The Story Behind Successful Breastfeeding

Posted on: November 5, 2008

What is needed for effective breastfeeding in the first hours after birth?

  • First and foremost, multi-disciplinary research has shown that skin-to-skin contact between mother and baby within the first hour of birth (amongst its many other benefits), is extremely necessary to start off a series of responses – hormonal, physical, and psychological – in both mother and baby to initiate good breastfeeding. This increases the already present levels of oxytocin hormone in both mother and baby, and ensures the “milk ejection” reflex.
  • This process starts off, what Breastfeeding Medicine expert Dr. Christina Smillie, MD, describes as “the Mother Baby dance”. If allowed to remain skin-to-skin with mother, the newborn infant can crawl to the breast (using its inborn stepping reflexes), find and attach himself to the mother’s breast.
  • If the newborn’s fists are not cleaned, he will experience the familiar smell of the amniotic fluid present inside his fists, as he puts his hand to his mouth (again a very characteristic newborn behavior). He is then able to associate the similar smell of his mom’s breasts, and locate them, as they also secrete a substance which has similar smells as the amniotic fluid.
  • The baby then sometimes reaches out, and massages the breast. This further stimulates the breast to release more oxytocin, which in turn helps with milk let-down.

  • Next, responding to mother’s instinctive stroking, talking and visual interactions with him, (the newborn is in a quiet, alert state for almost 90 minutes after birth), the baby’s brain releases oxytocin, which relaxes him, and initiates feeding behaviors in him. Soon after, he locates the source of the unique smells and warmer temperature – his mother’s breast. And, with his chin and lower lip touching mom’s breast, he opens his mouth wide and starts suckling.
  • What the baby first takes in is the extremely beneficial colostrum (the precursor of milk). This colostrum is high in antibodies that will benefit the newborn’s immunity for a lifetime. Colostrum, being extremely high in fat content, also satiates the newborn’s hunger. And, once the baby sleeps after his first full nursing, he may not need his next feeding, for up to 4 hours later.
  • Because the baby’s instincts have started the process of learning, and now that he knows he can successfully feed, he is able to latch on to mother’s breast and suckle well at his next feeding. He may feed as frequently as he needs – sometimes, hospitals may impose a 2-hour interval between feedings, which in my opinion does not have merit.
  • Oxytocin in the baby releases another set of hormones which are called cholecystokinens. These hormones ensure that the baby feels satiated for only a short time after a feeding over the first couple of days. This makes him want to feed more and increases his suckling action. This increased suckling is a good biological response, and ensures that mom’s breast is not engorged (feeling full, and tight) when the milk does come in, usually within 48 hours after birth, and effective breastfeeding continues. It is all good news – both for mom and baby.

My next post will focus on best practices that hospitals, care providers and new mothers can adopt in order to ensure that effective breastfeeding can occur at the earliest after birth.


  1. Anderson GC et al. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2003L2):CD003519
  2. Klaus M, Klaus P. Your Amazing Newborn. Reading MA: Perseus Books: 1998
  3. Christina Smillie, MD. Baby-led latching: A neurobehavioral model for how infants learn to latch on. Plenary Session Invited Lecture at Lamaze International Conference, September 14, 2008.

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