Due to a necessary change of habits (less outdoor activity or outdoor activity fully clothed and the use of sun screen), mothers are not able to synthesize sufficient vitamin D and so meet the baby´s requirements. As a result, it is necessary that infants under one year of age take 400 UI/d of vitamin D per day

The production of vitamin K is low and the amount obtained via breast milk is variable. In order to prevent haemorrhagic disease of the newborn (HDN), vitamin k should be given to babies just after birth.

Vegetarian mothers should take vitamin B12 supplements. If the mother does not take the supplements it will be necessary to supplement the child in order to combat serious problems that Vitamin B12 deficit may cause.

A 200 µg doses of iodine per day is recommended during pregnancy and during the whole period of breastfeeding. It is best administered in the form of potassium iodide. This supplement is given to the mother to guarantee the necessary intake by the child because the only available source for the baby is that received through breast milk feeding.

The iodine supplement does not affect or harm mothers who have had their thyroid glands removed, nor does it harm mothers who are taking thyroxine. Supplementation will not be necessary if the child suffers from congenital hypothyroidism, as the child suffers an abnormality of thyroid function and does not require iodine.

Up to six months of age, the child only drinks milk on demand (whenever the child wants), and DOES NOT require water, infusions or any other kind of liquid, not even when the weather is hot.

If the child is over six months of age and has started to eat other food, you may offer water but never force the child. Never add sugar to the water.

From six months onward, children are able to drink from a cup and bottles or teats will no longer be needed. In order to avoid contamination, the water should be carried in well sealed cool recipients. Try to avoid drinking directly from the bottle; use a cup or glass and throw the remaining water away.

Babies who are breastfeeding should not use dummies during the first month until they become well accustomed to breastfeeding because the use of a dummy or pacifier may hinder this learning process. Furthermore, sucking frequently stimulates the production of mother´s milk.

It is advisable not to use a dummy after one year of age so as to avoid problems due to prolonged use; (dental problems mid-ear otitis etc..)

The use of dummies should be kept to particular circumstances like during the mother´s absence or while driving. Apart from dummies or pacifiers there are other methods to calm the child like skin and body contact.

Recommendations by the Breastfeeding Committee and the work-group for the study of sudden infant death (SPA):

1. The safest way to sleep for children under six months of age is in a crib or baby cot placed near to parents rather than in bed with parents. And the child should always be placed on his or her back.
2. Breastfeeding has a protective effect and can reduce the risk of sudden infant death syndrome (SIDS). Although co-sleeping helps to promote breastfeeding, it also increases the risk of (SIDS) and is therefore not recommended in the following cases:
   • Infants under three months of age.
   • Premature babies or babies with a low birth weight.
   • Smoking, alcohol, drug taking or sedatives.
   • Situations of tiredness.
   • Co-sleeping on soft bedding or armchairs and sofas.
   • Bed- sharing with other persons.
3. If you wish to be closer to the child during the night you may use a sidecar crib or cot which is very convenient for nursing.

Galactogogues are medications that stimulate milk production. The most commonly used ones are: Sulpiride, Metoclopramida y Domperidona. They are effective but should only be used under medical supervision, and after checking that the feeding technique and frequency are adequate. It is important to rule out illnesses that may cause hypogalactia.

Combined with frequent extractions, these medications are indicated in the case of: unavoidable mother-child separation, moms with preterm babies with low levels of breast-milk, re-lactation and induced lactation. If you think you need medication consult an expert.

There is no scientific evidence regarding the efficacy of herbal galactogogues. Some may even be harmful and so are not recommended. (more information at www.e-lactancia.org)

Mother´s milk may be stored during a certain period of time depending on the characteristics of your fridge–freezer. It is advisable to cool the milk as soon as possible and then freeze it.

It should be stored in recipients used specifically for keeping food rations. Glass is better than other materials. Before use, wash the recipient well with soap and water and allow it to air-dry. You can use the dishwasher and it is not necessary to sterilize the recipient.

Defrost small amounts (just enough for immediate use), first in the fridge and then in warm water baths. Do not use the microwave oven and don’t heat it directly.

Once defrosted, the milk must not be refrozen. Do not store used milk.