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Great video from the Australian Breastfeeding Association

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Australian Breastfeeding Association Redlands Group Australian Breastfeeding Association Ballarat Group Hi

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Australian Breastfeeding Association - Timeline | Facebook

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What does good attachment look like? How do you know if your baby is attached properly? This video on breastfeeding has tips for good attachment to help you get your baby feeding well. The video includes an animated diagram, a mum's point of view and step-by-step instructions.

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10-minute video: essential viewing

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Attaching Your Baby at the Breast – Breastfeeding Series

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The way you hold your baby or position them will affect how easy it is for them to breastfeed effectively. You can breastfeed your baby in many different positions, so it's good to try different ones. This helps you find what's most comfortable for you and allows your baby to get just the right mouthful of breast to feed effectively and easily.

Breastfeeding positions for newborns

When you first start breastfeeding, you and your baby may take a while to master this new skill. Patience and trying different positions will help you find a position that works for you both.
Our video has some great tips on different ways to hold your baby.
If you're having problems breastfeeding, or with latching or attachment, do call our infant feeding support line on 0300 330 0700 to talk to a breastfeeding counsellor. Your midwife or health visitor may know about local breastfeeding support groups.

Getting some support with breastfeeding can help you to get comfortable in one or more of the breastfeeding positions that we describe in this article.

Here's how to get started...

Preparing to feed

Your baby will be happier and will latch more easily if you can identify and respond to their early feeding cues. If they are crying or upset, they need to be calmed before they are ready to feed.

Holding them against you, talking to them, walking around or gently rocking might help if they need to be calmed. Most babies like to have their hands free to touch and stroke your breast; this helps to reassure them that they are in the right place.

Read more about getting started with breastfeeding in our article here.

Laid-back position

Sitting upright

Lying down

Underarm or rugby ball

Holding your baby under your arm may be suggested to women who have given birth by caesarean, to avoid pressure on the wound. This position might also be suggested to mothers of twins. However, it can be difficult to maintain this position as the baby's weight is being taken by the mother's hand. Babies soon outgrow this position, and it doesn't allow them to use their instincts and reflexes to attach on to the breast (NHS, 2020; La Leche League, 2022).

Breastfeeding positions for a fast milk flow

If you have a fast milk flow, this could be due to a large supply of breast milk. A fast milk flow can make your baby cough, splutter and come off the breast, which is sometimes similar to reflux symptoms. If they're having problems, it could be that the baby needs more control when they're feeding. If this is the case, laid-back feeding, where the baby is more in control, could be useful as it helps your baby to attach better and pull back if they need to take a break.

Breastfeeding your baby as they grow

As your baby grows, they become more active in getting themselves into position, and they're longer and heavier. So you might need to adjust you and your baby's position to continue to feed comfortably and effectively.

A laid-back breastfeeding position could be useful with larger or older babies as you do not have to use your arms to hold their weight. You can always ask a breastfeeding counsellor for support with finding positions that suit you and your baby.

Breastfeeding position tips

Whichever breastfeeding position you choose, remember...

Get comfortable before you start.

Tuck your baby in closely to you.

Bring your baby to your breast or let them attach themselves rather than leaning towards them.

Avoid putting the breast in your baby's mouth; let them take it in themselves.

Check that their ear, shoulder and hip are all in a line - not twisted round.

If you are bringing your baby to your breast, make sure they are turned towards your breast, with your nipple level with baby's nose - they shouldn't have to turn their head.

Cushions, special breastfeeding pillows and other supports can prevent your baby's body from getting close enough to your body or may raise your baby's body too high for effective attachment. It's best to get your baby attached to the breast, then if support is needed tuck a pillow in under your arm at the point where you are feeling strain from the weight of the baby.

(UNICEF and NHS, 2022)

Many women and babies take a while to get used to breastfeeding and it can take a while to find the position(s) that work best for you. Experimenting with different positions can help you find the ones that work best for you and your baby.
Page last reviewed December 2022.
Further information

NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our helpline on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.

National Breastfeeding Line (government funded): 0300 100 021.

For further information on how to breastfeed, including positioning and breastfeeding attachment, and a section on expressing your breastmilk by hand, visit Unicef's Baby Friendly Initiative support area for parents.

Bump to Breastfeeding DVD: available from your midwife or library - see more at www.bestbeginnings.org.uk

Coulson S. (2012) Biological nurturing: the laid-back breastfeeding revolution Midwifery today. 101. Available at: https://midwiferytoday.com/mt-articles/biological-nurturing/ [Accessed 7th November 2022]

La Leche League. (2022) Positioning. Available at: https://www.llli.org/breastfeeding-info/positioning [Accessed 7th November 2022]

Milinco M, Travan L, Cattaneo A, Knowles A, Sola MV, Causin E, et al. (2020) Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial. Int Breastfeed J. 15(1):21. Available at: https://doi.org/10.1186/s13006-020-00261-4

NHS. (2020) How to breastfeed. Available at: https://www.nhs.uk/start4life/baby/feeding-your-baby/breastfeeding/how-... [Accessed 7th November 2022]

UNICEF; NHS. (2022) Off to the best start. Available at: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfe... [Accessed 25th November 2022]

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Breastfeeding positions: which are best for you? | Baby & toddler, Feeding articles & support | NCT

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Here we provide tips on breastfeeding positions, including laid-back, lying down, sitting upright and underarm positions.

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Unicef UK Baby Friendly Initiative | Positioning and attachment

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An article about how antibodies in breast milk protect your baby from infections.

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Ingredients lists showing the difference between breast milk and formula.

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The science of human milk and breastfeeding

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Simple, animated video about how lactation works.

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Simple, animated video about how lactation works.

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Expecting a baby? - Find out how your milk making Superpower works! Check out our fab new video explaining all about how lactation works.

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NCT leaflet

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NCT leaflet

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First Steps Nutrition guide

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NCT leaflet

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Association of Breastfeeding Mothers (ABM)

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Association of Breastfeeding Mothers (ABM)

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Lots to explore here in the ABM information library

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Browse support in our Information Library by stage, need, family member. Our most popular leaflet is Relactation: restarting breastfeeding after a gap.

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Our breastfeeding counsellors have been receiving lots of questions about coronavirus and breastfeeding. So here we answer your most frequent questions.

Does breastmilk contain coronavirus?

From the limited evidence that is currently available, it's not thought that breastmilk contains or can transmit coronavirus (RCOG, 2020). The biggest risk of infection is through close contact between mother and baby. We know that transmission is by airborne droplets from coughing and sneezing (RCOG, 2020).

Can I still breastfeed if I might or do have coronavirus?

Absolutely. In fact, experts think that the benefits of breastfeeding to bonding and feeding outweigh the potential risks of passing on the virus (RCOG, 2020). Breastmilk boosts a baby's immune system (Unicef, 2020).

You might find it helpful to talk everything through with one of our breastfeeding counsellors, or your healthcare provider. You can call our Infant Feeding Support line for information and support: 0300 330 0700, between 8am and midnight.

How can I breastfeed more safely if I think I might have coronavirus?

Experts recommend the following precautions for breastfeeding (these also apply to parents using formula milk):

1. Thorough hand washing before you touch your baby or anything to do with feeding. This may include nipple shields, breast pumps and dummies. Use soap and water and wash your hands for 20 seconds.

2. Not sneezing or coughing on your baby - make sure you cover your mouth and nose with a tissue or sleeve when you sneeze or cough.

3. Wearing a face mask, if available, while feeding.

4. Very carefully follow sterilisation instructions for breastfeeding equipment after using it - for more information see our article about how to sterilise feeding equipment. This includes making sure all food preparation areas are clean, such as kitchen worktops.

5. Potentially ask someone else to feed your baby your expressed breastmilk - see our article about expressing breastmilk for more information.

(NHS, 2020; RCOG, 2020)

Where can I go for support now many social activities have stopped?

It's always helpful to talk to other women who are breastfeeding for support, tips and company. Although breastfeeding drop-ins may be closed to limit the spread of coronavirus, peer support can be found on most social media platforms online, like this one.

As well as support from our breastfeeding counsellors and your health care providers, our breastfeeding commissioned services are offering virtual breastfeeding support via zoom groups, text messaging and one-to-one calls.

If you live in any of these areas and would like some support from a breastfeeding peer supporter, please get in touch:

Many of our local NCT branches are also providing online breastfeeding peer support via closed Facebook groups. Get in touch to find out more - search on your postcode and message your closest branch to see if they have any online peer support.

Will I be offered the coronavirus vaccine if I'm breastfeeding?

The Joint Committee on Vaccination and Immunisation (JCVI) say that it's safe for breastfeeding women to have the Covid-19 vaccination.

So if you are breastfeeding your baby, you should be offered the COVID-19 vaccine and booster. Further information can be found on the Royal College of Obstetricians and Gynaecologists website.

A health professional such as a GP or midwife can talk you through the risks and benefits to help you make an informed decision about vaccination. Be aware that lots of anti-vaccine stories are spread online and they're not based on scientific evidence. Find out more about breastfeeding and the vaccine here.

Further information

We support all parents, however you feed your baby. You can call our feeding support line on 0300 330 0700 (option 1) to talk to a breastfeeding counsellor about your questions or concerns, whether you're breastfeeding, using formula milk or introducing solids. They have had extensive training, will listen without judging or criticising, and will offer relevant information and suggestions. The line is open everyday from 8am to midnight, including bank holidays.

Read the the NHS advice on what you should do when you're self isolating.

Take a look at the latest public health guidance for pregnant women and parents.

Interactive, engaging and social, our antenatal course is a great way for you to meet other local parents, and get essential unbiased information and knowledge about pregnancy, birth and early days with your baby.

Click on the following links for guidance on self-isolation and social distancing in Arabic, Bengali, Cantonese, French, Gujarati, Mandarin, Polish, Portuguese, Punjabi, Urdu and Welsh.

For more information about coronavirus in various languages see here.

For more information and support, click on the links to see our articles about:

Coping with self-isolation and being stuck at home with your baby
How to look after your baby when you're not feeling well
Coronavirus: top tech and apps to keep you connected to friends
Dealing with anxiety over coronavirus
Coronavirus outbreak: surprising things you can get delivered

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Is it safe to breastfeed with coronavirus? | Baby & toddler, Feeding articles & support | NCT

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The thought of getting coronavirus while breastfeeding your baby might feel worrying. Here are the facts.

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By Kelly Bonyata, BS, IBCLC

The First Week

How often should baby be nursing?

Frequent nursing encourages good milk supply and reduces engorgement. Aim for nursing at least 10 - 12 times per day (24 hours). You CAN'T nurse too often-you CAN nurse too little.

Nurse at the first signs of hunger (stirring, rooting, hands in mouth)-don't wait until baby is crying. Allow baby unlimited time at the breast when sucking actively, then offer the second breast. Some newborns are excessively sleepy at first-wake baby to nurse if 2 hours (during the day) or 4 hours (at night) have passed without nursing.

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Is baby getting enough milk?

Weight gain: Normal newborns may lose up to 7% of birth weight in the first few days. After mom's milk comes in, the average breastfed baby gains 6 oz/week (170 g/week). Take baby for a weight check at the end of the first week or beginning of the second week. Consult with baby's doctor and your lactation consultant if baby is not gaining as expected.

Dirty diapers: In the early days, baby typically has one dirty diaper for each day of life (1 on day one, 2 on day two...). After day 4, stools should be yellow and baby should have at least 3-4 stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse, or even more often-this is normal, too. The normal stool of a breastfed baby is loose (soft to runny) and may be seedy or curdy.

Wet diapers: In the early days, baby typically has one wet diaper for each day of life (1 on day one, 2 on day two...). Once mom's milk comes in, expect 5-6+ wet diapers every 24 hours. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper. A piece of tissue in a disposable diaper will help you determine if the diaper is wet.

Breast changes

Your milk should start to " come in" (increase in quantity and change from colostrum to mature milk) between days 2 and 5. To minimize engorgement: nurse often, don't skip feedings (even at night), ensure good latch/positioning, and let baby finish the first breast before offering the other side. To decrease discomfort from engorgement, use cold and/or cabbage leaf compresses between feedings. If baby is having trouble latching due to engorgement, use reverse pressure softening or express milk until the nipple is soft, then try latching again.

Call your doctor, midwife and/or lactation consultant if:

Baby is having no wet or dirty diapers

Baby has dark colored urine after day 3(should be pale yellow to clear)

Baby has dark colored stools after day 4(should be mustard yellow, with no meconium)

Baby has fewer wet/soiled diapers or nurses less frequently than the goals listed here

Mom has symptoms of mastitis(sore breast with fever, chills, flu-like aching)

Weeks two through six

How often should baby be nursing?

Frequent nursing in the early weeks is important for establishing a good milk supply. Most newborns need to nurse 8 - 12+ times per day (24 hours). You CAN'T nurse too often-you CAN nurse too little.

Nurse at the first signs of hunger (stirring, rooting, hands in mouth)-don't wait until baby is crying. Allow baby unlimited time at the breast when sucking actively, then offer the second breast. Some newborns are excessively sleepy-wake baby to nurse if 2 hours (during the day) or 4 hours (at night) have passed without nursing. Once baby has established a good weight gain pattern, you can stop waking baby and nurse on baby's cues alone.

The following things are normal:

Frequent and/or long feedings.

Varying nursing pattern from day to day.

Cluster nursing (very frequent to constant nursing) for several hours-usually evenings-each day. This may coincide with the normal "fussy time" that most babies have in the early months.

Growth spurts, where baby nurses more often than usual for several days and may act very fussy. Common growth spurt times in the early weeks are the first few days at home, 7 - 10 days, 2 - 3 weeks and 4 - 6 weeks.

Is baby getting enough milk?

Weight gain: The average breastfed newborn gains 6 ounces/week (170 grams/week). Consult with baby's doctor and your lactation consultant if baby is not gaining as expected.

Dirty diapers: Expect 3-4+ stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse, or even more often-this is normal, too. The normal stool of a breastfed baby is yellow and loose (soft to runny) and may be seedy or curdy. After 4 - 6 weeks, some babies stool less frequently, with stools as infrequent as one every 7-10 days. As long as baby is gaining well, this is normal.

Wet diapers: Expect 5-6+ wet diapers every 24 hours. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper. A piece of tissue in a disposable diaper will help you determine if the diaper is wet. After 6 weeks, wet diapers may drop to 4-5/day but amount of urine will increase to 4-6+ tablespoons (60-90+ mL) as baby's bladder capacity grows.

Milk supply?

Some moms worry about milk supply. As long as baby is gaining well on mom's milk alone, then milk supply is good. Between weight checks, a sufficient number of wet and dirty diapers will indicate that baby is getting enough milk.
This information is also found as part of the professional Breastfeeding Logs.
Additional information

@
Breastfeeding Logs Hunger Cues - When do I feed baby? Resources: Is Baby Getting Enough Milk? Normal Growth of Breastfed Babies Breastfeeding Basics
Information is Your Ally in preparing to breastfeed: 10 Tips for Success by Eva Lyford
Tips for juggling a newborn and toddler Frequent Nursing
Worried about milk supply?
How does milk production work? Is your milk supply really low? My breasts feel empty! Has my milk supply decreased? How can I find help for my breastfeeding problem?
@ other websites

The Importance of Colostrum by Paula Yount

Baby Explains- Normal Newborn Behavior by Diana Cassar-Uhl, IBCLC

It's Not Just About Breastfeeding by Danielle Rigg, JD CLC

What is Normal? by Paula Yount

Breastfeeding as Baby Grows by Becky Flora, IBCLC

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Breastfeeding your newborn - what to expect in the early weeks * KellyMom.com

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Frequent nursing encourages good milk supply and reduces engorgement. Aim for breastfeeding at least 10 - 12 times per day (24 hours). You CAN'T breastfeed too often--you CAN breastfeed too little. Nurse at the first signs of hunger (stirring, rooting, hands in mouth)--don't wait until baby is crying.

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The purpose of breast compression is to continue the flow of milk to the baby when the baby is only sucking without drinking. It is possible to know when a baby is getting milk from the breast - the pause in the chin means baby got a mouthful of milk. The longer the pause, the more milk the baby got. If baby is no longer drinking on his own or drinking is slowing down, compressions can be used to "turn sucks or nibbling into drinks", and keep baby receiving milk. Breast compressions simulate a milk ejection reflex (let-down reflex) and stimulate a milk ejection reflex. See also our blog on breast compression.

The technique may be useful for:

Poor or slow weight gain in the baby

Fussy babies. Babies who are fussy usually want more milk.

Frequent feedings and/or long feedings

Sore nipples in the breastfeeding parent

Recurrent blocked ducts and/or mastitis

Encouraging the baby who falls asleep quickly to continue drinking not just sucking

A "lazy" baby, or baby who seems to want to just "pacify". Incidentally babies are not lazy, they respond to milk flow, so that if flow slows, babies may start to fall asleep. Or if they are older, they may pull away from the breast.

Please note: Babies are not lazy. They respond to milk flow. If flow is slow, or milk does not flow at all, young babies will tend to fall asleep. Older babies may pull away from the breast when flow is slow.

Breast compression is not necessary if everything is going well. When all is going well, allow the baby to "finish" feeding on the first side and then offer the other side. How do you know the baby is finished the first side? When the baby is just sucking (rapid sucks without pause) and no longer drinking at the breast ("open mouth wide - pause - then close mouth" type of suck). Breast compressions help baby to get more milk.

Breast compression works particularly well in the first few days to help the baby get more colostrum. Babies do not need much colostrum, but they need some. A good latch and breast compression help them get it.

IT MAY BE USEFUL TO KNOW THAT:

A baby who is well latched on gets milk more easily than one who is not latched on well. A baby who is poorly latched on can get milk only when the flow of milk is rapid. Thus, many breastfeeding parents and babies do well with breastfeeding in spite of a poor latch because most breastfeeding parents produce an abundance of milk. However, the breastfeeding parent may pay a price for baby's poor latching-for example: sore nipples, a baby who is "colicky", and/or a baby who is constantly on the breast (but drinking only a small part of the time).

In the first 3-6 weeks of life, many babies tend to fall asleep at the breast when the flow of milk is slow, not necessarily when they have had enough to eat and not because they are "lazy" or want to pacify. After this age, sometimes before, they may start to pull away at the breast when the flow of milk slows down. However, some pull at the breast even when they are much younger, sometimes even in the first days and some babies fall asleep even at 3 or 4 months when the milk flow is slow.

BREAST COMPRESSION-HOW TO DO IT
(Use with the other information provided in the "Latching and Feeding Management" information sheet)
1. Hold the baby with one arm.

2. Support your breast with the other hand, encircling it by placing your thumb on one side of the breast (thumb on the upper side of the breast is easiest), your other fingers on the other, close to the chest wall.

3. Watch for the baby's drinking, ( see videos) though there is no need to be obsessive about catching every suck. The baby gets substantial amounts of milk when he is drinking with an "open mouth wide-pause-then close mouth" type of suck.

4. When the baby is nibbling at the breast and no longer drinking with the "open mouth wide-pause-then close mouth" type of suck, compress the breast to increase the external pressure of the whole breast. Do not roll your fingers along the breast toward the baby, just squeeze and hold. Not so hard that it hurts and try not to change the shape of the areola (the darker part of the breast near the baby's mouth). With the compression, the baby should start drinking again with the "open mouth wide-pause-then close mouth" type of suck. Begin breast compression when the baby is not drinking much and before the baby gets too sleepy.

5. Keep the pressure up until the baby is just sucking without drinking even with the compression, and then release the pressure. Release the pressure if baby stops sucking or if the baby goes back to sucking without drinking. Often the baby will stop sucking altogether when the pressure is released, but will start again shortly as milk starts to flow again. If the baby does not stop sucking with the release of pressure, wait a short time before compressing again.

6. The reason for releasing the pressure is to allow your hand to rest, and to allow milk to start flowing to the baby again. The baby, if he stops sucking when you release the pressure, will start sucking again when he starts to taste milk.

7. When the baby starts sucking again, he may drink ("open mouth wide-pause-then close mouth" type of suck). If not, compress again as above.

8. Continue on the first side until the baby does not drink even with the compression. You should allow the baby to stay on the side for a short time longer, as you may occasionally get another letdown reflex (milk ejection reflex) and the baby will start drinking again, on his own. If the baby no longer drinks, however, allow him to come off or take him off the breast.

9. Offer the other side and repeat the process.
12. Remember, compress as the baby sucks but does not drink. Wait for baby to initiate the sucking; it is best not to compress while baby has stopped sucking altogether. Watch our videos to see how compressions are used. The information presented here is general and not a substitute for personalized treatment from an International Board Certified Lactation Consultant (IBCLC) or other qualified medical professionals.
10. You may wish, unless you have sore nipples, to switch sides back and forth in this way several times. But, remember, improving the latch is very important to preventing and treating sore nipples. Nipple soreness is caused by a poor latch.

11. Work on improving the baby's latch.

In our experience, the above works best, but if you find a way which works better at keeping the baby drinking with an "open mouth wide-pause-then close mouth" type of suck, use whatever works best for you and your baby. As long as it does not hurt your breast to compress, and as long as the baby is "drinking" ("open mouth wide-pause-then close mouth type" of suck), breast compression is working.
Make an appointment at the Newman Breastfeeding Clinic.
You will not always need to do this. As breastfeeding improves, you will be able to let things happen naturally.

This information sheet may be copied and distributed without further permission on the condition that you credit International Breastfeeding Centre it is not used in any context that violates the WHO International Code on the Marketing of Breastmilk Substitutes (1981) and subsequent World Health Assembly resolutions. If you don't know what this means, please email us to ask!

©IBC, updated July 2009, June 2017, October 2021

Questions or concerns? Email Dr. Jack Newman (read the page carefully, and answer the listed questions).

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International BreastFeeding Centre | Breast compressions to increase milk flow to the baby

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The purpose of breast compression is to continue the flow of milk to the baby when the baby is only sucking without drinking. It is possible to know when a baby is getting milk from the breast - the pause in the chin means baby got a mouthful of milk.

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Skip to main content

Read more for support for parents on tongue-tie

Many babies have a piece of membrane under their tongue (the frenulum) which does not usually cause problems. Tongue-tie (ankyloglossia) occurs when the frenulum is abnormally short, stopping the tip of the tongue from protruding beyond the lower gum. This may cause problems with feeding as a result of the inability to move the tongue in a normal way and therefore attach and suck effectively. The frenulum may reach the tip of the tongue and be easily seen, and may be either thin and stretchy or thicker/tighter. A posterior frenulum, which is at the back of the tongue, can be less easy to see and in some cases may only be felt. If you and/or your baby are experiencing feeding difficulties, an assessment of your baby's tongue function and a feeding assessment by a specially trained professional will determine whether a division of the membrane ( frenulotomy) could help.

Many tongue-ties are asymptomatic and do not require treatment, and some may resolve spontaneously over time. In some instances, support to improve attachment is all that is needed. However, if the condition is causing problems with feeding, surgical division of the lingual frenulum can be recommended and carried out as early as possible. This may enable the mother to continue breastfeeding rather than having to switch to artificial feeding.
NICE has approved the division of tongue-tie.

FIND OUT MORE

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Information for parents and health professionals on identifying and managing tongue tie, and other useful resources on the condition.

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Debunking the myths about low supply

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Forgive me for asking but...

Do you REALLY have low milk supply?

This is a very important place to start. Please bear with me. I don't mean to doubt your situation and be annoying patronising lactation consultant woman but it's crucial to note that the MAJORITY of new mothers who fear they have low milk supply DO NOT.

The majority of women who start to use formula because they worry they aren't making enough or baby isn't getting enough DO NOT HAVE A PROBLEM.

I cannot emphasise this enough.

Every day mothers panic and end breastfeeding or start using formula and there is not an underlying problem with their milk supply. But of course - once they start using formula without correct support, they often will start to send signals to their breasts to really reduce supply.

· You do not have low milk supply just because your baby won't go the X number of hours between feeds that the book on your coffee table tells you they should. Or your mother-in-law. Or the X number of hours your friend's baby is going between feeds.

A normal happy healthy baby who has a gorgeous mummy with a normal healthy milk supply might get hungry an hour after the last feed, or 90 minutes, or 45 minutes or two hours. They might be cluster feeding and hardly want to come off the breast at all. They might be having a growth spurt and feed every hour for a day.

· You do not have low milk supply because your breasts have stopped leaking. Some mothers leak less than others. MOST mothers notice that leaking reduces at the weeks go by and the teeny tiny sphincter muscles responsible tighten.

· You do not have low milk supply because your breasts feel softer than they used to. The excessive fullness we experience in the early days of breastfeeding is about vascular engorgement (blood and lymph) and it's about the body inefficiently storing unnecessary amounts of milk between feeds. As time goes by, the breasts get cleverer at storage (don't forget milk is also made while a baby is actually feeding). There is also less blood and lymph needed in the breasts as breast tissue growth slows down. At the beginning, it's often very obvious which breast is going to be fed from next. That feeling goes. And many mothers mistakenly connect it with a reduction in milk supply. We are not all supposed to continue feeling heavy and full throughout our breastfeeding experience. Don't ever think 'I'll wait to let my breasts fill up!' Noooooo. This shows a misunderstanding of how lactation works to a spectacular degree. When breasts are fuller, milk production slows down. When breasts are emptier, milk production increases. Emptier softer breasts may well be making a heap more milk in a 24 hour period than the engorged full versions.

· You do not have low milk supply because your baby feeds for a short time. Plenty of babies get everything they need in under ten minutes. Probably not five - but sometimes a feed might even be five minutes long. Lots of babies use their tongue and jaw muscles super efficiently and gulp and glug and slow down as the milk gets fattier and thicker and then come off happy. It might take them nine minutes or nineteen. A baby might start off life needing 30 minutes to drain a breast (when we say 'drain', breasts are never completely empty, it just means the baby has taken out all the milk they usefully want to). As a baby gets older, this can dramatically reduce. It doesn't mean less milk is going in. If a small sleepy jaundiced baby falls asleep very quickly at the breast without some solid minutes of good swallowing, that's a different story. Overall however, a longer feed does not always mean a better one.

· You do not have low milk supply because you have small breasts. Large breasts are a combination of fatty tissue and glandular tissue. You cannot tell much about someone's milk production by the size of the breasts. If you are really worried your breasts don't 'look right', we'll come back to this later.

· You do not have low milk supply just because your baby wakes up a lot. Plenty of young babies feed with similar intervals day and night. Plenty continue waking every 2-3 hours for a while.

· You do not have low milk supply because your baby won't 'go down' after a feed. So you feed your baby and they drop off to sleep on the breast. You move them to the Moses basket and they wake up as if you just placed them on a sheet of molten lead. And they seem to be rooting again. This happens because being next to you skin-to-skin was nice and cosy and relaxing and warm and it smelt good. The Moses basket is cold and NOT YOU. You probably triggered the Moro startle reflex when you moved them. You probably moved them about 15-30 minutes after a feed when the hormone cholecystokinin had dropped in their blood stream causing them to be more wakeful. Your teeny primate mammal baby finds the breast a lovely place to be. They like to suck to relax themselves. Babies like second helpings. This does not mean you are not making enough milk.

· You do not have low milk supply because your baby will take milk out of a bottle after a feed. Put a teat against a young baby's palate and you trigger that baby's sucking reflex. Babies will usually continue to take milk beyond the point that they need it. This is one of the reasons we see links between bottlefeeding and obesity.

You do not have low milk supply you cannot feel your 'letdown' reflex (milk ejection reflex). Some women feel an electrical tingle at the point the milk lets down. Some don't. Crucially some feel it for the first few weeks and then it fades. This fading sometimes worries people. It does not mean anything has changed with your milk supply and it is perfectly normal for the sensation to go.

· You do not have low milk supply because you don't pump very much milk. Pumping and breastfeeding are surprisingly unrelated. Your baby removes milk in a completely different way. Plenty of women with healthy milk supplies fail to pump much at all. Their bodies can't be tricked into eliciting the milk ejection reflex (or 'letdown'). Plus pumps don't always work. Suction goes as valves get old.

These are the things that REALLY tell you a mother might have low milk supply:

· Weight gain problems. A newborn is born and then loses weight. They regain birth weight at around two weeks. They then put on about 150-200g a week after that. That slows down after around four months. If your newborn loses more than 10% of their body weight, we might pay attention but we'll also want to look at things like your birth. Did you have a drip in labour that filled you and your baby with fluid? Did your gorgeous newborn look a wee bit like the Stay Puft marshmallow man in their first photos? That fluid elevated the birth weight and as it comes out again in the first few days, we might see more of a weight drop. That doesn't necessarily mean feeding or supply is a problem. However we wouldn't want your baby to lose weight after about day five or lose weight a second time. It might take some babies three weeks to get back up to birth weight.

Have a look at the chart in your red book. Notice how we have birth weight line and then a space where the curvy lines don't go and they start again at week two. Just because your baby was born on the 75th percentile, that doesn't mean we would expect them to definitely re-start on the 75th after that two week gap. That's why the lines don't continue. That's why we have that space. We start again at two weeks. Your baby might be on the 50th then. They then ideally will roughly stick in the same vicinity. But babies wobble around a bit. They might dip below. They might get close to the 25th. And then they might bob back up again. We don't expect all babies to hug a line exactly. This chart is a guide. It's about averages. It's not about mathematical certainties.

· Nappies. In the early days (first four weeks), we look at poo and pee. After your milk has come in (around day two to five), we'd expect to see six wet nappies in 24 hours and three poos the size of a £2 coin or bigger. After week four, some babies' poo rate can slow right down. This doesn't mean anything is wrong. Some babies can skip several days between poos and this isn't anything to do with milk transfer or supply. However if someone tells you it's OK for a ten day old baby not to poo for a few days, don't believe them. We'd need to investigate that situation. Only later on do we relax.

Weight gain and nappies. That's it. Those are the only things that tell us about milk supply. You may hear people say that 'babies should be settled after a feed' but some babies get wind or need to poo or have reflux or wake up and want second helpings. Let's be careful about even saying that. Let's look at weight gain and nappies.

So let's now assume you do have low milk supply. How many of you are still with me? I'm sorry if you are. I'm sorry if your baby only put on 60g last week and 90g or less or nothing the week before that and they are slipping down the percentiles. I'm sorry because I know how scary that can feel. Nothing feels like it matters more. There are things we can do.

1. Find people.

Find people who know about breastfeeding. Someone who tells you just to use formula in this situation is not who you need. If that's all they can offer you, they don't know about breastfeeding and you need someone else. You need someone who understands how lactation works. These people may actually still tell you to use some formula in some situations (or donor breastmilk) but they will do so alongside telling you how to protect and develop your milk supply. You also need people close to you to look after you. If you are going to do all the other stuff on this list, you need to have people who love you who will cook your dinner and run you a bath sometimes. And text you just before the weigh-in clinic next week to say they are thinking of you.
2. Breastfeeding M.O.T.
Someone like a breastfeeding counsellor or IBCLC (lactation consultant) should check your latch. You might not be sore and your nipples might not be misshapen after a feed but something still might be going wrong. Your latch needs checking. Is baby's chin deep into the breast? Is baby's body close to yours? Is baby's ear/ shoulder/ hip in a line?

They shouldn't just check your latch but look at your breastfeeding management. Are you feeding enough? Maybe your baby doesn't show cues very strongly and someone told you to wait for them and you're sometimes going four hours between feeds? Maybe you need to feed more frequently?

They may also need to take a closer look at your baby. Is there a reason why baby may not be transferring milk effectively? Is this someone who can look at baby's tongue, jaw and palate? Are they familiar with the term 'tongue tie' and especially 'posterior tongue tie'? Would they know what to do if there was one? That might mean suggesting an exaggerated latch or different positions or it might mean referring you to a tongue tie specialist.

When are you changing sides? Too quickly? (and baby is missing the fatty milk). OR did someone tell you to stick on one side forever to get that 'hind milk' and the baby is on 45 minutes without doing a heck of a lot? Maybe you need to change sides at 20-30 minutes instead and get baby a greater volume of milk overall and fatty milk overall. Both of these habits can cause weight gain problems. Get someone to help you recognise what swallowing looks like so you'll know when to change sides and when good feeding has finished.

3. Google ' breast compressions'. You'll get to a video and handout from Dr Jack Newman. You can finish a feed with breast compressions and get an extra dose of fatty milk into baby.

4. You have 3 sides and 4 sides. This is ' switch nursing'. Try and go back to the first side. There will be milk there. The more breastfeeding you do, the more milk you will make. The second time you return to that breast, the milk will be fattier and richer and you'll send great signals to your body to make more.

5. Find time.

If you are going to build up your supply, get help. You can't devote time to switch nursing and skin-to-skin when you have to go to Tesco to buy milk and pick up another child from school. If this is 'Operation Milk supply', who can help you? You'll read people talking about a 'babymoon'. Go to bed, they say. Just you and the baby. Feed lots. If that sounds appealing, go for it. Personally my babymoon would involve the sofa and box sets and crisps. However there's no point in babymoooning until next Christmas if your latch and breastfeeding management are the issues. Get that checked first.

6. Using a pump.

Baby feeding effectively is first choice but pumps can be useful. You can pump on an emptier breast to send even more signals to your milk supply. But we're not going to take a baby off the breast do be able to pump.

You don't need to wash and sterilize a pump every time you use it. Pop it in a plastic bag and put it back into the fridge between pumping sessions. 10 minutes is ample. If you are pumping for 30 minutes and 'nothing is coming' out, you are not getting a letdown and you are not doing yourself any favours. Use hand expression before and after (google 'Marmet hand expression') and prepare the breasts with warm compresses and massage if you can. You can take an hour and do some 'cluster pumping' or 'power pumping'. Pretend to be a baby having a cluster feed. Pump for ten minutes. Break for five. Pump again and repeat.

Just check your pump is the best one available. If it's second hand or you have had it a while, it might need servicing or replacement parts. You also might want to consider hiring a hospital grade double electric pump from someone like www.ardobreastpumps.co.uk to give yourself the opportunity to pump both sides together as effectively as possible.

Pumping shouldn't hurt. Make sure your flanges are the right size - that means they are the right diameter for the size of your nipple. Don't think that cranking up the suction will automatically do better things. And don't think, "I don't want to pump because I will empty my breasts and baby will have less milk." Certainly they might be less appreciative if you pump just before a feed is due and you leave them with an emptier breast full of thicker fattier milk but pumping overall will increase milk supply and stimulate milk production. You are not 'taking their milk away'.

You might also be someone who always gets better results with just using hand expression so stick with that.

Of course, you might not want to pump at all and just focus on feeding baby more effectively and frequently.

7. Galactagogues.

Taking herbs and medication that increase milk supply. Not right for everyone but some women really feel they helped. You need to read about side effects and dosage on sites like kellymom.com. Fenugreek, blessed thistle and goat's rue are popular. Some doctors prescribe domperidone in certain situations. These are never a substitute for good breast emptying and a breastfeeding MOT.

8. The science part.

In a book, this bit would be under a little flap as we're only talking to a small group of people.

Did you have breast surgery?

Are your breasts very widely-spaced or asymmetrical, or very tubular with a bulging areola? Did they not really change much in pregnancy (or puberty)?

Do you have PCOS? Some women with PCOS (not all) have a reduced milk supply.

These are times when it's worth finding an IBCLC and getting technical.

Some doctors will do hormonal testing for you. There are medications that can help develop breast tissue especially in pregnancy.

What about your thyroid levels? This is something relevant for more people than you might realise. If you are trying everything and low milk supply continues to be a problem, ask your doctor to check your thyroid levels. There are sometimes medical reasons mothers have a low milk supply and doctors and lactation consultants may be able to help you. These are not the most common reasons why people have low milk supply by a long shot. Hence the need for the flap.

Most people who genuinely have low milk supply got themselves into a pickle with using artificial nipples or not breastfeeding enough or breastfeeding ineffectively. And it can almost always be reversed.

Also remember that just because you had low milk supply in your first breastfeeding experience, it doesn't mean a subsequent lactation will also be a struggle. The development of all that breast tissue first time round often helps.

Hold in your mind the fact that women can relactate after not breastfeeding at all for several weeks. We CAN send signals to increase supply again in the vast majority of cases. There are tons of us in real life and online who want to support you.

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Forgive me for asking but... Do you REALLY have low milk supply? This is a very important place to start. Please bear with me. I don't mean to doubt your situation and be annoying patronising lactation consultant woman but it's crucial to note that the MAJORITY of new mothers who fear they have low milk supply DO NOT.

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Articles from NCT on feeding your baby

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Whether you're breastfeeding, formula-feeding or both, you'll find lots of useful articles about feeding here. Plus, tips on introducing solids when you're ready.

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NCT leaflet

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From First Steps Nutrition

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Cow's Milk Allergy Advice | Help on CMPA | Allergy UK

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Information on Cow's Milk Allergy / Cow's Milk Protein Allergy, with free factsheets on related topics to do with CMA / CMPA. For more guidance, contact our free helpline.

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Good evidence based information on choosing and using formula milks

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Infant milks for parents & carers — First Steps Nutrition Trust

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First Steps Nutrition Trust is a charity which provides clear, evidence-based and independent information and support for good nutrition from pre-conception to five years of age.

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If you're planning to bottle feed with expressed breast milk or infant formula, these tips will help keep your baby safe and healthy.

Buying bottle feeding equipment

You'll need a number of bottles and teats, as well as sterilising equipment.

There's no evidence that one type of teat or bottle is better than any other.

Simple bottles that are easy to wash and sterilise are probably best.

Making up bottles

Make sure your bottles and teats are sterilised and wash your hands thoroughly.

If you're using infant formula, follow the instructions on the packaging carefully when you make up the feed.

See how to make up baby formula.

How to bottle feed your baby

Bottle feeding is a chance to feel close to your baby and get to know them.

Make sure you're sitting comfortably. Enjoy holding your baby and looking into their eyes as you feed them.

Hold your baby fairly upright for bottle feeds. Support their head so they can breathe and swallow comfortably.

Brush the teat against your baby's lips and, when your they open their mouth wide, let them draw in the teat.

Always give your baby plenty of time to feed.

Keep the teat full

When bottle feeding, keep the teat full of milk, otherwise your baby will take in air.

If the teat goes flat while you're feeding, gently poke your little finger into the corner of your baby's mouth to release the suction.

If the teat gets blocked, replace it with another sterile teat.

Winding your baby

Your baby may take short breaks during a feed and may need to burp sometimes.

When your baby has had enough milk, hold them upright and gently rub or pat their back to bring up any wind.

Throw away unused milk

Throw away any unused formula or breast milk after you have finished bottle feeding your baby.

Be guided by your baby

All babies are different. Some want to feed more often that others, and some want more milk.

Just follow your baby's lead.

Feed them when they seem hungry and don't worry if they don't finish the bottle.

Don't leave your baby alone

Never leave your baby alone to feed with a propped-up bottle as they may choke on the milk.

Help with bottle feeding

Talk to your midwife, health visitor or other mothers who have bottle fed if you need help.

You'll find the phone number for your health visitor in your baby's red book.

Your questions about bottle feeding

Why doesn't my baby settle after feeds?

If your baby swallows air while bottle feeding, they may feel uncomfortable and cry.

After a feed, hold your baby upright against your shoulder or propped forward on your lap. Gently rub their back so any trapped air can find its way out.

There's no need to overdo it - wind isn't as big a problem as many people think.

Why does my baby sometimes vomit after feeds?

It's normal for babies to bring up a little milk during or just after a feed. This is called possetting, regurgitation or reflux.

Keep a muslin square handy just in case.

Check that the hole in your baby's teat is not too big. Drinking milk too quickly can make your baby sick.

Don't force them to take more milk than they want during a feed.

Sitting your baby upright on your lap after a feed may help.

If it happens a lot, or your baby is violently sick, seems to be in pain or you're worried for any other reason, talk to your health visitor or GP.

Can formula make my baby constipated?

When using formula, always use the amount of powder recommended on the packaging.

Don't add extra formula powder. Using too much can make your baby constipated and may cause dehydration.

If your baby is under 8 weeks old and hasn't done a poo for 2 to 3 days, talk to your midwife, health visitor or GP, particularly if they are gaining weight slowly.

Your baby should be gaining weight and have plenty of wet and dirty nappies.

Infant formula and allergies

If you think your baby might be allergic to or intolerant of formula, talk to your GP. If necessary, they can prescribe a special formula feed.

Some formula is labelled as hypoallergenic, but this isn't suitable for babies with a diagnosed cows' milk allergy.

Soya formula should only be given to babies under medical supervision.

Always talk to your GP before using hypoallergenic or soya-based formula.

Read more about cows' milk allergy and lactose intolerance.

Get Start4Life pregnancy and baby emails

For information and advice you can trust, sign up for weekly Start4Life pregnancy and baby emails.

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If you're planning to bottle feed with expressed breast milk or infant formula, these tips will help keep your baby safe and healthy. You'll need a number of bottles and teats, as well as sterilising equipment. There's no evidence that one type of teat or bottle is better than any other.

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How often should I bottle-feed my baby?

When it comes to bottle-feeding or breastfeeding, all health professionals recommend 'responsive' feeding. This means learning to recognise the early signs that your baby is hungry (often called feeding cues) and never forcing them to finish a feed if they've had enough.

This is particularly important for babies who are formula fed because they can be over-fed and either become sick or put on too much weight (UNICEF UK, 2016).

Responsive feeding may therefore help reduce the risk of obesity (DiSantis et al, 2011).

Watch our video for tips on how to bottle-feed your baby.

How do I know when my baby is hungry?

Your baby's early feeding cues can include movements like:

sticking their tongue out

putting their hands to their mouth

starting to get restless

opening their mouth and turning their head to the side

sucking on their fists or fingers.

(NHS, 2015; UNICEF UK, 2016)

Crying is usually a late sign of hunger. If you wait until your baby starts crying for milk, you might find it more difficult to settle them for a feed (UNICEF UK, 2016). If your baby is upset, try to soothe them before you offer a feed. Skin-to-skin contact is great for calming babies.

How do I bottle-feed my baby?

You can read more about expressing breastmilk for a feed. If you're using formula milk, you'll need to safely prepare your baby's feed first.

Find somewhere comfy to sit and hold your baby close to you. They should be fairly upright, with their head supported, so they can breathe and swallow comfortably (NHS, 2015; UNICEF UK, 2016).

Feeding your baby responsively is a lovely way to bond with them (UNICEF UK, 2016; First Steps Nutrition Trust, 2017). Try talking to them gently and look into their eyes to reassure them during feeds. This helps them to feel safe and loved (NHS, 2015; UNICEF UK, 2016; NHS, 2018).

Focusing on your baby while you're feeding them also helps to pick up their feeding cues. Research has shown that mums who were distracted by things like using a mobile device or talking to another adult were less sensitive to their baby's cues. Distraction made mums more likely to overfeed their baby, possibly increasing their risk of obesity (Golen and Ventura, 2015).

Hold them upright and rub or pat their back to bring up any wind (NHS, 2015; UNICEF UK, 2016). Read our tips for bottle-feeding your baby for more information.

Babies should never be left alone to feed with a propped-up bottle, as they could choke on the milk (NHS, 2015; First Steps Nutrition Trust, 2017).
A quick guide to responsive/paced bottle feeding:

Hold your baby in an upright position, with their head supported, close to the parent's body.

Touch the teat against your baby's top lip, encourage them to open their mouth and pull the teat into the mouth.

Keep the bottle in a horizontal position (not tipped above your baby where the weight of the milk could force them to drink too quickly). A horizontal positions means when your baby pauses in sucking, the milk stops flowing, so they aren't forced to drink.

Allow pauses in drinking. When your baby pauses, withdraw the bottle slightly or completely to give them a break. They may need to burp in the pauses.

Short breaks allow babies to register fullness, so they can regulate the amount of milk they drink.

If your baby is showing hunger cues, offer the bottle again.

Be careful not to force your baby to take the bottle or to finish the bottle.

Follow your baby's lead on how much they want to drink, rather than going by how much is in the bottle.

(UNICEF 2017, UNICEF 2016, NHS 2015)

Who should bottle feed my baby?

Babies build up trust and confidence during feeding, gradually learning what to expect. This is partly how they develop healthy emotional and social attachment (UNICEF UK, 2016). In the early weeks and months, it might help to keep most of your baby's bottle-feeds for you and your partner, or one other trusted person (NHS, 2015; UNICEF UK, 2016).

If someone else is bottle-feeding your baby, talk to them about how you feed your baby so there's some consistency (UNICEF UK, 2016).

How much milk should I give them?

You can usually trust your baby to feed according to their appetite, so be guided by them. In the early weeks, your baby might be unpredictable, and their needs may change day by day. Newborn babies generally take quite small amounts of formula to start with in frequent intervals (NHS, 2015; First Steps Nutrition 2021).

As a general rule, by the end of the first week most babies will require approximately 150ml to 200ml per kilogram of body weight per day, until they're six months old. For example, a baby weighing 6kg at the end of four months, would approximately need 900ml to 1200ml of infant formula per day (First Steps Nutrition Trust, 2021).

A formula fed baby will need to be fed according to the guidelines for their weight and age (First Steps Nutrition, 2021).

Babies are likely to need night feeds for first year of life, as 70% of 6-18 month olds wake up at least once per night (Hysing, 2014).

Babies start eating solid food from about six months - this leads to a gradual reduction in the amount of milk they need. But as milk is still their main food for the first year of life, most babies are still drinking around a pint of milk a day at 12 months (NHS, 2015; First Steps Nutrition 2021).

What if my baby refuses the bottle or is fussy with bottle-feeding?

If your baby is hard to feed after the first 20ml to 30ml then they may need a break at this point (see the information about responsive feeding above). You could try changing their position, putting them over your shoulder to see if they need burping and then offer them the bottle again. If they're not interested, they may just need to feed little and often - this is normal for some babies (NHS, 2015).

If this doesn't help or your baby is often fussy or fights the bottle, ask your health visitor to watch you feed them, as they might have some suggestions (NHS, 2015).

If you've breastfed your baby so far, they may be reluctant to take a bottle at first. The different sucking actions needed may confuse them and they may not take a bottle feed from you (Zimmerman and Thompson, 2015). There are plenty of different things you can try to help your baby.

You could ask someone else to offer them a bottle.

Hold your baby in a different position from your normal breastfeeding one.

Offer the bottle when your baby isn't particularly hungry. When a breastfed baby is hungry, they are thinking about the breast, so might get agitated if offered a bottle until they learn that this is also food.

You can try a variety of teats.

Some breastfed babies never drink from a bottle, but move straight onto a sippy cup (NHS, 2017).

How do I know if my baby is getting enough milk?

There are certain signs that will tell you if your baby is getting enough milk. For example, their weight gain and number of wet and soiled nappies. Generally, your baby should be producing around six wet nappies a few days after birth (NHS, 2017).

Read our article Is my baby feeding well and getting enough milk? to find out more.

What sort of bottles and teats should I use?

You can use whichever bottles and teats you and your baby prefer. Yet the use of larger bottles (more than 6oz) has been associated with increased formula intake among two month old babies, leading to a risk of overfeeding (Wood et al, 2015).

Some teats are more suited to paced bottle feeding. Choose teats that fill with milk when the bottle is held in a horizontal position, as some need the bottle to be inverted to fill the teat. These are less suited to responsive feeding.

You can buy teats with different sized holes that vary the flow depending on your baby's age and ability to suck and swallow (UNICEF UK, 2016; Which?, 2018).

It's important to replace bottles and teats when they look worn. This is because it's not possible to keep them clean otherwise and worn teats can also disintegrate or split (NHS, 2017).

You might like to take a look at our page on how to make up formula safely.
This page was last reviewed in March 2021.
Further information

We support all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our support line on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.

You might find attending one of our NCT New Baby courses helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Read more about bottle-feeding in the UNICEF UK 2016 guide to infant formula for parents.

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How to bottle-feed your baby | Baby & toddler, Feeding articles & support | NCT

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When it comes to bottle-feeding or breastfeeding, all health professionals recommend 'responsive' feeding. This means learning to recognise the early signs that your baby is hungry (often called feeding cues) and never forcing them to finish a feed if they've had enough.

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Some research about being responsive to your baby's needs..

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School of Health & Social Care, Swansea University

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Why you might want to put the baby books down...

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This video guides mothers through how to hand express, and talks about the times when hand expression might be useful.

See the Breastfeeding Network website for FAQs and a leaflet all about expressing and storing breastmilk.

Problems viewing this video? Try viewing here or Please contact us

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Hand expression video - Baby Friendly Initiative

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See the Breastfeeding Network website for FAQs and a leaflet all about expressing and storing breastmilk. Problems viewing this video? Try viewing here or Please contact us

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This page gives you some tips on how to hand express and store your breastmilk. It also answers some frequently asked questions on this topic.

You might be thinking of returning to work, or study, or planning a night out. It can also help relieve pressure from a blocked duct or mastitis. Expressing small amounts of colostrum before your baby is born can help give your baby extra milk in the first few days.

Please also refer to our downloadable leaflet on Expressing and Storing Breastmilk.

If you will be exclusively expressing (feeding only expressed breastmilk), whether for just a few days or longer, you might like to read our blog post on this.

Note: If your baby has been ill or was born prematurely please discuss this information with your health professional to check that the storage times apply. This is especially important if you are bringing your colostrum or milk into hospital for your baby.

Your breastmilk

Can be expressed by hand, by hand pump or by electric pump. Once you know how, hand expressing is easy and needs little equipment.

Contains anti-infective ingredients that limit the growth of unwanted bacteria.

Should still be handled and stored carefully to stop unwanted bacteria from getting into your milk and growing.

Stays at the highest quality when stored in a fridge, particularly when running at 4°C or below. Note: some fridges run higher at 5-10°C - if you don't know the temperature of your fridge assume it is running at this higher temperature.

Can be frozen, which affects some (but by no means all) of the nutrients and anti-infective ingredients of breastmilk.

Expressing breastmilk

When you first start to express it is common to get only a few drops of milk. As with breastfeeding, the more you practice, the easier it gets. Expressing at a different time of day may work better for you.

When might I need to express?

Before your baby is born - you may be advised that your baby might need extra milk when they are born. You can express and store your first milk (colostrum) from 36 to 37 weeks gestation. You can read more about this here.

In the first few days - if your baby is sleepy, or to help them attach and feed.

For both these stages your midwife will give you small oral syringes to collect your milk. These are usually 1ml to begin with.

Use the ideas in this leaflet to discover what works for you. Colostrum usually starts in tiny droplets and is often sticky - having help to collect these drops in the syringe can be useful.

Aim to express twice a day from 36-37 weeks for no more than 10 minutes, freezing the same day.

Once your baby is born, express as needed aiming to stimulate your breasts at least 8 times a day including once overnight through direct breastfeeding or expressing as this will increase your milk supply to meet your baby's needs and can help you feel more comfortable.

Hand Expressing

Once your milk is flowing, you will need a wide mouthed container like a sterile plastic pot or container that is well-cleaned and scalded with boiling water - a jug is ideal - so get this ready before you start.

Remember to wash your hands first.

Find somewhere comfortable to relax, then to help your milk to flow (let down) you might:

Relax with a warm drink, music or TV.

Have your baby close, or look at a photograph, clothing or toy to remind you of your baby.

Warm your breasts in a bath, shower or using warm flannels and practice expressing.

Try some ways to gently massage your whole breast, working from the outside toward your nipple.

Take care not to drag your skin:

Stroke with your fingertips

Roll using your knuckles.

Try using circular movements.

Make a 'C' shape by placing your thumb above and your fingers below your breast 2-3 centimetres back from your nipple

Gently press your thumb and fingers together, release your fingers and repeat in a rhythmic movement.

Sometimes pressing inwards back towards your chest wall as you squeeze helps. You may need to experiment with how far back from your nipple to squeeze - everyone is slightly different.

When the milk flow slows, re-position your fingers and thumb (as if moving them around a clock face), then express another area of your breast.

Try to express all areas of your breast and alternate between breasts.

See this video on hand expressing from UNICEF for more ideas.

Good hygiene is very important:

Always wash your hands before expressing and handling breastmilk and ask others giving expressed milk to do the same.

Always use a sterile container with a lid, not the collection jug, to store your breastmilk. You can buy disposable containers. Take care with plastic bags that can puncture easily.

Try to use a different storage container each time you collect milk. If necessary, newly collected milk may be cooled and added to previously stored milk on the same day only.

Label the storage containers or syringes with your name, breastmilk, time and date and put inside a clean sealed bag or box before storing. Name and date the bag too.

Store your breastmilk in the fridge or freezer as soon as possible.

Store away from meat products, eggs or any uncooked foods. Store at the back of the fridge and not in the door.

Storing expressed breastmilk

How long can I keep my breastmilk at room temperature if a fridge is not available?

If your breastmilk is freshly expressed it will keep for 6 hours without refrigeration, either at home or away from home. See 'travelling with breastmilk' section below for more details.
If your baby has been ill or was born prematurely please discuss this with your health professional to check that the same storage times apply.
How long can I store breastmilk in the fridge?

You can store your breastmilk for up to 3 days where you don't know the temperature, or it runs between 5-10°C.

Breastmilk can be stored for 5 days in a fridge running at 4°C or lower.*
*One study has shown fresh breastmilk can be used for up to 8 days when the fridge temperature is kept stable at 4°C or below.

If the fridge temperature goes above 4°C during this time, use your milk within 6 hours or throw away.

If you can't use a fridge at 4°C, try using a cool bag or box with deep frozen ice packs (changed every 24 hours). Protect your milk from direct contact with the ice packs or it may freeze - try wrapping the ice packs in kitchen towel. The bag can also be used to carry milk.

The lower the storage temperature, the longer expressed breastmilk can be stored. The storage temperatures given here include a degree of caution so that your milk remains safe for your baby.

If you wish to store your breastmilk for longer than 5 days, freeze as soon as you can after expressing.
If taking colostrum or milk into hospital follow their storage and transport times. REMEMBER: The more often the fridge door is opened, the more likely the temperature will rise. Try to check the temperature of every fridge (or cool bag) used for storing your milk each time you use it. If the fridge has no built in thermometer, use a fridge thermometer which can be bought cheaply from kitchenware stores.
How long can I store breastmilk in the freezer?

Breastmilk can be stored in a freezer at -18°C for up to six months.

You can store breastmilk in the ice compartment of a fridge for two weeks.

Safe Storage of breastmilk in the home

This table aims to provide a guide to how long you can store breastmilk for a full term baby with no additional health concerns.

Why are there variations in recommendations for storing expressed breastmilk?

More information about this can be found at the bottom of this page.

Please note that previous versions of our leaflet are still available in our shop and the information is still correct, noting the above.

Feeding baby expressed breastmilk

What happens if my baby doesn't take all of one bottle? Can I put it back in the fridge or on the side use it again?

Once the baby has drunk from a bottle of expressed milk it should be used up within an hour or thrown away. To avoid wasting your expressed breastmilk it is best to offer the baby only a little (e.g. 30ml) at a time until you know your baby's pattern. You can do this by keeping most of it in one container, in the fridge, and using it to top up the baby's bottle a little at a time.

Defrosting frozen breastmilk

How do I defrost my milk?

Ideally, defrost frozen breastmilk in the fridge. This milk should be used once fully defrosted which usually takes about 12 hours. If your breastmilk is still frozen after this time or you need to use it quickly, try defrosting under cool, then warm, running water. Dry the outside of the container with kitchen paper before use and use immediately. If you frequently find your milk is frozen after 12 hours in the fridge, try to freeze in smaller quantities.

How long can I keep defrosted breastmilk?

Defrosted breastmilk should be used straight away once it has fully defrosted. Throw away any unused milk.

Why can't I defrost breastmilk in a microwave?

Breastmilk should not be defrosted in the microwave because it heats unevenly, destroying antibodies and nutrients. There is also a risk of scalds and the milk would need to be left at room temperature before use.

Travelling with expressed breastmilk

How do I bring my milk home, which I have expressed at work or elsewhere?

Try to use a cool bag for transportation and put the milk in the fridge once you are home.

Fresh breastmilk can be transported within 24 hours provided storage temperatures are maintained using an insulated box or bag and deep frozen ice-packs, and total storage and transportation times do not exceed the recommended storage times.

Previously refrigerated breastmilk can be kept cool (10°C or below) for up to 24 hours when in a well-insulated bag with deep-frozen ice-packs. Take care not to freeze your milk by wrapping the ice-packs in kitchen paper first. Ensure this milk is used within the recommended refrigeration storage times as mentioned above.

Re-heating expressed breastmilk

How do I re-heat expressed breastmilk?

Expressed breastmilk can be used straight from the fridge. It does not need to be warmed. If you would like it warmed place the container (such as a bottle or sealed cup) in warm water to take the chill off. Take care not to over warm.

If the milk smells sour DO NOT USE.

When stored, the cream and milk may separate out. This is normal. Shake gently to mix before use.

Some babies are reluctant to take milk from a bottle, particularly at first. Try offering milk from a cup or spoon. They may be less reluctant when someone else gives it. If expressed milk is refused try not to worry - your baby will make up any missed feeds by breastfeeding more often or for longer on your return. See also info on this page about introducing a bottle.

Finding a breast pump

The two UK breast pump hire companies are:
Ardo breast pumps Medela breast pumps
Your midwife, health visitor or a local breastfeeding supporter may also be able to give you details of pump hire services near you.

Useful links
Human Milk Foundation
UKAMB (UK Milk Banks - find out about donating or receiving milk)
Milk Bank Scotland
Antenatal Expressing - more detailed information about this

References

(links checked May 2023)

Cook, P. Food Standards Agency. MCN10. 2006 Handling and storage of expressed breastmilk pp1-12 https://www.nice.org.uk/guidance/ph11/documents/mcn-consultation-expert-report-handling-and-storage-of-expressed-breast-milk2

Eglash, A, Simon, L, and The Academy of Breastfeeding Medicine, ABM Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants, BREASTFEEDING MEDICINE Volume 12, Number 7, 2017 (c) Mary Ann Liebert, Inc. pp390-395 https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/8-human-milk-storage-protocol-english.pdf See correction to freezer temp here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065517/

Forster, Della A et al. (2017) Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial. The Lancet, Volume 389, Issue 10085, 2204 - 2213 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31373-9/ppt

Hands A. (2003) Safe storage of expressed breastmilk in the home. MIDIRS Midwifery Digest, vol 13, no 3.

Royle, J. Weaver, G. (2016) Guidelines for the Preparation and Handling of Expressed and Donor Breast Milk and Special Feeds for Infants and Children in Neonatal and Paediatric Health Care Settings. 2nd Ed. Section 6, p18-32
BDA Guidelines for the Preparation and Handling of Expressed and Donor Breast Milk and Specialist Feeds for Infants and Children in Neonatal and Paediatric Health Care Settings
IMPORTANT: If you have any further questions on expressing or breastfeeding, do contact your midwife, health visitor or breastfeeding supporter for help and support. You can also call the National Breastfeeding Helpline on 0300 100 0212, open 9.30am-9.30pm every day of the year.

Page reviewed and updated November 2019

Variations in Recommendations for Storing Expressed Breast Milk

Written by Anabel Hands

In 2003, aware of the confusion for mothers resulting from the significant variations in recommendations for storing expressed breast milk, the BfN decided to collate all available information from primary research papers, and national and local guidance documents. These findings were published in the MIDIRS Midwifery Digest 1. The study found that storage temperature clearly determines storage time. Recommended storage times given in our Expressing and Storing Breast Milk leaflet were based on the primary research papers discussed in the study. You can find the link to this leaflet below for more information 2.

Our publication was sent to other breastfeeding organisations, including the Department of Health (DH), to facilitate agreement on storage recommendations using the results of primary research. The DH asked the National Institute of Clinical Excellence (NICE) to review breast milk storage guidelines, and official storage recommendations were changed from 24 hours in the fridge to up to 5 days at 4°C or lower, two weeks in the ice compartment of a fridge and up to six months in a freezer (March 2008) 3.NICE also recognised that refrigeration preserves the unique properties of breast milk more effectively than freezing. The National Health Service (NHS) adopted these guidelines, which appear in their leaflet Off to the best start (updated November 2009) which you can find a link to below 4.

Although a little different to BfN guidelines, the NICE and NHS recommendations took into account that fridge temperatures can vary and that a 5-day storage time covered most situations, including the need for milk expressed at the end of one working week to be used at the beginning of the following week. Some busy hospital neonatal units restrict the time milk is refrigerated as an added precaution; this is because their fridges are opened very frequently, which may affect the storage temperatures 5.

Other breastfeeding organisations, such as La Leche League, updated their published recommendations to distinguish between acceptable storage (8 days in the fridge) from ideal storage (72 hours in the fridge), and also recognised that refrigerated expressed breast milk was preferable to frozen breast milk (March 2012) see link below for more information. These recommendations are in line with the BfN leaflet 6.

It is important for mothers and breastfeeding supporters to note that leaflets and recommendations inconsistent with the published research are still in circulation, particularly on the Internet, and that countries outside of the UK may recommend different guidelines.

Please note that previous versions of our leaflet are still available in our shop and the information is still correct, noting the above.

References

1. HANDS A. Safe storage of expressed breast milk in the home. MIDIRS Midwifery Digest, vol 13, no 3, Sep 2003, pp 378 & 385.

2. BfN (Breastfeeding Network) leaflet. Expressing and storing breast milk. September 2004.

3. National Institute for Health and Clinical Excellence (NICE) Public health guidance 11: Maternal and child nutrition. March 2008.

4. Department of Health. Off to the best start. Crown Copyright 2007 278957 5p 200k Nov 09 (BEL) 299223.

5. MCN consultation: Expert report & Handling and storage of expressed breast milk. 05 April 2007.

6. La Leche League International. "The Breastfeeding Answer Book" Updated March 2012.

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Expressing and storing breastmilk - The Breastfeeding Network

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This page gives you some tips on how to hand express and store your breastmilk. It also answers some frequently asked questions on this topic. You might be thinking of returning to work, or study, or planning a night out. It can also help relieve pressure from a blocked duct or mastitis.

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The Mush Stops Here

Baby Led Weaning, quite simply, means letting your child feed themselves from the very start of weaning. The term was originally coined by Gill Rapley, a former health visitor and midwife.

According to the most recent research most babies reach for food at around six months, which is also the time that mothers are being encouraged to wean* by their Health Visitors, in accordance with the WHO guidelines.

The distinct advantage of weaning at around six months is that by then, our children are developmentally capable of feeding themselves proper food, in other words - no more mush!

You just hand them the food in a suitably-sized piece and if they like it they eat it and if they don't they won't. (But they do, really they do... check out the baby with the pork chop).

That's the essence of Baby Led Weaning. No purees, no ice cube trays, no food processor, no potato masher, no baby rice, no weird fruit and veg combos... just you and your child, eating food that you enjoy with you and your family.

Please browse the site, or come and join us on the very welcoming Baby Led Weaning Forum

* re 'wean'. This is meant in the Brit sense, not the American. In the UK, 'weaning' means 'adding complementary foods', whereas in the States it means 'giving up breastfeeding'. Two nations divided by a common language, and all that. In fact, there is even a helpful hands-across-the-ocean translation thread on the subject on the forum, which solves the mystery of what the UK equivalent of the Graham's Cracker might be. (While we're on the subject of terminology... if it was up to me, I'd have called this whole thing Baby Self-Feeding, but that ship has sailed, my friends, and Baby-Led Weaning it is.)

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Baby Led Weaning, quite simply, means letting your child feed themselves from the very start of weaning. The term was originally coined by Gill Rapley, a former health visitor and midwife. According to the most recent research most babies reach for food at around six months, which is also the time that mothers are being encouraged to wean* by their Health Visitors, in accordance with the WHO guidelines.

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It seems that all the the information I see regarding toddler nutrition assumes that your toddler is no longer breastfeeding and is eating mainly solids. As a result, many moms of breastfeeding toddlers (particularly those who are eating few solids) have lots of questions about how to adapt this information to their particular child.

Introduction

Your child can continue breastfeeding just as often during the second year, but offer solid foods a few times a day. After 12 months, you can begin offering the solids BEFORE baby nurses, if you wish, instead of after. Your milk is still an important part of baby's diet and will offer him many benefits (nutritionally, immunilogically and emotionally). There is not any particular "recommended number of times per day" that a toddler should be nursing. Some are only nursing once or twice a day, while others continue to enjoy lots of time at their mother's breast. As baby slowly moves into eating more solids, your milk will fill any nutritional gaps nicely. Once you do start to breastfeed less often, remember that you must make a greater effort to ensure that your child eats several meals of nutritious food each day.

Cow's milk?

Many nursing moms are told that they must introduce cow's milk at a year. Your nursing toddler is already getting the best milk he can get - mother's milk! Breastmilk has a higher fat content than whole cow's milk (needed for baby's brain growth), and all the nutrients of human milk are significantly more bioavailable than those of cow's milk because it is species specific (not to mention all the components of mother's milk that are not present in cow's milk).

There is no need to add cow's milk to your toddler's diet (or the equivalent nutrients from other milks or foods) as long as your baby is nursing at least 3-4 times per day. Cow's milk is really just a convenient source of calcium, protein, fats, vitamin D, etc. - it's not required. There are many people in many parts of the world who do not drink milk and still manage to get all the calcium, protein, fats, vitamin D, etc. that they need.

Good non-dairy sources of protein include meats, fish, peas & beans (chick peas, lentils, baked beans, etc.), tofu and other soy products, boiled eggs, peanut and other nut butters (if your child is not allergic).

Good non-dairy sources of fats include soy and safflower oils, flax seed and flax seed oil, walnuts, fish and fish oils, avocado. Adding fats to cooking and baking can work well, for example, stir fry in safflower oil or make mini-muffins with soy or rice milk, oil or butter, and eggs.

Calcium may be derived from many nondairy sources.

Vitamin D can be supplied by sunlight exposure and food sources.

If your child is not nursing regularly and is not allergic to cow's milk products, but simply doesn't like cow's milk, you can incorporate milk into your child's diet in other ways. Many children like cheese, whole-fat yogurt or ice cream. You can also put milk into various food products: pancakes, waffles, muffins, French toast, scrambled eggs, mashed potatoes, and baked goods.

Some moms wish to offer cow's milk to their toddler, but baby doesn't like it. Over the age of 12 months, milk becomes a more minor part of a child's diet. It is sometimes helpful to mix increasing amounts of cow's milk with your expressed milk to help baby get used to the taste. Many dietitians see nothing wrong with adding some flavor (such as strawberry or chocolate) to cow's milk.

Pediatricians now recommend that any cow's milk be whole milk from a cup after the first year and until the child is at least 2 years of age. This ensures that your child receives enough fat, which is essential to proper brain development. After the age of two, if growth is good, you can switch to low-fat or nonfat milk. Note: If your child is nursing, then remember that mom's milk is "whole" milk - the more breastmilk your child gets, the less need to worry about your child getting additional fat from whole milk or other sources.

It's best to limit the amount of cow's milk that your child receives to 2-3 cups (16-24 ounces) per day, since too much cow's milk in a child's diet can put him at risk for iron-deficiency anemia (because cow's milk can interfere with the absorption of iron) and may decrease the child's desire for other foods.

How much should my toddler be eating?

Between ages one and five, a child's growth is in a decelerated stage; that is, they have slowed down in growth. Since growth slows down, their need for calories subsequently decreases, which in turn leads to a smaller quantity of food ingested per day. Added to the decelerated growth is a burgeoning independence which limits the variety of foods your child is willing to eat ("finicky eater"). Rest assured that toddlers do not need as much food as you might expect because of this slowing down of the growth rate. Three small meals and two snacks a day (and some will eat a good bit less) will probably be enough to fuel even the most active toddler. Please realize, too, that finicky eaters are the rule rather than the exception.

Some toddlers are eating very few solids, or even no solids, at 12 months. This is not unusual and really depends on your child - there is quite a big variation. We like to see breastmilk making up the majority (around 75%) of baby's diet at 12 months. Some babies will be taking more solids by 12 months, but others will still be exclusively or almost-exclusively breastfed at this point. It is normal for baby to keep breastmilk as the primary part of his diet up until 18 months or even longer. An example of a nice gradual increase in solids would be 25% solids at 12 months, 50% solids at 18 months, and 80% solids at 24 months.

Some children take a little longer to begin taking solids well. Some of them have food sensitivities and this may be their body's way of protecting them until their digestive system can handle more. Others are late teethers or have a lot of difficulty with teething pain. At this point there is NOTHING that your milk lacks that your child needs, with the possible exception of enough iron. As long as his iron levels are within acceptable levels and when he does eat you are offering him foods naturally rich in iron, then you have plenty of time before you need to worry about the amount of solids he's getting.

All you need to do is to continue to offer foods. Don't worry if he's not interested or takes very small amounts. Your only true responsibility is what you offer, when you offer it and how you offer it, not whether or not he eats it. That has to be up to him. Trying to force, coax, or cajole your child into eating is never recommended. Continue to nurse on demand, day and night, and trust your child to increase the solids when he's ready. As baby slowly moves into eating more solids, your milk will fill any nutritional gaps nicely.

Average toddler growth

see Average Toddler Growth

Feeding suggestions for toddlers

Finger foods are always great for toddlers, and your toddler will also begin to learn how to feed himself with a spoon and fork. Many babies prefer to eat foods which they can pick up and feed themselves, rather than foods that must be spooned to them. A lot of babies would rather have food right off the table than the blander-tasting baby foods.

After the age of twelve months, continue to be on the lookout for any allergic reactions to new foods and keep in mind that the choking hazard is still very real. Supervise your toddler's meals in case of choking, and continue to avoid foods such as popcorn, hard candies, hot dogs, jelly beans, chunks of carrots, grapes, raisins, and nuts. Cut or finely chop such foods, or simply wait until your baby gets older.

Toddlers should be offered a variety of foods. They can eat the same things as the rest of the family. Foods rich in protein, calcium, and iron, along with fruits and vegetables, breads, etc. should be made available on a routine basis. Serve the most healthful foods possible, but don't expect your toddler to eat a big meal at each sitting. Most children, when offered nutritious meals and snacks and allowed to eat what they wish, will meet their nutritional requirements over several days or even a week. Don't let your child fill up on empty-calorie snacks, but don't force him to eat when he doesn't want to.

Many toddlers eat better when they have food available throughout the day, rather than just at a few set times (see grazing). Simply offer your toddler nutrient-dense snacks throughout the day (cut-up vegetables, bite-sized pieces of fruit, hard-boiled-egg slices, yogurt, whole wheat breads and cereals, cheeses) and let him eat what he wants. Some parents have had good luck with Dr. William Sears' suggestion of a "nibble tray," where you fill a tray (like an ice cube tray, muffin tin, etc.) with several types of healthy foods and leave it out for your toddler to nibble on throughout the day.

Check out the current USDA daily food guide for preschoolers (ages 2-6).

Additional information

Feeding the Picky Eater by William Sears, MD

Is your child getting enough to eat? How to tell by William Sears, MD

Calorie Boosters for Kids by Kelly Vieira, MS, RD

Daily Food Guide for Preschoolers from the US Department of Agriculture

Dietary Reference Intakes (DRI) and Recommended Dietary Allowances (RDA) from the USDA Food & Nutrition Center

Latham MC. Human nutrition in the developing world, (FAO Food and Nutrition Series No. 29). Rome: Food and Agriculture Organization of the United Nations, 1997.

Dairy

Calcium and nursing toddlers by William Sears, MD

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Nutrition for Breastfeeding Toddlers * KellyMom.com

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It seems that all the the information I see regarding toddler nutrition assumes that your toddler is no longer breastfeeding and is eating mainly solids. As a result, many moms of breastfeeding toddlers (particularly those who are eating few solids) have lots of questions about how to adapt this information to their particular child.

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A food allergy is when the body's immune system reacts unusually to specific foods. Allergic reactions are often mild, but they can sometimes be very serious.

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Foods to avoid giving your baby - NHS.UK

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Which foods babies and toddlers should avoid, including salt, sugar, nuts, low-fat foods and saturated fat.

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Guide to weaning from First Steps Nutrition

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Guide to weaning from First Steps Nutrition

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Check out stylish,
functional breast pump bags
and accessories from
our sponsor Sarah Wells Bags.

By Kelly Bonyata, IBCLC, Becky Flora, IBCLC and Paula Yount

Breastfeeding is not an all-or-nothing process. Night weaning is a workable alternative for many moms, and baby continues to receive the many nutritional and immunilogical benefits of breastmilk.

Remember that sleeping through the night is a developmental milestone (like walking or toilet training) that different babies will reach at different times. At some point, your child will sleep through the night - even if you do nothing to encourage it.

If night weaning is not going well, then consider backing off and trying again a little later. The closer your child is to reaching this milestone on his own, the easier it will be for both child and parents.

Getting your baby to sleep is not a battle to be won, as it is so often portrayed in books and the media. The real goal should be for your family to get the sleep they need, while respecting the needs of the youngest family member(s).

Gentle methods for encouraging less night nursing

Following are suggestions for easing your baby into less night nursing...

Eliminate discomfort

Teething.If you suspect teething at all, it may help to give baby a pain reliever before bedtime (check with baby's doctor for suggestions). Some babies nurse more often to try to relieve gum pain. Teething pain is often worse at night.

Room temperature.Find your baby's temperature comfort level: some babies will wake if they get too hot or too cold.

Solid foods.Has baby recently started solids? Many babies (particularly those under six months) start or increase night waking after the introduction of solids, due to problems digesting the food. Try avoiding solids in the evening, or consider decreasing or eliminating the solids until baby's digestive system matures more. Several studies have shown that adding solids to a baby's diet does not help baby to sleep more at night.

Allergy.Babies with food allergies, environmental allergies or eczema may wake more at night due to discomfort.

Reflux.Discomfort from reflux may also keep baby up at night.

Illness.Illnesses like ear infections and colds can interrupt baby's sleep, and result in increased night nursing. A bad diaper rash or other rash might also affect baby's sleep. Anytime baby suddenly increases night waking, keep an eye out for illness.

Maximize baby's nursing during the day and during any night wakings

Nurse more during the day.Encourage baby to nurse more often during the day (perhaps every 2 hours instead of every 3), so that she takes in more milk during the daytime hours.

Minimize distractions.During the day, nurse in a room that is as free of distractions as possible. Turn off the light, close the door, pull the blinds, etc. Get your older children busy doing something before you start nursing. Try nursing while lying down. Sometimes babies can become so distracted during daytime feedings that they don't take in enough milk and then have to make up for it with more frequent night feedings. One study showed that older babies can consume as much as 25% of their total daily intake of mother's milk during the night, probably partly because of daytime distractibility.

Tank up before bedtime.Nurse often in the hours leading up to bedtime (at least every 1-2 hours). Some moms nurse on one breast only during this time period so that baby gets more of the higher fat milk available at the end of a feeding (this helps baby go longer between feedings). When baby wakes at night, try nursing on the other breast for all or most of the night, again so that baby gets more of the higher-fat milk.

Listen to your child.Only your child knows if she's really hungry - don't automatically assume that your child is not hungry or thirsty. Many adults wake at night for a drink of water or even to get a snack.

Maximize sleep for the entire family

Dream feed.Nurse baby right before you go to bed (even if baby has already gone to bed), so that you get a longer period of sleep before she wakes again. Many babies barely wake at this time, even though they may get a good nursing in.

Try to begin settling baby before he's overtired.Some babies have a hard time going to sleep when they're overtired, so keep an eye out for signs of sleepiness.

Try different sleep arrangements.Find out what sleeping arrangement work best for the entire family while continuing to meet baby's needs.

Full-time co-sleeping.Many babies sleep better when they are close to mom. Consider sleeping close to your baby - many families have found that baby and the rest of the family gets more sleep this way (click here for information on safety). Sleeping near your baby and nursing baby to sleep will not teach bad sleep habits. All the co-sleeping babies/toddlers who I know have begun to sleep through the night at some point without any type of training or encouragement or change in sleep location.

Part-time co-sleeping.Part-time co-sleeping works for many families, where baby sleeps in her crib until the first night waking and then joins mom and dad for the rest of the night.

Separate beds.If you're not comfortable with baby in your bed or if you are currently sleeping with baby and no one is getting any sleep, then try other options. Consider placing baby on a pallet on the floor beside the bed, or place baby's crib with the rail down beside your bed. That way, baby will be close enough that nursing won't interrupt sleep quite so much (such as when you get up each time and go to baby's room). Another option that works for some families is putting a bed for just mom and baby in baby's room for awhile, or Dad might instead choose to sleep in another location himself.

Gentle methods of night weaning for toddlers

Limit Access.After you nurse, place the baby back in her area, or slide her away from you so that close proximity doesn't encourage more frequent nursing. Wear clothing that makes it harder for baby to access your breast at night.

Get Dad in on the nighttime routine!If your baby appears to be waking only for comfort during the night, she may accept Dad as the comforter (and won't expect Dad to nurse her). Dad can comfort baby in other ways, such as offering a drink, just lying next to her, holding her, etc. Dad may even be able to sleep with baby in another room with less interruption than if baby were sleeping near mom.

Increase daytime contact.Allow baby unlimited nursing and cuddling during the day. Sometimes toddlers will seek out the breast more at night when they aren't getting enough close cuddling during the day. Sometimes we as busy mothers, especially if we have other children, forget to pick these little ones up often during the day and just sit and cuddle with them. If you can increase this close contact during the day, she may need it less at night. If you work, night nursing may be her way of trying to reconnect with you.

Talk to your child.With an older child, you may be able to explain something like this, "When the sun goes down, or when we go night-night, num nums (or whatever she calls them) go night-night, too. She probably won't accept or understand this completely at first, but if you say it before bed each night and repeat it each time she awakens, in time she'll "get it".

Just say "no"... or "later."With an older child (over 18 months), feel secure enough to say "no" (at least some of the time) while staying sensitive to your child's needs. At night, you might say, "not now, but we will later." She may - or may not - awaken again to nurse later.

Substitute other comfort measures.You also may try other things to settle her, such as a back rub, just holding and cuddling, getting her a drink of water, humming softly, etc.

Is night weaning necessary to get baby to sleep through the night?

People may tell you something to the effect of "If you nurse your child at night (or sleep near your child, or a zillion other things), you won't be able to discontinue it in the future." This sells books, but it isn't true at all!

Remember that night waking in babies and young children is temporary!

Children grow out of night waking, even when we do nothing to discourage it. This period of time will be a very tiny part of your child's years with you.

A child's internal timetable for sleeping through the night can vary greatly. Some parents are comfortable with letting the child lead when it comes to night weaning, but for others night nursing truly interferes with their quality of life. If night nursing is not working for you, then encourage changes while taking into account the needs of your child.

Your goal is to maximize sleep for everyone, and if what you're doing works, then you've met your goal. If it's not working (or stops working) then you can always do things differently. All parents find that they change the way they do things as their child grows older and reaches different developmental stages - sleep is just another thing that changes as your child grows.

Additional information

@

@ other websites

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Breastfeeding is not an all-or-nothing process. Night weaning is a workable alternative for many moms, and baby continues to receive the many nutritional and immunilogical benefits of breastmilk. Remember that sleeping through the night is a developmental milestone (like walking or toilet training) that different babies will reach at different times.

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Introducing your baby to their first foods is an important time in your baby's life and can be lots of fun. Health professionals agree you should start giving your baby their first solids when they are around six months old (NHS, 2019a). A baby's digestive system needs time to develop so that it can cope with solid foods (UNICEF, no date).

While not all babies instantly enjoy solids, you may see some happy and funny faces as your baby tries their first foods. Family life is about to get messier as your baby explores new tastes and textures.

When should my baby try their first foods?

Your baby should only need breastmilk or formula milk for the first six months of their life. Experts say that introducing solid food earlier than this has no advantages. It may even increase the risk of your baby getting an infection or illness (UNICEF, no date; First Steps Nutrition Trust, 2020).

Waiting until your baby is six months old before you introduce solids also means they'll be more likely to be able to feed themselves (Rapley and Murkett, 2010; Brown, 2017). At this age, your baby will also be able to manage foods in their mouth and swallow properly, which reduces the risk of choking (Rapley and Murkett, 2010). Babies don't produce all the enzymes needed to digest food thoroughly until they are about one year old (Naylor and Morrow, 2001; Brown and Lee, 2013).

How do I know if my baby is ready for solids?

Your baby will give you various signs that they might be ready for their first foods:

Your baby can sit up with support and hold their head steady.

They can swallow their food - babies who aren't ready automatically push food out of their mouth with their tongue.

They can pick up food and put it in their mouth. (NHS, 2019a)

Sometimes, your baby might seem hungrier but this on its own does not mean they need to start solids. Babies sometimes have growth and accompanying appetite spurts. Although some people believe that solids will help babies to sleep through the night, research doesn't support this (Brown and Harries, 2015; Murcia et al, 2019).

In the first six months of their life, you can respond to your baby's increased need for milk by feeding them more frequently if breastfeeding. You can also give them more milk feeds up to the maximum daily recommended amount if formula feeding (Marasco and Barger, 1999).

Most babies start to cut teeth when they're around six months old, and this helps them to bite and chew their food. Some babies get their first teeth earlier than this. Whenever they get their first teeth, babies don't need teeth to chew and will manage pieces of food quite well without (Brown, 2017).

A baby who is unsettled and putting their fists in their mouth a lot may be teething rather than hungry (NHS, 2019b).

What if my baby was premature?

If your baby was born prematurely, there is no definitive age when introducing solids is recommended. Some healthcare practitioners say a baby's four months corrected age is the youngest age to introduce solids. Looking out for the signs of readiness listed above is even more important with a premature baby (Bliss, no date).

You might want to speak to your GP or health visitor for further advice (NHS, 2019a).

Getting started: Introducing solid foods

From six months old, babies can eat a wide variety of foods and there's no need to begin with bland flavours. Babies will only need small quantities at first, because their tummies are still small (NHS, 2019b).

Some parents opt for baby-led weaning. Others choose to make homemade dishes and then purée or mash foods.

You might opt for pre-packaged baby purees and baby foods, or a combination - it's up to you. It's important to check the sugar content of commercially produced infant food, as it can be very high. Purees in pouches are not recommended for this reason (First Steps Nutrition Trust, 2018). Read our tips on how to get started with introducing your baby to their first foods.

Baby-led weaning

Baby-led weaning is when parents offer pieces of food for their baby to grasp in their hands and feed themselves. Rather than you feeding your baby, baby-led weaning puts your baby in charge of picking up and eating what they choose. Read more in our baby-led weaning for beginners and baby-led weaning tips articles.

It can be slow to begin with. Your baby joining in at family meals can help them as they'll watch and copy other family members.

Your baby's first solid foods

You can offer your baby their first solid foods at a time that suits both of you, although it might be easier if your baby is not tired or too hungry (NHS, 2019a).

There is little evidence to tell us which foods are best for your baby to start with. But vegetables and fruit can make good first foods. You could try starting with:

Soft fruit or cooked vegetables chopped into sticks or pieces large and firm enough for your baby to pick up with their whole fist.

Mashed or pureed fruit or vegetables.

Baby rice or cereal - mix the rice with a bit of your baby's usual milk.

For a younger baby who is being spoon-fed starting on solid foods, you can add expressed breastmilk or formula.

You might be surprised that your baby can cope with pieces of lean, well-cooked meat or fish, pasta, pulses, beans or bread that they can hold and suck. (NHS, 2019a; First Steps Nutrition Trust, 2020)

Food for babies should not have salt added at either the cooking stage or afterwards (NHS, 2018). Babies also don't need sweet foods, such as biscuits or cakes, or foods high in saturated fats (NHS, 2018).

Iron-rich foods for babies

Anaemia (low iron levels) is one of the most common problems among young children (Daniels et al, 2018). So iron-rich foods are important in your baby's diet.

Iron-rich foods include red meat, pulses (peas and beans) and iron-fortified cereals. Vitamin C, which is in fresh fruit and fresh or frozen vegetables, can help your baby absorb iron. Breast milk and formula milk also contain iron.

Which foods should be avoided?

After six months of age, babies can eat small quantities of most foods except:

whole nuts and similarly unyeilding foods that could cause them to choke

foods that might cause food poisoning under the age of one year, such as raw egg (if no Lion mark is present), unpasteurised cheeses and raw shellfish

honey because of the risk of botulism

rice drinks because of the levels of arsenic

shark, swordfish or marlin due to high mercury levels.

What about food allergies?

If your baby already has an allergy or there is a family history of allergies, you might want to be particularly careful when introducing foods and perhaps speak to your GP or health visitor first (NHS, 2021). There is no evidence that introducing egg or peanut products before six months old rather than at six months prevents allergies (SACN-COT, 2016; NHS, 2021).

Some studies have suggested that babies at increased risk of peanut allergy might benefit from early introduction to peanut-containing foods (Du Toit et al, 2015). But it's too soon to say whether guidance to families will change.

Keeping your baby safe

Some parents worry that starting to eat solids puts their baby at risk of choking. Here are some precautions you can take to keep them safe when you're feeding your baby solid food:

Make sure your baby is sitting upright and steady.

Always stay with your baby while they are eating.

Don't rush your baby - let them take their time.

Cut food items like grapes and baby tomatoes lengthways.

Avoid foods like whole nuts, which children under five years should not have, because they are a choking hazard.

(Rapley and Murkett, 2010; NHS, 2021)

As well as being extra careful, you could learn what to do if your baby is choking. If they are choking, they won't make any noise at all (NCT, 2016). You might find it helpful to attend an NCT baby first aid course at this stage to help build your confidence.
This page was last reviewed in December 2021.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our NCT New Baby courses helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

You might find attending one of NCT's Introducing Solids Foods workshops helpful as they cover topics like when to start your baby on their first foods. They also cover topics like purees, baby-led weaning and what foods to avoid. These courses are run by NCT qualified practitioners and you will also get to meet other local parents with babies of a similar age to yours.

Some parents find attending a Baby First aid course helpful.

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Introducing your baby to solids | Baby & toddler, Feeding articles & support | NCT

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Here you'll find lots of helpful information on when to introduce your baby to solid foods and tips to make it easier, and what baby-led weaning is.