
By feeding your baby frequently during this transitional time, you can minimise engorgement and weight loss in your newborn.
When responded to with skilled attachment and support for a tired mother to rest during this challenging period, the normal, frequent feeding of a breastfed baby, will result in reduced rates of hyper-glycemia and jaundice. It will reduce newborn weight loss to below the red flag of 10%, and allow mothers to avoid the challenges of engorgement.
#4: Colostrum (And Breastmilk) Is Not the Same as Formula
Infant formula marketing was highly effective in the middle of the 20th century. Knowledge of normal newborn feeding and sleeping behaviour was displaced by what was considered normal for the bottle fed baby.
Delayed first breastfeeds, restricted feeding and strict routines of four hourly feeds led to breastfed babies quickly needing to be supplemented with formula after feeds. This regime quickly became normalised in Western maternity wards. Babies were kept in nurseries, returned briefly to mothers for a strictly regulated feeding time, and then returned to the care of nurses, who delighted in cuddling and “topping up” the babies in their care.
Nursing Mums A History of the Australian Breastfeeding Association 1964-2014 explains:
“Hospitals continued to pay lip-service to the importance of breastfeeding, although the clock controlled all matters relating to it. The first breastfeed was supposed to take place six hours after birth, and the time intervals were strictly monitored, typically two to three minutes at each breast on the first day, five minutes on the second day and ten minutes on the third day.
Once the milk came in, it was recommended that the baby suck for fifteen minutes at the first breast until it was empty, followed by five minutes at the second. The aim of such time restrictions was to prevent nipple damage, although in practice it was often not long enough to fully satisfy a baby who was drowsy, fussy or a slow feeder and the expectation that feeds should be completed within a designated time frame frequently increased mothers’ anxiety.”
With hospital stays as long as two weeks, mothers and babies became familiar with the attempted breastfeed, followed by the successful formula feed. Many mothers quickly moved to fully formula feeding their babies.
Today, we know that mothers and babies should be kept together with skin-to-skin contact for as long as possible after the birth. Ideally this should be hours, but essentially, the first hour. A baby will initiate the first feed without intervention, unless affected by drugs in labour. This first feed signals to the breast that it's game on!
The placenta is stimulated to come away naturally by the release of oxytocin, in response to the stimulation of the baby seeking the breast. The lack of the placenta allows lactation to begin its steady progression, from colostrum to transitional milk to mature milk over the first 14 days.
Learn more about the important first hour after birth here.
#5: Colostrum Can Be Shared
Just like the dairy farmers mentioned earlier, those caring for mothers and their newborn babies have long-known that a baby who cannot meet all its needs from her own mother’s milk will be best fed that of another mother.
Milk banks were commonplace in hospitals until the fear of HIV/AIDS in the 1980s, which led to their hasty closing down. Now we know better: human milk can be safely treated by pasteurisation, and made available following strict protocols to protect all involved – just as blood banks do with much-needed blood. Indeed, breastmilk is often thought of as “white blood”.
Milk banking in Australia is currently only available in a few cities, and is often restricted to premature babies who meet a criteria of need. With the relative low cost of commercial infant formula, the high-cost of providing donor milk is often prohibitive in getting funding to set up and maintain milk banking services.
Yet, if donor milk was more freely-available and reliance on formula top-ups was reduced, community health would be vastly improved over a lifetime.
#6: Colostrum Is Not Valued By All
Indonesia has very poor breastfeeding initiation rates (just 30%, whereas Australia is 96%). This is due to the fact that they offer pre-lacteal feeds, due to cultural beliefs about colostrum.
But their exclusive breastfeeding rates up to 6 months of age are far better than Australia. Indonesia's rate at 6 months is 49% and Australia has a dismal 15%. In fact, a recent study found that only 50% of Australian mothers are exclusively feeding their babies at 2 months of age. The global goal is 50% exclusive breastfeeding at 6 months.
Naomi Hull, IBCLC (International Board Certified Lactation Consultant) explains:
“I was working on this with a fellow student who is from Indonesia, and she discussed how the community and peer support is so much stronger in Indonesia. Whereas here in Australia, we have many myths, pressure to return to work, routines to enforce, lack of information, poor community support/isolation, lack of consistency with information, and we're pushed out of hospital before milk comes in etc.”
While babies in Australia, whose early feeding is compromised by the often routine and unnecessary introduction of formula, is partly or fully displacing breastmilk from them diet. They will generally gone on to live satisfactory, if compromised lives. Those living in developing countries can be put at risk by the same practices.
Maureen Minchin, renowned author of the best-selling book Breastfeeding Matters and the newly-released Milk Matters cautions:
“More babies die if not given breast milk from birth, as gut colonisation is going to progress, and without breast milk it will include more pathogens.”
Kate Mortenson IBCLC, previous Director of the Lactation Resource Centre in Melbourne agrees:
“Suspicion of colostrum is very widespread in some areas of Asia. It is responsible for many deaths. The quicker a baby is put skin to skin and allowed to feed the better the health outcome in any country but in resource poor settings is a matter of life and death. Publications from WHO and UNICEF graph the rise in infant mortality the longer the delay to first feed. In many areas of the world long term breastfeeding is common but exclusive bf uncommon causing much illness and death in resource poor settings. Where education campaigns promote exclusive bf from birth in these areas infant mortality falls.”
It's time that colostrum was returned to its place of worship as ‘liquid gold’. All babies deserve their birthright: their own mother’s milk from the very first day. They deserve for their gut health to remain unchallenged by other milks or foods until around six months of age, which is recognised as best practice around the world by leading organisations.