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Exclusive Breastfeeding

4 June 2025

Exclusive breastfeeding is feeding babies only breast milk without the addition of other liquids or foods. The Ministry of Health recommends exclusive breastfeeding for the first six months of the infant’s life. Breastfeeding should not be combined with infant formula as formula is an ultra-processed food that lacks hundreds of natural components present in breast milk that contribute to development, a stronger immune system, and support of microbiome.
To maintain the choice of exclusive breastfeeding, it's important to be aware of the potential challenges along the way and how to cope with them.

  • During the first 24 hours: respond every time the infant wants to nurse, even if not much milk is expressed. Skin-to-skin contact also helps to establish breastfeeding. Infants should not be left in the nursery. Choose full rooming-in or no separation at all.
  • During the second 24 hours: respond every time the infant wants to nurse, even at night. If a need arises to supplement the breastfeeding, more breast milk can be pumped.
  • During the first days at home: during the day, expose the infant to light and noise, and at night, maintain a quiet and dark environment. Even at night, it's advisable to breastfeed rather than prepare a bottle, as it doesn't actually help the mother gain more sleep. It's better to get help during times when the infant doesn't fall asleep immediately after breastfeeding.
    • During the first weeks: know that growth is uneven, and by monitoring growth at the Family Care Center, where the nurse will confirm that everything is normal. If it seems that the weight gain is not as expected, increase the frequency of feedings, reduce the use of a pacifier and schedule another weight check at the Family Care Center.
  • During the first weeks: know that growth is still uneven, and by monitoring growth at the Family Care Center, the nurse will confirm that everything is normal. Know that there are periods in which breastfeeding will be demanded more frequently and that this is natural (growth spurt’). You should go out for some fresh air, you deserve it!
  • Return to work: Approximately one month before your return, you should prepare - choose a breast pump, begin pumping and get the infant used to the bottle.
    In any case and at every stage, if you have any question, difficulty or pain during breastfeeding - consult the Family Care Center nurse or lactation consultant as soon as possible.

Breastfeeding has many benefits for both infants and mothers. If you have chosen to breastfeed - know that you are provided with the best possible food for your infant, which changes based on their age and development. Breast milk provides the raw material that is suitable for human beings, laying the groundwork for rapid physical development, particularly the brain and eyes, that occur during this critical period. Breastfeeding encourages the growth of friendly bacteria in the microbiome of our digestive tract, thereby affecting the child’s short-term and long-term health. It also helps build a strong immune system that protects against inflammation and infection. Breastfeeding helps you recover from childbirth, protects you health and helps develop your bond with your child.
For more information about the benefits of breastfeeding

What is exclusive breastfeeding?

Exclusive breastfeeding is feeding babies only breast milk (or pasterized breast milk from a donor through the National Human Milk Bank), without the addition of other liquids or foods. The Ministry of Health recommends exclusive breastfeeding for the first six months of the infant’s life. There is no need to supplement with water at this age because breast milk provides enough fluids, but the Vitamin D and iron supplements recommended by the Ministry of Health should be given, and if the infant is sick - medication should be given according to the instructions of the treating physician.
In the first six months after birth, the longer you extend exclusive breastfeeding, the greater the contribution to your baby's health: Studies show that there are fewer infectious diseases, less obesity, and better development compared to breastfeeding combined with formula or formula feeds alone. In addition, the digestive tract of infants is extremely sensitive, and absorption is adapted to the composition of breast milk. You should know that breast milk contains hundreds of different components that are transferred to infants and used to build an immune system adapted to their environment so that it will serve them now and in the future. Breast milk essentially helps infants maximize their developmental potential.
Breastfeeding in general, and exclusive breastfeeding in particular, contributes to your health as well - lowering the risk of contracting diseases such as breast and ovarian cancer, diabetes, hypertension, heart attack and stroke. It is therefore strongly recommended that you attempt to breastfeed from the beginning and continue for as long as you can. You may discover that it is easier than you thought.

I breastfeed but what is the problem with supplementing with infant formula?

  • Ultra-processed food: infant formula is made of cow’s milk, which is perfect for calves. Cow's milk undergoes processes designed to adapt it to infants growing need, but the result is an ultra-processed food. Over the years, it has become increasingly understood that consumption of ultra-processed foods can cause a variety of health problems.
  • Lack of immunological components: Infant formula contains only approximately 40 components and lacks hundreds of immune system and brain development components found in breast milk. Even in infant formula brands that are marketed as "premium," and contain added types of sugars that are similar to the sugars found in breast milk, they still do not contain the same ingredients - neither in quantity nor in variety.
  • Change of microbiome: Exposure to infant formula also changes microbiome and increases the risk of disease.
    Because of the tremendous difference between formula and breast milk, it is possible to distinguish between breastfed infants and formula-fed infants in a wide variety of health indicators: infants who are not breastfed are more prone to contracting infectious diseases, obesity, and poorer mental development in comparison with infants who are exclusively breastfed. The measures of infants who are fed breast milk supplemented by infant formula were found to be average, indicating the negative impact of supplementing breast milk with infant formula.

Why choose exclusive breastfeeding from the moment of birth?

Exclusive breastfeeding is particularly important in the first days after childbirth:

  • To produce breast milk: the body learns the quantity of milk to produce based on the infant’s demand. Even if milk doesn't come out at first, attachment creates stimulation to the breast that messages your body to produce milk. If infants receive fluids other than breast milk (formula or water), they will be less likely to want to breastfeed, and the message to the mother's body to produce milk will not adequately meet their needs. Supplementing with infant formula in the first days of life, even in small quantities, is the most common reason for reduced milk production and even stoppage.
  • To learn how to breastfeed: infants need to learn how to breastfeed, and breastfeeding is very different from bottle feeding. Bottle feeding at this critical learning stage may make it difficult for them to learn how to properly breastfeed. The infant’s very latching on to the breast is part of the breastfeeding learning process. Improper latching increases the risk of injury to the breast. Studies show that infant formula supplements in the maternity ward may impede successful breastfeeding later on.
  • To prevent the development of milk allergy: At this stage, the cells in the intestine are not sufficiently developed to absorb proteins, and substances pass more easily into the bloodstream. This may be why scientific studies show that exposure to cow's milk-based formula during this critical period increases the risk of developing a cow's milk protein allergy later on.
    With exclusive breastfeeding, breastfeeding will be established in the first few days and pave the way for easier and even enjoyable breastfeeding later on.

I am not sure that I will be able to exclusively breastfeed for six months, how will I cope with the challenges?

The most important thing is to believe in yourself, to trust your body and to become familiar with the natural process that you are undergoing in breastfeeding and particularly at the beginning (Hebrew) . Sometimes it seems like you don't have enough milk, sometimes challenges arise along the way but before you give up exclusive breastfeeding and supplement with formula, it's worth trying to address them in various proven ways, depending on the infant's age:

Like any beginning, the start of breastfeeding can be confusing and challenging, and that is completely natural and normal. During the first 24 hours, you should remember several things (the staff in the maternity ward will help you with this):

  • To respond to need: Infants do not eat on a regular basis but based on their needs. Every time they wake up and show signs such as looking for the breast- it’s time to offer them to eat.
  • To latch (and not to worry): During the first 24 hours, you are not expected to produce much milk - infants do not need more than half a teaspoon per meal on average. Even if milk does not come out, the baby's attachment to the breast is part of the process of learning how to breastfeed. Latching creates stimulation to the breast that sends your body a message to produce milk.
  • Staying together: Separation between mother and her infant in the maternity ward can affect the establishment of breastfeeding. Even if the neonatal staff is asked to wake the mother to breastfeed, by the time she gets to the infant, he will already be awake, frustrated and stressed, making it more difficult to breastfeed and put him back to sleep. In contrast, infants who stay with their mother with zero separation or full rooming-in breastfeed more on demand and acquire better breastfeeding skills. The mother’s milk production is also better established. Studies also reveal that mothers who room-in sleep the same number of hours or even more hours than mothers who choose to return their babies to the nursery, and their sleep is better and deeper.
  • Know that there is weight loss (and not to worry): Infants are born with excess fluid in their bodies that is designed to protect them from dehydration. Weight loss in the first days is normal, expected and not a reason for concern.
  • To maintain skin-to-skin contact: Contact between your skin and the infant’s skin has important physiological value for both of you and helps establish breastfeeding. Because contact maintains the infant's body temperature and reduces stress, thereby reducing the risk of developing low blood sugar levels (hypoglycemia), it is important to maintain skin-to-skin contact even after leaving the delivery room.
    More about skin-to-skin contact

At this stage, frequency of breastfeeding is expected to increase – around 10–12 breastfeeding sessions per day at uneven intervals. This is what you should know about these second 24 hours:

  • Respond to need: it is important to allow the infant to latch to the breast anytime they want. The increased frequency of demand for breastfeed is a natural process and not an indication that you do not have enough milk.
  • Express drops: If the need arises to supplement breastfeeding during this time of day, try to pump breast milk (at this stage, most women are less successful at pumping). Every drop that is expressed in the first two days is excellent and it is critical that the infant receives it.
  • Breastfeed at night as well: Despite the challenges of breastfeeding at night, if you breastfeed immediately after your infant wakes up, they will likely fall back asleep after having breastfed. Breastfeeding infants do not need to have their diaper changed at night because their stool causes less skin irritation than the stool of infants who are formula-fed.
  • Sleep when possible: At this stage, you should try to sleep at every possible opportunity and consider which visitors you want to receive.
  • Make sure to have support: it is advisable to make sure that you have someone who will look out for your needs and the needs of the infant. At night, the person can help care for the infant in your room if they do not fall asleep immediately after breastfeeding.

After arriving home, you may be concerned that you will now have to cope on your own, without professionals around you. It is important that you know - you are not alone. Beyond your family and community, the Family Care Center nurses will be by your side to instruct and support you with any question or concern you may have. These are the things you should pay attention to that will help you maintain exclusive breastfeeding:

  • Differentiate between day and night: After arriving home, it is not easy to get up several times at night to breastfeed. Stay the course, the situation will improve! To help your infant learn the difference between day and night, daytime breastfeeding can expose him to light and noise, while at night, maintain a quiet, unlit environment. Here too, breastfeeding has an advantage over formula: in the evening, melatonin ("the darkness hormone") is secreted into breast milk, which helps infants learn the difference between day and night.
  • No bottle at night: The idea of preparing a bottle for the night, so that the partner can feed the infant instead of you is not particularly beneficial. In fact, a study that reveals that mothers who did so ultimately slept half an hour less than those who breastfeed. If the infant wakes up, therefore, you should immediately breastfeed it and they will generally fall back asleep rather easily once they have fed. If they remain awake after having breastfed - this is the time to request help from someone else to take care of the infant and help them fall asleep so that you can go back to sleep.
  • Contact us for advice: schedule an appointment at the Family Care Center nearest to your place of residence for two or there days after your discharge from the hospital. During the appointment, they will make sure that the infant is well, that you are feeling well and that the breastfeeding is going well. If you have any questions about breastfeeding, do not hesitate to consult with the nurses at the Family Care Center or with a lactation consultant through the Family Care Center Nurses Hotline, or schedule an earlier visit at the Family Care Center.
    Everything you need to know about the Family Care Center

Breastfeeding slowly becomes a more familiar routine, and this is a good thing. It doesn’t mean that there are no more challenges or difficulties and that questions will not arise. This is what you should know to help you continue:

  • Know that growth is not uniform: Infants grow rapidly but not evenly, and sometimes there is a change in percentiles and in growth curves. If after one month, the infant does not appear to be gaining sufficient weight, they will be weighed the next week. In most cases, there is no problem or need for intervention. If something does not appear right in the infant’s growth curve, the Family Care Center nurse will refer you to a physician for an assessment.
    What is the growth curve and what is a percentile?
  • Increase frequency: Even if the growth curve shows the infant not gaining weight exactly according to the curve, this does not necessarily mean that their diet should be supplemented by infant formula. What, then, can be done? First of all, make sure that they are properly latching onto the breast. Painless breastfeeding is a good sign. The frequency of breastfeeding sessions can be increased by one or two times a day. Use of a pacifier can be reduced and then another weighing at the Family Care Center. In many cases, this solves the problem. If you are still concerned, you should consult the nurse at the Family Care Center or lactation consultant and ask them to show you how to express or pump breast milk, and then give this to him as a supplement by teaspoon or cup - and schedule a weighing for several days time.
  • Get professional advice: Often, with good intentions, you will be warned about breastfeeding with phrases like "He's crying, maybe he's hungry," or "Your milk is too thin." You don't need to listen to every opinion and advice, believe in yourself and your body. If you have difficulty breastfeeding, for example if it still causes pain, it is important to get in person advice from a lactation consultant, a Family Care Center nurse, or a lactation consultant as soon as possible. There are also free consulting hotlines that can be contacted.
    For information about lactation counseling.

At this stage, you are already better familiar with breastfeeding, with your body and your infant. There are several developmental milestones that you should become familiar with and learn how to cope with them:

  • Know that growth is still not uniform: infants continue to gain weight at an uneven pace. In the first months, infants can move up or down in percentiles, and this does not indicate poor breastfeeding. If something does not appear right in the infant’s growth curve, the Family Care Center nurse will monitor growth and accordingly refer you to a physician.
  • Know that there is a ‘growth spurt’: there are periods in which the infant will demand to breastfeed more frequently for several days. This is not a sign that you have no milk but rather that the infant’s needs have changed. You should breastfeed upon demand, and balance is generally restored after two days. If this lasts for more than one week, consult the Family Care Center nurse or lactation consultant.
  • Get out of the house for some fresh air: At this stage, you may reasonably feel that you want to get out of the house and take a small break. You can do it! Although getting ready to leave the house with your infant may be slightly awkward, do not allow this to stop you - it will do both of you some good. If you decide that you deserve some time for yourself, this is also possible. Leave the breast milk you pumped for the person who is left to care for you and instruct them to feed only if the infant demands, by feeding slowly and attentively and in the amount you left. If you plan to be without your infant for more than 3 hours, you should take a breast pump with you so that your breasts don't become engorged.
    More about pumping breast milk

On the one hand, the longer you can extend maternity leave, the easier it will be for you to continue exclusive breastfeeding. On the other hand, even if you have only 15 weeks of maternity leave, and you need to return to work, it is possible. Exclusive breastfeeding also has advantages in the context of placing the infant in daycare or nursery school: according to studies, they are sick less than other babies, so you will have to miss fewer days from work. This is a short period of effort that will pay off for you, the infant, and the family. In addition, starting at six months of age, the infant will also begin to eat supplementary foods, and the amount of milk you will need to pump will gradually decrease.
To prepare to return to work and still continue to exclusively breastfeed, you need to start preparing about a month before the return:

  • Choose a breast pump: If you haven’t already started pumping, this is the time to learn about the types of pumps and the pumping method. Consult nurses or lactation consultants at the Family Care Center or in the community regarding the choice of pump that corresponds with your needs and pumps.
  • Begin pumping: Pumping should begin several weeks before the return to work, to become accustomed to pumping once a day, thereby storing bags of breast milk in the freezer.
    More about pumping and storage
  • Getting used to the bottle: This is the time to begin getting your infant used to drinking from a bottle, in small quantities and with patience. Occasionally, try to allow someone else to feed the infant with the bottle so that they can more easily adjust.
  • Consult: If a difficulty arises around your return to work , you should seek advice at the Family Care Center or from a lactation consultant to receive more tips and coping methods upon your return to work.
    More about breastfeeding and returning to work

Tip

Tip

It's a good idea to prepare a few batches of pumped milk to store in the freezer and use in case you want to give your infant breast milk in a way other than breastfeeding.

Breastfeeding is a short period in life, yet it has a major impact on your health and that of your infant now and in the future, as well as on their development not only in infancy and childhood but throughout life. Mothers are exposed to a lot of advertisements, gifts, and advice that encourage giving formula, but it is important to remember that formula companies are commercial entities, and that your goal is to promote the health and development of your infant. Sometimes you will hear unprofessional and out-of-date advice even from staff members who did not study breast milk and breastfeeding. You should consult a certified authority such as nurses at the Family Care Center and lactation consultant.
Finally, take a moment every day to appreciate yourself and your efforts at breastfeeding, and to enjoy your infant, who grows up so fast.

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