Skin-to-skin contact and breastfeeding soon after birth stimulate production of the mother's breastmilk. Breastfeeding also helps the mother's womb contract, which reduces the risk of heavy bleeding or infection and helps to expel the placenta (afterbirth).
The newborn needs no other food or drink while the mother's milk supply is coming in and breastfeeding is being fully established. Giving any other food or drink may slow the production of milk. It can also increase the chance of diarrhoea and other infections. The milk produced by the mother is nutritious and the right amount for the newborn. The baby should breastfeed as often as she or he wants.
A baby who has problems suckling in the first few days should be kept close to the mother, offered the breast frequently, helped to take the breast and given breastmilk expressed directly into the mouth or fed expressed breastmilk from a clean cup (not from a bottle). The mother should receive help to improve the baby's attachment and suckling, and should also be shown how to express breastmilk, if necessary.
A mother's own milk is best for low-birthweight babies. However, not all of these infants are able to feed from the breast in the first days of life. For them, other options are available. In order of preference, they are: expressed breastmilk (from the mother); donor breastmilk (only if the donor is HIV-tested and the milk is correctly heat-treated); and infant formula. All of these should be given by cup, spoon or paladai (a cup feeding device), or medical tubes used by a trained health worker in a health facility.
Heat-treated breastmilk involves heating expressed breastmilk (enough for one or two feeds) in a small pan or in a metal container standing in a pan of water until it comes to a boil. The milk is then left to cool in a clean, covered container before it is fed to the baby by cup. A trained health worker can provide further guidance on expressing and heat-treating breastmilk.
It is best for the mother and her baby to stay together in the same room immediately after birth. If a mother gives birth in a hospital or clinic, she is entitled to have her baby near her, 24 hours a day. She should insist that no formula or water be given to her baby if she is breastfeeding.