If available, breast milk is the best thing you can feed to your newborn baby. In addition to containing all the essential vitamins and nutrients your baby needs for about the first six months, your breast milk is alive, albeit an ever-evolving work in progress. It’s designed to change with your baby’s development and growing immune system by providing antibodies your infant needs to help fight off bacteria and viruses. Often referred to as “liquid gold,” breast milk begins with colostrum, which is present around the sixteenth week of pregnancy and lasts until the baby is about a week old. Colostrum acts as a laxative to help clear out meconium (your baby’s first poop). It’s rich in antibodies and helps protect your baby’s gut in the early days. Your milk then changes to transitional milk around day seven until about day twenty-one and finally becomes mature milk, which completely meets the growing needs of your baby until about six months of age. If you become ill, your breast milk will make antibodies to help protect your baby from getting sick.

According to the American Academy of Pediatrics (AAP), breast milk can help lower the risk of allergies, asthma, parasites, viruses, ear infections, and diabetes, among many other things. The World Health Organization (WHO) recommends breastfeeding exclusively for six months, if possible.

Early prenatal education with a lactation specialist can help get you off to a good start. Learning about milk production, having a breast exam, and knowing what to expect those first few hours and first few days of your baby’s life can also help by lowering your stress levels. Because you’ll have some basic knowledge about what changes your body is about to make and what to expect from your baby in those first few hours, you will know whether things are going right, and if not, you’ll know to ask for help to get things back on track. Tips to help get milk production off to a good start would be skin-to-skin contact and breastfeeding just after delivery, if possible. Breastfeeding or hand expression within an hour of birth, rooming with your baby if you’re delivering in a hospital, and breastfeeding often will all help support a full milk supply.

This is a broad question with many different answers. Each mother and baby are a unique couple unto themselves. Issues a mother may have experienced with one child may not translate to her next baby. Breastfeeding difficulties can be as easy as fixing a latch issue or more complex, such as a breast infection. A few of the more frequent problems that can arise can involve the mother’s anatomy, such as flat or retracting nipples, which can make breastfeeding in the early days a challenge. The birth experience, such as a long or traumatic birth, can delay milk production. Stress, postpartum depression, anxiety, or the baby’s anatomy, such as a tied tongue (when the tissue under the tongue is too short to maximize range of motion), can all have an effect on breastfeeding. Knowing when and how to seek help is important for all new parents.

A lactation consultant helps troubleshoot breastfeeding issues. Having a knowledgeable consultant who can diagnose issues and prepare a plan can mean the difference between continuing to breastfeed or stopping. Sometimes we are there just for emotional support for new mothers, and other times we can help solve complex feeding issues. While our scope is defined, it covers many areas and issues.

Again, this is one of those broad questions. Certainly, if baby isn’t getting enough food from mom, we are going to have to feed the baby, and then we will attempt to find out why mom isn’t producing enough breast milk or diagnose any other feeding issues. As a lactation consultant, if I believe that breastfeeding is stressing out a new mother to the point that she isn’t enjoying the experience or if she’s sought to remedy the situation to no avail, I may suggest she move on and feed her baby another way. I would rather a new mother look back on her baby’s first year with enjoyment and tenderness rather than stress and guilt. While breastfeeding can be amazing, it’s not the only piece to the mother-and-baby bonding experience.

Breastfeeding isn’t for everyone, nor should any new mother be shamed for not choosing to or not being able to breastfeed. We can never know another person’s history, therefore we shouldn’t judge how someone else chooses to feed their baby. Some women have extremely sensitive nipples making breastfeeding and even pumping excruciating; and some women have medical concerns that won’t allow for it. And of course other women choose not to simply because they don’t want to. My job is to support the woman in her infant feeding journey, which may or may not include breastfeeding. Depending on the circumstances, seeking help from a professional may help bridge any issues that may come up, whether psychosocial or physical. No mother should ever feel guilty for not breastfeeding.

Donor breast milk or formula are among the most common ways to feed a baby if you’re not breastfeeding. Some women choose to exclusively pump and provide their babies with their breast milk via a bottle or an alternative feeding system. Other alternatives may include using an SNS (supplementary nursing system), which allows feeding at the breast with a supplement such as breast milk, formula, or donor milk. In the early days for baby, a syringe or finger-and-cup feeding are both great ways to support breastfeeding. Another device might be hands-free bottle-feeding. All of these options can help to provide baby with the supplements required to keep them healthy and happy while you work to get your milk supply to increase in volume or work on an alternate feeding plan.

How and what nourishes your baby is important, so my best advice to new parents is to read up on breastfeeding and the alternatives and, if possible, find a professional you feel comfortable with. Always know that even if your ideal feeding plan doesn’t happen, you can always craft a plan in line with your ideals and keep your baby happy and healthy at the same time.

Look for a board-certified lactation consultant, also known as an IBCLC. I would suggest starting with recommendations from friends or family or your pediatrician. Sites like Yelp can help you find an IBCLC in your area. Finding the right lactation professional and beginning a relationship with someone who supports your feeding plan prior to having your baby can help ensure you and your little one are able to meet your breastfeeding goals.