Following the delivery of the placenta after childbirth, levels of the hormones oestrogen and progesterone drop quickly. The body starts to release a hormone called prolactin, which stimulates the body to produce breast milk.

Special cells in the breast (acini cells) make milk, which is then stored in the breast. When the baby touches the breast a hormone called oxytocin is released, beginning a process known as milk let-down or ejection reflex. This pushes the milk to the areola (nipple and surrounding area), and releases it as the baby feeds. When you first start breastfeeding, let-down happens without you having much control over it. Later it becomes a reflex action in response to the baby’s cry or just by thinking about the baby or feeding.

To make breastfeeding easier, you should start as soon as possible after birth. It is important when you are learning about breastfeeding to ask for help with positioning and attachment to help prevent discomfort. The baby needs to be able to take enough of the nipple and surrounding area (areola) into the mouth to stimulate release of the milk.

Babies have a strong suckling instinct even when they are newborns. Whichever way you feed your baby, spending some time with skin-to-skin contact as soon as possible after the birth is very important. As long as you and the baby are both well enough, you should be able to hold your baby almost straight away. If you have had to spend some time apart, spending that time together when you can, still has benefits for both of you. It helps by:

* allowing you and your baby to bond,
* steadying the baby’s breathing,
* calming the baby and keeping them warm, and
* getting breastfeeding off to a good start.

Your baby will need to be fed as often as they are hungry to help establish your milk supply. Every time that you feed your baby, messages are sent to your brain, which then sends messages to your breast to produce more milk.

For the first few days after birth, the breasts produce a yellowish substance called colostrum. This is rich in fats and protein and easy for the baby to digest. Colostrum also contains infection-fighting antibodies (immunoglobulins), which strengthen the baby’s immune system.

The baby will feed frequently on colostrum until a supply of mature breast milk is established (this can take up to ten days). Mature milk has a more watery appearance. At the beginning of a feed it is almost blue in colour and becomes white by the end of a feed as the fat content increases.

Breasts produce two kinds of milk needed by the baby, in perfect quantities:

* foremilk - is thin and watery, and quenches the baby’s thirst. It is the first milk to come out at the start of a feed, and it is low in fat, but high in milk sugar (lactose).
* hindmilk - as the feed continues, the fat content increases, and the milk starts to consist of hindmilk. This is rich in fat, provides calories for energy, and promotes the growth of the baby. As the baby grows, it is important that they receive the hindmilk in order to meet their nutritional needs.

Allow your baby to feed from one breast until they decides to stop. After a short break, offer the other breast. Your baby may not need milk from the second breast at first, but is more likely to need it as they grow. Start the next feed on this side.

Breast size bears no relation to how much milk you can produce. A woman with small breasts can produce just as much milk as a woman with large breasts.

Feeds usually vary in length, from anything between a few minutes to up to one hour, and there is no ideal length of feed. The average length of a feed is influenced by:

* whether the baby is positioned at the breast correctly,
* the speed of milk let-down and rate of flow,
* the quantity of milk available, and
* the baby’s age.

For some mothers, breastfeeding comes easily, while for others it may present more of a challenge. If you are finding breastfeeding difficult or painful, ask your GP, midwife, breastfeeding counsellor, or health visitor for advice as soon as you can.