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Polski • Română • العربية • ਪੰਜਾਬੀ • اردو • Български • বাংলা

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Polski • Română • العربية • ਪੰਜਾਬੀ • اردو • Български • বাংলা

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Please contact or midwife or health visitor if you experience any breastfeeding challenges.

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Cup Feeding - Video - Global Health Media Project

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If a small baby is able to swallow but not yet able to feed well enough from the breast, the mother can feed her baby by cup. This video shows how to feed a

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Ask your midwife to complete a breastfeeding assessment with you

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Midwife Infant Feeding Team: 01782 672212

Whilst you are under your community midwife you can access the infant feeding team.

The team are available from 8:00am - 3:30pm

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National Breastfeeding Helpline: 0300 100 0212

NCT Infant Feeding Line: 0300 330 0700

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Health Visiting Service

Stoke Hub: 0808 178 3374

Staffordshire Hub: 0808 178 0611

Midwifery Team:

Central Team: 01782 233582

North: 01782 231152

County: 01785 230839

Newcastle: 0300 1230904

South: 01782 231822

General Community Midwife Hub

01782 672 181

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Please speak to your community midwife or the relevant base to book onto antental education classes.

Central Team: 01782 233582

North: 01782 231152

County: 01785 230839

Newcastle: 0300 1230904

South: 01782 231822

The antental education sessions include labour and birth and a two hour breastfeeding workshop.

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Free antenatal infant feeding workshops available from 33 weeks,

Zoom sessions run from 7.30pm and Face-to-Face sessions run from 4.30pm. To book please click the link https://forms.office.com/r/HBU2abdcZB,

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Free Antenatal Classes by the Family Hubs

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Free Antenatal Classes by the Family Hubs

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Free antenatal classes available to anyone with a Stoke on Trent postcode

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inourplace | Solihull Approach - Online courses for emotional health and wellbeing.

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Free wellbeing online courses in Stoke-on-Trent - inourplace

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Discover free online courses, brought to you by the Solihull Approach, to support the emotional wellbeing of parents, carers, grandparents and teenagers.

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Team Baby: getting ready to breastfeed:

https://abm.me.uk/product/team-baby-online-course/

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It doesn't just take the parent who has the breasts to make breastfeeding work, it takes a team and you can make all the difference! It's about knowing how breastfeeding happens, knowing how newborns behave, accessing qualified support when things are challenging, providing encouragement and emotional support - and practical support around the home too.

This FREE course is aimed at,

Expectant couples

grannies and grandads

sisters and the brothers

aunties and the uncles

friends and supporters

The course is broken down in to 5 sections which include articles and videos to empower you to become informed and confident.

1. The decision to breastfeed

2. How breastfeeding works

3. How newborns behave

4. What challenges can arise

5. Where to get help

At the end of each section, you'll also find a 'partner challenge' - an activity you can do with your partner. It can take a few minutes in the car on the way to the supermarket, or however long you like. You can do them at any point in the course or afterwards!

Please note this course is compatible only on Edge, Chrome and Safari Browsers.

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A free online short course to empower you to become informed and confident around the topic of breastfeeding

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Parental groups and support – Family Hub

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Family Hubs support children and young people from birth until they reach the age of 19 (or up to 25 for young people with special educational needs and disabilities). They bring council, health and community services together so families can access the right support at the right time.

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This video guides mothers on 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? Contact us.

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Hand expression video - Baby Friendly Initiative

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

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Expressing your breast milk with a pump - Start for Life

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There are different types of pumps you can use to express your breast milk - manual and electric. Find out about both on Start for Life.

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Unicef UK Baby Friendly Initiative | Meeting baby for the first time

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Skin-to-skin contact and breastfeeding right after birth

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You’ve just given birth for the first time and now for another new thing – breastfeeding. So how exactly do you do it? Here’s our guide to getting started.

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What is laid-back breastfeeding or biological nurturing?

Laid-back breastfeeding is where you to use a comfortable, reclined position to feed your baby. It's really a relaxed approach where breastfeeding is seen as a relationship between you and your baby, with no need to follow a series of instructions.

Laid-back breastfeeding is also known as biological nurturing or the natural breastfeeding position (Colson, 2003).

What are the benefits of laid-back breastfeeding?

Laid-back breastfeeding:

Helps to release your baby's many feeding reflexes.

Encourages high levels of the nurturing hormone oxytocin in both you and your baby, helping you both to learn how to breastfeed together.

Uses gravity, which helps to support your baby as they lie on your body, giving them the freedom to use their instinctive feeding behaviour. Gravity also helps your baby to latch more effectively as they're able to use their natural reflexes, so you're less likely to get sore nipples.

Uses skin-to-skin contact, although it also works well when you're wearing a thin layer of clothing or whatever you're comfortable in.

Many mums say laid-back breastfeeding helps them to bond with their baby and get to know them sooner. That's because laid-back breastfeeding encourages mums to spend lots of time with their baby in the laid-back position even when their babies are not hungry or feeding.

Can be used at any time - it's about you feeling comfortable and well-supported, and finding whatever position feels right for you and your baby.

(Colson, 2008, 2012, 2019)

Laid-back breastfeeding: how your newborn latches on

Mums and babies most commonly use laid-back breastfeeding in the hours after birth. This is when your baby may spend time lying tummy-to-tummy with you.

In this period of close contact, you might notice your baby wriggling, pushing with their feet, and moving their head from side to side on your chest. These are primitive feeding reflexes, and you are helping your baby to use these to find your breast (Vinall, 2015; UNICEF, 2019).

Laid-back breastfeeding after a caesarean

Laid-back breastfeeding is useful following a caesarean birth, or in any situation where it's difficult to sit comfortably upright. That's because it allows for you to find your own relaxed and supported position (Colson, 2019). If it's hard to move or lift your baby, ask someone to help you both to get comfortable.

Continuing with laid-back breastfeeding

As your baby learns to breastfeed, they'll probably adapt easily to different positions, making laid-back breastfeeding very flexible, whether you're at home or out of the house.

If you're finding breastfeeding difficult, uncomfortable or painful, the laid-back breastfeeding approach can often help and breastfeeding counsellors use it widely (Vinall, 2015). To find your nearest breastfeeding counsellor or support group, call our Infant Feeding Support line on 0300 3300 700.

How to do laid-back breastfeeding in public

Laid-back breastfeeding doesn't have to be a very reclined or exposing position. In fact, you can sit in any comfortable, slightly reclined position, much in the same way as you might on a sofa or a deep chair.

Many coffee shops, for example, have soft chairs and sofas that would be suitable for laid-back breastfeeding in public. You could also use a changing bag or your coat to support you when you recline if you're out and about.

Your baby can be more diagonal than if you were reclined right back. You only need to be wearing loose enough clothing to allow your baby access to your breast, to sit in comfort with your friends and enjoy being out of the house.

Tips: laid-back breastfeeding and helping your baby latch on

1. Lean back if you're sitting or recline on any supportive surface. But do not lie flat on your back. It's okay to adjust your position until it feels right.

2. Hold your baby close so they're lying on your tummy with their core fully supported. If you've had a caesarean birth, you might want to place your baby to one side - away from your scar.

3. There should be constant contact between you but you don't need to put pressure on their neck or back. As you relax into the chair or bed, your baby relaxes into your body.

4. In this position, your baby's feet and legs will brush against your body, and usually find something to push against (such as your leg/hand/the bed/your partner's hand).

5. You will notice them nuzzling their face or bobbing their head from side to side until they locate the breast, then open their mouth wide as they latch on. As his or her mouth finds the breast, his sucking reflex starts to work.

The great thing is, you can use laid-back breastfeeding whenever you like, for as long as you like. And just remember - cuddles will not spoil your baby (Unicef, 2018).
This page was last reviewed in October 2019.
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.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

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.

Colson S. (2003) Cuddles, biological nurturing, exclusive breastfeeding and public health. Journal of the Royal Society for the Promotion of Health. 123(2):76-77. Available at: https://doi.org/10.1177/146642400312300206 (accessed 22nd October 2019)

Colson S. (2019) Biological Nurturing - Instinctual Breastfeeding 2nd Edition. Pinter & Martin, London.

Colson S, Meek JH, Hawdon JM. (2008) Optimal positions for the release of primitive neonatal reflexes for early breastfeeding. Early Human Development. 84:441-449

Colson S, DeRooy L, Hawdon J. (2003) Biological nurturing increases breastfeeding duration. MIDIRS Midwifery Digest.13(1):92-97.

Rosin SI. (2019) A Case Study of Biological Nurturing. Journal of Human Lactation. 35(2): 318-322. Available at: https://doi.org/10.1177/0890334419829044 (accessed 22nd October 2019)

UNICEF. (2018) The Baby Friendly Initiative building a happy baby: a guide for parents. Available at: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2018/04/happybaby_leaflet_web.pdf (accessed 22nd October 2019)

UNICEF. (2019) Meeting your baby for the first time. Available at: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/relationship-building-resources/meeting-baby-for-the-first-time-video/ (accessed 22nd October 2019)

Vinall R. (2015) The value of introducing laid-back breastfeeding Perspective. Dec 2015. Available at: https://www.nct.org.uk/sites/default/files/related_documents/Vinall%20The%20value%20of%20introducing%20laid-back%20breastfeeding_0.pdf (accessed 22nd October 2019)

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Laid-back breastfeeding: benefits and uses | Baby & toddler, Feeding articles & support | NCT

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Many mums and babies use laid-back breastfeeding straight after birth but it has many benefits even after that first snuggle. Here's how...

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Meeting baby for the first time video - Baby Friendly Initiative

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Baby Friendly’s video on skin-to-skin contact and how it can help mothers and babies get their relationship off to the best start.

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Breastfeeding is a gift you can give your baby. A healthy, full term baby is likely to know instinctively what to do at the breast.

During the early weeks skin-to-skin contact helps your baby connect to their instinctive breastfeeding skills and helps you and your baby enjoy breastfeeding. Each person discovers what works for them, and what works for one may not work for another. Mary Renfrew wrote in Journal of Human Lactation that learning to breastfeed is like mother and baby learning a dance. Use what works in these suggestions and tailor them for you and your baby. Trust that you know what works for you and your baby. You will know when the positioning is ideal for you, when you and your baby are comfortable. When positioning is right for you, your nipples stay healthy and your baby can feed most efficiently. Concern about sore nipples or breastfeeding comfortably is a common reason to contact La Leche League. Improving positioning helps eliminate many cases of sore nipples.

You may have noticed this description is long. Be assured that many nursing parents have successfully accomplished breastfeeding their babies for centuries and you too will learn how to best position your baby. These suggestions are not meant to tell you that if you follow all the steps the position will be "right". The suggestions are meant to gives you ideas on how you and your baby can learn to breastfeed and enjoy the breastfeeding experience.

However, like other seemingly simple tasks, it takes a lot of words to describe what other mothers have found works well for them. LLL Leaders are experienced in guiding mothers and other nursing parents through the positioning process. If you feel overwhelmed by preparing to breastfeed your baby, contact your local Leader for information and support. They will be happy to simplify matters for you.

In the first three to five days after birth, if you experience nipple soreness beyond a slight tenderness when your baby latches on, it may be a sign that something isn't right with the baby latch, position, or suck. An adjustment to the latch or positioning can help your baby be more comfortable. When you have mastered the "dance" of breastfeeding, sore or cracked nipples are allowed to heal.

If nipple pain worsens after the early days of breastfeeding your nipple pain may be due to other causes like thrush, bacterial infection, or tongue-tie. Contact an LLLeader for help if you need further assistance to improve your sore nipples. See information on sore nipples for more information.

Learn to recognize your baby's early feeding cues so you have time to get in a good position before he becomes desperately hungry. Early cues include your baby opening their mouth, moving their head side to side - also known as the rooting reflex or sucking on hands and fingers. Don't wait for baby to cry to let you know they are hungry. Crying is a very late hunger cue.

Basic Steps for Positioning

We will discuss several different positions. If you have pain or feel uncomfortable, try a different position. Adjusting the position can significantly improve breastfeeding pain.
Some general tips are:

1. Position yourself comfortably with back support, pillows supporting your arms and your baby, and your feet supported by a footrest or a large book.

2. Position your baby close to you, with their hips flexed, so that they do not have to turn their head to reach your breast. Their mouth and nose should be facing your nipple. Their body should be so close that they is touching you. If possible, ask a helper to hand you your baby once you are comfortable.

3. Support your breast so it is not pressing on your baby's chin. Your baby's chin should touch your breast, then the baby's nose.

4. Attach or latch your baby onto your breast. Encourage your baby to open their mouth wide and pull your baby close by supporting their back (rather than the back of their head) so that your baby's chin touches your breast first. His nose will be touching your breast. Your hand forms a "second neck" for your baby.

5. Enjoy! If you are feeling pain, detach your baby gently and try again.

These steps may need to be repeated frequently during the early weeks. You and your baby will find a technique that works for you after some practice.

Going Beyond the Basics

As you and your baby become more experienced at breastfeeding, you will find that breastfeeding positions can be altered in many ways, even from feeding to feeding. As long as you are comfortable and your baby is nursing successfully, use what works for you. Try experimenting with the four positions below.

Remember, in any of these positions, it is usually important to bring your baby to your nipple height.

Leaning over your baby can often cause backaches, neck/shoulder strain or sore nipples.

Laid-back Breastfeeding or Biological Nurturing

Laid-back breastfeeding, or Biological Nurturing, means getting comfortable with your baby and encouraging you and your baby's natural breastfeeding instincts.

Dress yourself and your baby as you choose. You and your baby skin-to-skin is good option too.

Position yourself comfortably in bed, on the couch, or in a recliner with back support, and pillows to also support your head, shoulders, arms. Lean back, with your pillows for support. When you comfortably lean back, and put your baby on your chest, gravity will keep your baby in position with their body molded to yours.

Let your baby's cheek rest somewhere near your bare breast. Rub your nipple on your baby's upper lip to encourage them to open wide. Bring your baby close. Have their chin touch your breast first, and then their nose will touch your breast.

Position your baby close to you, with hips flexed, so that they do not have to turn their head to reach your breast. Your baby's feet need to be supported by your body so they don't dangle in the air.

Use one hand to hold your breast as needed and the other hand to support baby's thigh or bottom.

If you feel pain, detach your baby gently by using your finger to touch the corner of your baby's mouth and try again.

Relax and enjoy each other.

Cradle Position

The cradle position is most commonly used after the first few weeks. The cross-cradle position (see below) gives you more control.

To nurse your baby while cradling or holding them across your lap, your baby should be lying on their side, resting on their shoulder and hip with their mouth level with your nipple. The whole front of their body should touch the front of your body.

Use pillows to lift your baby and support your elbows to bring your baby up to nipple height, especially during the first few weeks.

Support your breast with either the "U" hold" or "C" hold as described in the "Breast Support Techniques" section below.

Your baby's head will be on your forearm and their back will be along your inner arm and palm. When you look down, you should see his side.

Your baby's mouth should be covering at least a half inch of the dark area around your nipple. Make sure your baby's ear, shoulder and hips are in a straight line. As a newborn, your baby's head and bottom should be level with each other.

Cross-cradle Position

During the early weeks, many mothers find a variation of the cradle position, called the cross-cradle position to be useful.

To nurse your baby in this position, your baby is supported on a pillow across your lap to help raise them to your nipple level. Pillows should also support both elbows so your arms don't hold the weight of your baby; they will tire before the feeding is finished.

If you are preparing to breastfeed on the left breast, your left hand supports that breast in a "U" hold. If you are breastfeeding on the opposite breast, reverse hand used. (See the "Breast Support Techniques" section of this FAQ for a description of this hold.)

Support your baby with the fingers of your right hand.

Do this by gently placing your hand behind your baby's ears and neck with your thumb and index finger behind each ear. Your baby's neck rests in the web between the thumb, index finger and palm of your hand, forming a "second neck" for baby. The palm of your hand is placed between your baby's shoulder blades.

As you prepare to latch your baby on to you, be sure their mouth is very close to your nipple from the start.

When your baby opens their mouth wide, you push with the palm of your hand from between the shoulder blades. Their mouth will be covering at least a half-inch from the base of your nipple.

Clutch or Football/Rugby Position

This is a good position if you have had a Cesarean birth, as it keeps the baby away from the incision. Most newborns are very comfortable in this position. It also helps if you have a forceful milk ejection reflex (let down) because your baby can handle the flow more easily.

In the clutch position you support your baby's head in your hand and their back along your arm beside you. You support your breast with a "C" hold. (See "Breast Support Techniques" section of this FAQ for a description of this hold.) Your baby is facing you, with their mouth at nipple height. Your baby's legs and feet are tucked under your arm with their hips flexed and their legs resting along your back so the soles of their feet are pointed toward the ceiling. (This keeps your baby from being able to push against your chair.) Pillows help bring your baby to your level.

Side-lying Position

For some people, this position works best after the early days of breastfeeding. The other positions may be easier to learn first. Practicing this position during the daytime can be very helpful.

You may find lying down to nurse is a comfortable position, especially at night. Both you and your baby lie on your sides facing each other. You can use pillows behind your back and behind or between your knees to help get comfortable. A pillow or rolled blanket behind your baby's back will keep them from rolling away from you. Your baby can be cradled in your arm with their back along your forearm. Having your baby's hips flexed and their ear, shoulder and hip in one line helps your baby get milk more easily.

Breast Support Techniques

As you hold your baby in any of the above positions, you may need to support your breast with your free hand. This removes the weight of your breast from your baby's chin, allowing them to breastfeed more effectively.

"C" hold-See the cradle hold illustration above. Support your breast with your thumb on top, away from your areola (the darker skin surrounding the nipple) and the fingers underneath. Your fingers should also be well back from your baby's mouth. This hold is helpful when breastfeeding in the clutch or football position as well as the cradle position.

"U" hold-Place your fingers flat on your ribcage under your breast with your index finger in the crease under your breast. Drop your elbow so that your breast is supported between your thumb and index finger. Your thumb will be on the outer area of your breast and your fingers will be on the inner area. This hold is helpful when breastfeeding in the cradle and cross-cradle positions.

Is My Baby Latched on Well?

When latching on your baby, use your nipple to tickle the center of your baby's bottom lip. This will encourage your baby to open their mouth wide (like they are yawning). Aim your nipple slightly towards the roof of their mouth, bringing your baby to you, chin first.

Good latch-on checkpoints for your baby include:

Your baby's nose is nearly touching your breast, that is, no further away than a credit card edge

Your baby's lips are flanged

At least ½ inch of your breast around the base of your nipple is in your baby's mouth.

If the latch is uncomfortable or painful, gently place your finger in your baby's mouth, between his gums, to detach him and try again.

A baby who is offered the breast will suck without swallowing as they position the nipple in their mouth and tells your breast they are ready for the milk to let down. When your baby begins to receive milk, you will see their jaw working all the way back to their ear. your baby's temples will wiggle. You will also hear them swallowing, quickly at first, then more slowly, as their appetite is satisfied.

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Breastfeeding Positions, Latch, and Positioning

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Learn about breastfeeding positions, including the importance of the latch, steps for positioning, and common breastfeeding positions with images and tips.

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Here is a series of photos showing laid back breastfeeding - click on an image to click through as slides. Our thanks to C and her baby for allowing us to take the photos to share with you.

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Photos of laid back breastfeeding - Cambridge Breastfeeding Alliance

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Here is a series of photos showing laid back breastfeeding - click on an image to click through as slides. Our thanks to C and her baby for allowing us to take

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Can I see Natural Breastfeeding positions in action?

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5 ways to make feeding comfortable for you and your baby

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The Breastfeeding Friend, a digital tool from Start for Life, offers practical information and advice on breastfeeding.

Get answers to questions asked by new mums, and tips on things like sore nipples and what to do if your baby cries during feeds.

Think of it like your health visitor but, because it's a digital tool, it's available whenever you need it - all day and all night.

The Breastfeeding Friend is available on Amazon Alexa and Facebook Messenger.

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Find out how to get NHS trusted advice from the Start for Life Breastfeeding Friend, available on Amazon Alexa and Facebook Messenger.

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The first week with a breastfeeding newborn

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The first week with a breastfeeding newborn

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The first week with a newborn can be a wonderful and exciting time, but adjusting to a new life can also be overwhelming, especially when parents aren't sure what to expect. In this guest blog, lactation consultant Emma Pickett explores what's "normal" in the first few days, and encourages mums to trust their baby and their own instincts of love, affection and responsive feeding.
I've been taking calls from new parents on the National Breastfeeding Helpline since it opened in 2008. Calls often begin with a mum in tears and she's sounding desperate. Breastfeeding really matters to her and she wants it to work. She's overwhelmed and confused. The first voice we hear might sometimes be the partner's and a mum is too upset to even come to the phone.

Hundreds of these calls end with a contented calm voice saying, "Thank you. It's such a relief to know that's normal. I feel so much better now". As it happened, breastfeeding was actually going OK; what was interpreted as a breastfeeding 'problem' was actually a new baby's normal and natural response to their new environment. The family just didn't know how babies were 'supposed to behave'.

If I had a magic wand, I would download into all parents the knowledge of what is normal in a newborn. Think The Matrix film - but instead of the ability to pilot helicopters or practise high level martial arts, you'd know about cluster feeding and a newborn's desire for closeness, nappies and normal fussiness. The National Breastfeeding Helpline would be quieter overnight but we'd all feel a lot more relaxed and able to enjoy these teeny new people in our lives.

But actually ... you've already had that download. You just may not have realised it. It's deep in there after millions of years of evolution, facilitated by hormones and natural instincts. It may not mean you know the exact details of the colour of baby poo on day three, or how to correct a baby's latch without help, but there's so much you do know. You may not have grown up surrounded by breastfeeding, and for some aspects you will need support and information, but there's a ton you do know about your baby: things that just feel right and things that don't. And your baby had the download too. Sometimes it gets fuzzied with a birth that didn't go to plan but their instincts are in there too.

Two things that are normal:

1.Babies want to be close to you.

Imagine a news story about a baby gorilla just born in London zoo: "ZSL London are delighted to announce the birth of new baby Fumbi. Mother and baby are in good health" but days later it's reported that staff are concerned. Fumbi's mother (despite being surrounded by other older female gorillas and having observed newborn care) keeps trying to put Fumbi down. She places her in the hay and walks off repeatedly and appears to be trying to avoid holding her for long periods. Fumbi is agitated. Her heart rate and respiratory rate shows signs of distress. She's losing heat (because teeny newborn gorillas have a large surface area and need to be held to regulate their temperature). Fumbi isn't feeding as often a newborn usually does because of the periods of separation. The mother appears to be missing out on some of the oxytocin- (the hormone that promotes feelings of love) induced bonding that helps the formation of their early relationship. Fumbi is at risk.

Oh dear. Something seems to have happened to Fumbi's mother. We'd be worried.

However, this is exactly what is happening in human homes across the UK today (though not in many other countries and cultures). We are primates just as gorillas are. We're designed to be close to our babies. We can see that by looking at the constituents of our breastmilk. Other mammals have much higher fat milk so babies can be left while mum fishes or grabs a rabbit for lunch. Our babies are born immature because of our pelvis shape from being upright and our large brains, and they are designed to have milk regularly for a relatively long time. We are supposed to hold our babies. Some people call us 'carry mammals'.

But instead we get the message that babies can be 'spoilt'. We are supposed to encourage them to be independent and sleep apart from us. If we can't put them down, if they want to sleep touching us, if we hold them when they sleep - we've apparently failed some test. Though it's not quite clear who the examiner is.

There are popular books that even use terms like 'accidental parenting' just to load on the value judgments. Parenting experts such as Truby King in the 1910s told parents to avoid cuddling and unnecessary attention and the spectrum of 'advice' has been flip-flopping backwards and forwards ever since. Today one book will tell you to wear your baby in a sling as much as possible and another will tell you to arrange a baby's sleep by the clock and leave a baby only a few weeks old to cry if necessary.
What does your baby want?
They don't want to be put down and eaten by a sabre toothed tiger (less of a problem these days). They don't want to waste energy keeping warm and crying when they don't need to. They want to keep those calories to lay down fat and develop their brain. They want to use your breathing rate to regulate their own respiratory rate. They want you to notice when they start to show early feeding cues. They want your familiar smell and taste. You are home to them.

"My baby won't go down in its Moses basket". Yes, it's frustrating when you thought that was what they were 'supposed to do'. But would it feel easier if you knew that wasn't likely to be their first choice and there are good biological and evolutionary reasons for that?

"But I'm not going to get any sleep". According to the Baby Sleep Information Source, "70-80% of breastfed babies sleep with their mother or parents some of the time in the early months, and many studies have found that mothers and babies who bed-share breastfeed for much longer than those who sleep apart." Research shows that these mums breastfeeding through the night (and mostly bed sharing) will also be getting better quality sleep and be more rested than other parents. Good sleep is possible if we stop battling nature.

The book "Sweet Sleep: night time and naptime strategies for the breastfeeding family" is a great place to start. It talks to you about creating a safe space where everyone gets a better night's sleep.

A lot of your baby's urges are eminently sensible. If they don't want to sleep in a separate pile of hay, trust them. They are here today because those urges have kept them safe over the generations.

Don't expect to be up and making a moussaka on day five. The feeling that you 'shouldn't' be holding your baby is exacerbated when we live in a society which tries not to let new parenthood change our lives. Our bodies aren't supposed to change. Our commitment to work isn't supposed to change. Our ability to engage with political life and housework and social media isn't supposed to change. Actually, throughout much of human history, mum isn't going to do much of anything for a good 40 days. Someone else is making the moussaka, just as you would have once made the moussaka for them. We are supposed to be doing nothing else other than eating the food made by others (really doesn't have to be moussaka), sleeping and being with our new baby.

2.They come to the breast for lots of different reasons and they usually have a good reason for doing so.

Just as parents feel they've failed if their baby doesn't sleep in the separate pile of hay (aka fancy Moses basket that cost £75 and granny knitted a blanket for), they feel a failure if baby is at the breast 'too much'. I have written elsewhere on the dangerous obsession of the infant feeding interval. It's dangerous for both babies and mothers. But we need to remember breastfeeding isn't just about feeding and it never has been.

Babies have jobs to do. They are helping you to form new breast tissue in the first few weeks. They are elevating your prolactin levels (the hormone that governs milk supply). They are stimulating oxytocin (which is the key hormone in relationship-building and creating a sense of calm and well-being). They are increasing milk volume and altering fat content. They are reducing levels of the stress hormone, cortisol. They are facilitating digestion and the passing of stools. They are hydrating, regulating their temperature, feeling emotionally secure, growing brain connections and trying to get to sleep (which is one of the purposes of breastfeeding.)

To think breastfeeding is just about food and calories (and "quick, measure the gap between breastfeeds!") is to do nature a huge disservice. Measuring all the different reasons a baby comes to the breast is like trying to measure fairy dust. Do you count all the times your partner cuddles you, strokes your arm, kisses you, smiles at you affectionately, communicates with you, has a drink of water, eats a snack or has a meal? You wouldn't find an app for that.

Stop thinking about minutes. No one can tell you a baby should feed for X number of minutes because we all have different physiology and our babies do too. Create your world around you so you can meet your baby's needs in the way they are asking you to. Don't try and mould your baby to fit into a world that has become obsessed with counting and measuring. If you know you are a routine person and you are struggling with a feeling of 'losing control', give yourself a few weeks and see how it feels to trust your baby. Once your milk supply has maximised, you'll have some options. Try and 'control' too early and you'll find things go out of your influence in ways you can't come back from easily.

Get help if things feel wrong - if breastfeeding hurts, if you're not sure about weight gain or nappies, if you can't work out how to meet your own needs for food and sleep. There are lots of people who will help out and we're at the end of a phone or a Twitter account or Facebook page. But don't confuse your baby behaving unexpectedly for something going 'wrong'. Maybe no one told you what normal would be.
If we let normal happen it will make all of our lives easier in the long term. You're creating a little person who enters this world with their needs being met.
This blog was originally featured on the Growing Families conference website.

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Guest blog: "Is this normal?" The first week with a breastfeeding newborn - Baby Friendly Initiative

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In this guest blog, lactation consultant Emma Pickett explores what's "normal" in the first week with a newborn, and encourages mums to trust their baby and their own instincts.

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Kathryn Kelly, NCT antenatal teacher, explains: 'The Fourth Trimester is a way of describing the period after birth when both parents and baby are adjusting to their new lives.

'We think of other trimesters as being three months long, and we can think in terms of roughly another three months after the birth to make the adjustments to being a new family.'

What's the fourth trimester like for babies?

Having been in your warm womb for nine months, your baby has now got to get used to a sensory overload of sights, sounds and smells, as well as a frequently colder environment where they're not constantly supported by your protective amniotic fluid.

Kathryn says: 'Babies have been used to being fed continuously, sleeping when they want to, and being rocked in the cosy embrace of their mum's tummy. When babies are born we introduce gaps between feeds, and put them in a different place to sleep. It's no wonder that they can find this scary, and it's natural that they cry to express their fears.'

Understandably, babies are likely to cry more in this three-month period than any other time in their life. But however logical it might be, it doesn't make this period any easier for new parents. Knowing that other parents are going through the same experience, and thinking of this period as the fourth trimester, might help.

'Parents describe it as a very useful concept, which reminds them that it is OK to find the early days with a baby hard. It is a period of transition, where women become mums, men become dads, and babies adjust to life outside the womb,' Kathryn says.

What can you do to help your baby in the fourth trimester?

Fundamentally, the closer your baby feels to you, the happier they will be. According to Kathryn: 'Anything that mum, dad or other carers can do to replicate the womb-like world will help their baby feel safe. And when we feel safe, we thrive. For your baby, this means holding them close, perhaps in a sling, so they feel the warmth of your body, hear your heartbeat, and are gently rocked as you go about your day (or night).

'Feeding for babies, just like for adults, is about more than just nutrition, it's also social - a way of sharing and being with those we care for. Feeding your baby whenever they they want to will support their emotional development, as well as their physical and intellectual development.

'Your baby will sleep when they're tired, and you will both feel safer if they're close to you. Many parents tell me that in the early days their baby won't sleep in their Moses basket or crib, but only when they're held by a parent. This is perfectly normal and understandable when you think about the baby's point of view. It's important that parents find out about the safer sleep guidelines, and work out a way of sleeping that suits them as a family.'

Can you 'spoil' your baby in the fourth trimester?

No. Despite some people saying that babies need to 'learn' that you won't rush to pick them up every time they cry, in this crucial Fourth Trimester period you can't care for them too much. In fact, the more you look after them when they're upset, the more reassured and confident they'll be.

How might you be feeling?

Even if you're not an international tennis champion, parents who have gone from living busy, independent lives, can find the sudden change to around-the-clock care for a completely dependable infant hard.

Add to that the need to recover from a traumatic or difficult birth, and you can understandably feel like you're the one in need of a little TLC. Kathryn says: 'With the emotional changes in a woman's body, plus the realisation of the enormous responsibility of having a baby, new mums can feel overwhelmed and tearful at times.

'Partners can be dealing with their own response to the birth, their changing identity, and strong feelings about protecting and providing for the family. All of these feelings can also be affected by the way both mum and her partner were parented themselves.'

As with all stages of early parenthood, it's worth remembering that this stage will pass. In what seems no time at all, you might be looking back at the period with fondness at how tiny and attached to you your baby was when they were first born.

However, that is not to downplay how challenging the Fourth Trimester can be for parents. When you're in it, it's all-consuming. You can feel like you don't know what you're doing and you're constantly one step behind.

So, what should I do?

If you think in terms of the first three months of your baby's life being a Fourth Trimester, it can be easier to take the pressure off getting back to 'normal'. You wouldn't have been trying to rush around tidying the house and welcoming endless visitors when you were heavily pregnant, so don't put pressure on yourself to do it now.

'When women are discharged from healthcare some people might think that means they should be able to return to normal life, but there is a long period of adjustment and care needed at home,' says Kathryn. 'Friends and family can support new parents with food, help around the house, and reassurance that they are doing a great job of looking after their baby.'

This is especially important for mums who are raising their baby alone, in which case asking for help from friends and family in advance can help ensure you get the support you need.

Kathryn adds: 'Having very modest aims in the early days - getting outside most days (perhaps a short walk around the block), eating well, resting as much as possible - will change over time to meeting up with friends regularly, getting some exercise every day, and doing the most necessary housework.'

When will the crying settle down?

'As babies grow and change, things that seemed easy one day might feel very difficult another,' Kathryn says. 'A baby's crying tends to peak at around week six, which can mean that parents feel they must be doing something wrong, or that there is a problem with their baby. However, this is normal, and has usually reduced by three months.

'Parents report the excitement and happiness that comes when they see their baby is starting to interact with them, including smiling for the first time.'

Where can I get more help?

'Part of the challenge of this early period is the feeling that there is so much to learn, and to worry about,' explains Kathryn. 'Using safe sources when looking for information about caring for yourself or your baby will reduce anxiety.

'Reputable sources such as NCT practitioners and the website, or NHS health professionals and are a good place to start. Avoid sources of information (including people or media) who make you feel bad about your parenting, and stick with people who you trust and who support you.

'Although things can feel like they're getting harder in the early weeks, most people are feeling much better by around three months after the birth, and some will feel fine before that. If parents are still finding life a real struggle at that point they might consider talking to a health professional, or seeking more support from friends and family, to help them until they are feeling more in control.'

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.

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. To find out when an NCT nearly new sale is happening near you, search here.

You might find attending one of NCT's New Baby groups 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.

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What is the fourth trimester? | Baby & toddler articles & support | NCT

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Everyone knows that pregnancies last three trimesters - so what exactly is the Fourth Trimester? We explain what this crucial stage is, and what it means for you and baby

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Whatever your birth options, your active participation is a big help in getting breastfeeding off to a good start. Making informed choices about where and how you give birth is the first step.

Even when medical concerns limit your choices, there may be more options available than your medical team shares with you. Take time to do research and discuss your preferences and choices with your birth partner. If you find you can't give birth in your preferred place, you can still follow the suggestions on this page for helping birth go well.

Birth options

Consider a birthing place where you can participate actively, whether you are having a vaginal or caesarean birth. Options may include giving birth in hospital, at home or at a birthing centre. Your choice may affect which midwifery team(s) care for you during pregnancy and labour. Think about giving birth supported by caring people you feel comfortable with. Follow your instincts to find a place where you can feel safe and private during and afterwards. If you feel stressed in labour, your body naturally produces 'fight-or-flight' hormones that may slow down labour and delay birth. If you feel in control, you are less likely to need unnecessary birth interventions that can affect breastfeeding.

Questions to ask

Which midwifery team(s) will be looking after me during my labour?

Will I be able to get to know the midwives beforehand?

Are options such as a low-tech birthing room or birth pool available, and how often are they used?

If I give birth at home or in a birthing centre, what will happen if I need to move to hospital?

Do the staff encourage labour in a variety of positions-for example, walking, standing, kneeling, kneeling while leaning forwards and holding on to something, or being on all-fours?

Will I be encouraged to hold my baby in skin-to-skin contact as soon as he is born and to continue to hold him afterwards as often and as long as I want?

Hospitals

A hospital that is a certified UNICEF Baby Friendly Hospital, or is working towards certification, will be implementing the UNICEF Ten Steps to Successful Breastfeeding programme. It's a good idea to plan a hospital visit before making up your mind. The website www.birthchoiceuk.com also has information on options, including statistics on caesarean section rates. According to The World Health Organisation, caesarean rates of more than 15% do not make birth safer.

Who will support you? In addition to a midwife, many mothers choose to have their partner, friend or other family member as a birth companion. Some mothers employ a doula too. A doula is a trained, non-medical labour-support person who can support you and your partner at home during labour, in hospital and in the days after the birth.

Labour

It can help to think of labour as 'work', with each contraction bringing you nearer the birth. After spending nine months keeping your baby nourished and nurtured in your womb, your cervix has to change tactics and open up for the birth. You'll feel your muscles working hard with the unfamiliar exercise. Most mothers can ease into an unmedicated labour which often has a wave-like natural rhythm. Breathing and relaxation techniques can be a very effective way of coping with the ebb and flow of contractions.

Ways to help labour go well

Preparation: talking to other mothers, reading and attending antenatal birth classes will help you feel more ready. Write down your birth preferences and discuss them with your midwife. But be prepared to go with the flow if your circumstances or feelings change. If you have older children make sure you have organized someone to care for them, wherever you plan to give birth.

Read about LLLGB's Antenatal Breastfeeding Classes here.

Privacy: consider who you want around you during labour, and ask those supporting you to protect you from unwelcome visitors. In hospital, create your own privacy by treating the room as your space. Keep the door closed, bring your favourite music, your own pillow and wear your own clothes if possible.

Eat and drink when you feel like it, especially in the early stages of labour. This gives you more energy to manage your contractions, the birth and those amazing first hours after your baby arrives. Prepare for it to take time: labour gradually develops from the normal Braxton-Hicks 'warm-up' contractions of your uterus, into stronger contractions that usually become painful and harder to ignore. Some women find contractions stop and start over a period of days or even weeks.

Every labour is different, even if you've had a baby before. As labour progresses you'll probably become more inwardly focused, concentrating on the work you are doing and less inclined to chat to the people around you. Your body will release natural pain-relieving endorphins. Towards the end you will feel like pushing.

Listen to your body: move around and change position when you are uncomfortable or if labour doesn't seem to be progressing. Follow your body's urges; lie on your side and rest if you feel tired; wander about or go outside for a walk if you feel like it. You're not ill-and you don't have to labour or give birth in bed. Lying on your back during labour generally delays birth and makes it all harder. It might also mean you need more pain relief medication which can interfere with breastfeeding.

Cutting the cord only after it has stopped pulsating reduces your baby's risk of anaemia in the first year of life.

Labour interventions

Knowing beforehand about possible interventions will help you to ask questions and decide whether to accept what you are offered. You might want to discuss these possibilities with your midwife. However, in the unlikely event of an emergency, medical staff will need to take action quickly to ensure the safety of you and your baby but they will tell you what is happening.

Induction

What can happen: the drug syntocinon (artificial oxytocin) is used to induce or speed up labour. It produces stronger, and possibly more painful contractions than your own naturally produced oxytocin. This often leads to further interventions, such as pain relief medication, an assisted delivery or a caesarean section.
What you can do: avoid routine induction if you and your baby are healthy. Consider whether there is a family history of 'overdue' babies. Review your dates, weigh up the risks and talk to your midwife about waiting a little longer to see if labour will start naturally. Some believe that having sex can help you go into labour.

Medications

What can happen: pethidine, epidural anaesthetics etc cross the placenta into your baby's bloodstream. He may feel groggy and have difficulty coordinating latching on and sucking at the breast for up to two weeks after the birth.
What you can do: Using non-medical pain relief such as water, massage, moving around and TENS can reduce your need for medical pain relief. If your baby is affected by medications, keep him in skin-to-skin contact as much as possible, even when he's asleep. Use Biological Nurturing™ laid back breastfeeding positions so you can watch for baby feeding reflex cues like mouthing movements, lip twitches or sucking whilst asleep and help him take the breast. Until they are feeding well, frequently express drops of your colostrum directly into their mouth.

Intravenous (IV) drips

What can happen: IV drips are used for certain induced births and caesarean births. Fluid from IV drips may cause engorgement in the early days. This makes it difficult for your baby to latch on deeply at the breast and may lead to nipple damage. Their birth weight may also be higher from any excess fluid which they then lose in the first few days.
What you can do: A few hours delay in weighing your baby may give a more realistic birth weight. Frequent feeds will help you avoid or reduce engorgement as your milk volume increases. To relieve engorgement, soften your breast by gently pressing swelling away from the nipple with your fingers (a technique known as reverse pressure softening). You can also hand express some milk.

Birth interventions

Episiotomy and assisted delivery with forceps or ventouse

What can happen: cuts and tears that need stitches may make sitting upright uncomfortable in the days after birth. Forceps or ventouse delivery can also leave your baby feeling sore, bruised and with a headache.
What you can do: m ove around in labour and choose your own positions for the birth: kneeling while leaning forward, being on all-fours etc. When breastfeeding, use Biological Nurturing™ positions to get comfortable and to help your baby recover. These and side-lying positions also limit pressure on your baby's head.

Caesarean section

What can happen: a caesarean is major abdominal surgery. You will take at least six weeks to recover from the birth and need help looking after your baby. Your baby may be affected by the anaesthetic (epidural or general) and be less able to feed well at the breast for the first few days.
What you can do: Insist on skin-to-skin contact with your baby as soon as he is born. You could write this in your birth preferences beforehand, just in case. If a general anaesthetic is required, a family member can be present and hold your baby skin to-skin until you are able to, and help you hold him if you're feeling shaky. Avoid any routine bottles-your baby can wait a short time for you. If possible reading our pages on caesarean birth and antenatal expression of colostrum before you go into labour. Biological Nurturing™ and side-lying positions can help you get comfortable whilst breastfeeding. Or try an underarm rugby hold.

Syntometrine injection

What can happen: once your baby is born, the placenta separates from the uterine wall. A routine syntometrine injection may be offered to assist this as many believe that this injection reduces the risk of excessive bleeding. Following a normal birth, few mothers need the injection. Side effects of syntometrine can include nausea or a headache, which may affect the early hours you spend with your baby.
What you can do: discuss this intervention with your midwife when writing your birth preferences. Keep warm and undisturbed. Skin-to-skin contact with your baby and breastfeeding immediately after birth encourages oxytocin production. Oxytocin contracts your uterus so your placenta is expelled naturally.

Separation

Sometimes and for various reasons you may be separated from your baby following birth. Plan to be in close body contact with your baby as soon as possible as this is the best way to establish breastfeeding. Separation because of health concerns may make breastfeeding harder, but it's still possible.

Hold, or at least touch, your baby immediately after the birth or as soon as you can. Once you are together again make up for lost time by spending as much time as possible snuggling together skin-to-skin or lightly dressed. If your baby is in special care you can still touch and stroke him and may be able to hold him against you in 'kangaroo mother care' for long periods of time. And if he can't feed at the breast straight away then expressing your milk for him is important. Many mothers say that this is the single most important thing they have done while they are waiting to start breastfeeding.

The first 24 hours

Your newborn baby already knows your voice and smell-and you are their whole world. He needs to be in continuous close contact with you and to have your milk as soon as he is ready. Breastfeeding is known as the fourth stage of birth. Lean back with your baby snuggled up against you, skin-to-skin, in full body contact.

Avoid interruptions until after they have had their first breastfeed. Weighing and washing need to wait-this is much more important. Watch as he nuzzles your body and uses their legs to push himself to your breast. They may turn their mouth towards your breast-the rooting reflex. Their head may bob around as he tries to latch on or he may just lick for a while. They may take a look around at their new surroundings. But sometime soon they'll probably take a big mouthful of breast. They may feed for quite a while or they may take a few sucks and fall asleep, waking on and off, sucking and feeding whilst asleep.

Your baby's instinctive feeding responses work when he is asleep too and will h elp him find the breast, latch, suck and drink. Your body will respond by releasing prolactin and oxytocin, the hormones that make and release milk. These hormones also help you bond with your baby making mothering easier and more natural.

Some babies will feed on and off for an hour or two, others more continuously for a shorter time. Keep your baby on your body or close by while he sleeps so you'll notice when he is ready to feed. A young baby's sleep cycle lasts about 60-90 minutes. Transitioning from light to deep sleep may be hard for him and it helps to hold him as he goes into deep sleep.

And so to sleep

If your baby has an enjoyable feed just after birth, they may sleep for up to six hours. This gives you time to rest and eat. Hold your baby as much as you want-ideally skin-to-skin wearing just a nappy and a blanket over their back to keep him warm.

If a baby is wrapped and put down, they won't be reminded to rouse and feed. If you think they need a feed you don't need to wake them. With them snuggled against you it's easy to gently encourage them to latch on while they are in a light (REM) sleep. Watch for rapid eye movements under their closed eyelids, arm and leg movements, sucking activity and changes in their facial expression and then encourage them to latch on.

If your baby doesn't feed within an hour of the birth, they may sleep deeply. Keep them skin-to-skin with you and drip expressed colostrum into their mouth every hour or two until they are ready to latch on.

If your baby doesn't feed frequently over the next few days, hand express colostrum and drip it into their mouth every couple of hours, including at least once between midnight and 5am to boost your milk producing hormones. When your baby is awake, you will probably want to gaze intently at each other and enjoy getting to know one another. Read the section on Wakeful Nights for more on sleep.

If your baby needs special care

You are still the most important person to your baby. They will recognise your voice and smell and they need your milk as soon as they can take food. Breastmilk protects a baby from NEC (gut damage) and other illnesses so ask staff to show you how to hand express. If you are well, start hand expressing within six hours of the birth; if you are unwell, as soon as you feel able.

Until your baby is able to breastfeed:
Express milk 8-10 times in 24 hours to build your milk supply, including once during the night. You can switch to using a pump as your milk increases. Talk to your baby and touch them as much as possible. Ask staff when you can start skin-to-skin contact with them. This helps your milk production and your milk ejection reflex (let-down). It also calms and stabilises your baby and feels wonderful.

Early Days

Day 2
Give your baby plenty of chances to learn to breastfeed by holding them in skin-to-skin contact most of the time. You can wear a gown or loose pyjama top and wrap it round them, or cover them with a blanket. Expect your baby to feed 8 to 12 times in 24 hours, including night feeds. Relax and enjoy these special hours together.

Days 3 to 5
Your colostrum will start to change from golden to bluish-white as you produce more milk. Your breasts will start to feel full, even engorged or sore, making it harder for your baby to latch on well. They need to get a deep latch so feeding won't make your nipples sore, so: breastfeed (or express) frequently. If your breasts feel softer and more comfortable after feeding, your baby is getting milk.

Avoid using bottles or dummies. If a supplement is needed try using a spoon, flexible feeding cup or syringe. Use a cold compress for 15-20 minutes between feeds to reduce swelling, or place cold cabbage leaves inside your bra. Apply moist warmth to your breasts for up to two minutes just before feeding to help your milk flow.

Problems with feeding

If your baby is sleepy from a difficult birth or medications used, they may not feed well. You can drip hand expressed colostrum directly into their mouth or give it to them by cup, spoon or syringe. As you produce more milk, you can use a pump until your baby is feeding well. Ask for help to get breastfeeding established. When they latch on, it should feel comfortable for you (after the first few sucks).

If your baby is finding it hard to latch on

When your baby bobs their head and licks the nipple, it naturally makes it easier to latch on. Reverse pressure softening has a similar effect by moving fluid away from the nipple area: press all five fingertips of one hand around the base of the nipple.

Apply gentle steady pressure for about a minute to leave a ring of small dimples on the areola. You can also press with the sides of fingers. Place your thumb on one side of the nipple and two fingers on the other side where your baby's lips will be.

Falling hormonal levels after the birth can make you feel emotional, upset or weepy. This is absolutely normal and typically lasts just a few days.

Jaundice

Jaundice is common and normal in newborns. Getting breastfeeding off to a good start can prevent it becoming a problem which needs treatment. If your baby has jaundice, frequent breastfeeding and/or expressed breastmilk will help clear the yellow bilirubin pigment. If further treatment is needed, our page Jaundice in Healthy Newborns has more information.

Wakeful nights

While your baby is small, you will find some nights are particularly wakeful, including the second night just before your milk 'comes in'. Your baby may want to feed very frequently, doze off and then wake again, protesting if put down.

Keep your baby close so they can feel your presence and hear your heartbeat, just as in the womb. Let them breastfeed frequently-it will boost your milk production.

If you need to put them down to sleep, wait until they fall into a deep sleep. You could cover them with a sheet or blanket while feeding, then lay them down on the cover to avoid contact with a cool surface.

Avoid using mittens-their hands are familiar and soothing, mittens feel strange. And the touch of their skin on your breast boosts oxytocin and your milk.

It's never too late to try breastfeeding

If your birth is more difficult than anticipated, you and your baby have problems or are separated for any reason after the birth it may take you both a little longer to feel closely connected and get breastfeeding going well.

If this happens to you, keep your baby with you. Decline offers from others to look after him-ask them to do something practical to help you instead. Relax together with your baby snuggled up against you in Biological Nurturing™ laid-back breastfeeding positions, either lightly dressed or in skin-to-skin contact. Spend as much time as possible with their whole body against yours.

Take a warm bath together and focus on just admiring him. Breathe in their special smell, nuzzle and kiss him-some mothers even get an urge to lick their babies. All these can encourage your baby's natural instinct to feed and help you feel more motherly and that you belong together.

How often will my baby need to feed?

Babies have tiny tummies so they can't wait long for food. Even adults rarely go longer than a couple of hours without a drink, snack or meal. Breastmilk is quickly digested so in the early weeks a baby needs to nurse pretty constantly- at least 8-12 times in a 24-hour period, including feeds at night. You release more of the milk-making hormone prolactin during night feeds. Late afternoon/ evening feeds are often closer together too. This 'cluster feeding' is normal.

As your breasts adjust, they will feel softer. It doesn't mean your milk supply has dropped. From Day 3 onwards 3-5 poos (at least the size of a 2p coin) per 24- hours are reassuring signs. Frequent feeds are a gradual transition from continuous feeding in the womb. Hunger is a new sensation for your baby so try not to make him wait until he's too desperate to feed well.

Watch for:

Mouth movements, including smacking or licking their lips.

Sucking on lips, tongue, hands, fingers, toes, toys, or clothing.

Rooting, head bobbing or nuzzling against whoever is holding them.

Fidgeting or squirming a lot.

Fussing.

Crying

Crying is nature's emergency siren and a late sign of hunger. It's designed to summon help quickly. As well as being stressful for you it's stressful for your baby. Crying raises cortisol levels (which can affect brain development) and increases your baby's blood pressure. Life will be happier for everyone if you can respond quickly. Once you get to know your baby better you'll be able to work out what they need most of the time as soon as they start to fuss, long before they need to cry. And thye'll learn to relax knowing that you'll look after them.

Sucking patterns

Watch your baby's pattern of sucking. They will suck rapidly until milk starts to flow. Once the milk is flowing you'll see a pattern of suck-swallow-suck-swallow. The frequency of sucks gradually slows as the feed progresses.

Once swallowing movements start to trail away and your baby relaxes and gets sleepy, it can be useful to change sides. This can prompt them to take some more.
Getting rest
Many mums feed lying down in bed at night (or in the day) to get more rest. Research shows that keeping your baby close while they are asleep protects against Sudden Infant Death Syndrome (SIDS) but you should never sleep on a sofa or chair with your baby. Do not share a bed with your baby if any adult in the bed smokes, has drunk alcohol or taken prescription or other drugs. Talk to an LLL Leader and read our page Safe Sleep & the Breastfed Baby as you decide how best to manage night-times.

Visitors

It's OK to set limits on visiting-in fact it's a really good idea. The first few days are a very special chance for you and your partner to get to know your baby peacefully together. If the birth was difficult it may help to write down your birth story or talk to someone about your feelings to help you come to terms with how it all happened.

Support

No matter how birth goes, with good friends and support, most mothers and babies breastfeed.
Calling an LLL Leader or going to your local LLL Group while pregnant means you'll make breastfeeding friends and have access to support and information right from the start. If you have problems in the first week, or if your baby isn't feeding well, seek help as soon as possible.

As well as your midwife or health visitor, you can contact an LLL Leader. You can also find lots of information on common concerns in the first weeks in our Further Reading section.

Written by Rachel O'Leary, Sue Upstone, Karen Butler and mothers of LLLGB.
Kimberly Seals Allers' photos on this site are used under a creative commons license of Black Breastfeeding 360° http://mochamanual.com/bb/

Further Reading
Adjusting to Motherhood
Caesarean Birth & Breastfeeding
Positioning & attachment
Comfortable Breastfeeding
Engorged Breasts - Avoiding & Treating
Is My Baby Getting Enough Milk?
My Baby Won't Breastfeed
Jaundice in Healthy Newborns
Safe Sleep & the Breastfed Baby
Sleepy Baby - Why & What To Do
Successfully breastfeeding your premature baby
What's the Big Deal With Skin-to-Skin
Mothering through special care

Other websites
www.birthchoiceuk.com
www.biologicalnurturing.com
www.unicef.org.uk/babyfriendly

Books
The Womanly Art of Breastfeeding, LLLI. London: Pinter & Martin, 2010.
Birth: Countdown to Optimal, Donna, S. Chester le Street: Fresh Heart Ltd, 2011

References
An Introduction to Biological Nurturing: New Angles on Breastfeeding, Colson S. Amarillo, TX: Hale Publishing, 2010.
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, TX: Hale Publishing, 2010.
Supporting Sucking Skills, Watson Genna, C. Burlington, MA: Jones & Bartlett, 2012.

This information is available in printed form from our shop.

Copyright LLLGB 2016

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Birth & Breastfeeding - La Leche League GB

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active participation is a big help in getting breastfeeding off to a good start: follow our suggestions for helping birth & breastfeeding go well

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Nipple pain in a breastfeeding mother is common but not normal. It often happens when mothers first start breastfeeding and is usually due to a baby not attaching deeply. This video shows how nipple pain happens and what a mother can do to help herself.

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What To Do About Nipple Pain - Video - Global Health Media Project

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Nipple pain in a breastfeeding mother is common but not normal. It often happens when mothers first start breastfeeding and is usually due to a baby not attaching deeply. This video shows how nipple pain happens and what a mother can do to help herself.

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Engorged Breasts - avoiding and treating - La Leche League GB

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Engorged breasts are painful. They feel heavy, hard, warm and sensitive -as if they are ready to burst! As well as being painful, engorgement can lead to other breastfeeding problems if not treated. Being able to recognise engorgement will help you to treat it promptly, avoiding complications.

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Upright rugby hold exaggerated latch breastfeeding position

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Positions for Breastfeeding - Video - Global Health Media Project

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The way a mother holds her baby affects how easy it is for her baby to feed effectively. This video shows basic points important for any position and then

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How to breastfeed - The Breastfeeding Network

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Getting Started Breastfeeding should be COMFORTABLE How you sit (or lie down) and how close you hold your baby as you feed can make a difference to how well things go. Sometimes a little difference in how your baby is feeding can make a big difference to how comfortable it is for you and how [...]

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If you suspect your baby has a tongue tie (restricted frenulum), then please contact your midwife or health visitor for a breastfeeding assessment.

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Knowing it's time to feed

If possible, try to feed your baby when you are both relaxed and comfortable.

Your baby will let you know they are hungry by doing things like:

sucking their fists

licking their lips

wriggling and opening their mouths, as if they're searching for your breast

Encourage your baby to feed fully from each breast. This will help them get the fattier milk that comes towards the end of the feed.

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If possible, try to feed your baby when you are both relaxed and comfortable. Your baby will let you know they are hungry by doing things like: sucking their fists licking their lips wriggling and opening their mouths, as if they're searching for your breast Encourage your baby to feed fully from each breast.

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Breastfeeding Attachment - Breastfeeding Series

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Sling Safety - The T.I.C.K.S Rule - Lewisham and Greenwich NHS

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Unicef UK Baby Friendly Initiative | Positioning and attachment

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Breastfeeding Network Shropshire, Telford & Wrekin

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Support for Transgender & Non-binary Parents

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Support for Transgender & Non-binary Parents

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La Leche League is an international, nonprofit, nonsectarian organisation. 1 LLLGB supports everyone who wants to breastfeed or chestfeed in reaching their goals. We do not discriminate based on sex, gender or gender identity.

Trans men, trans women and non-binary individuals may choose to breastfeed or chestfeed their babies. You do not need to have given birth to breastfeed or chestfeed, as we can also see in the experiences of those nursing adopted babies.

Transgender dad Trevor MacDonald writes that, "It is equally important to note that some trans people experience severe gender dysphoria when breast or chestfeeding, and that they may decide not to nurse their babies for mental health reasons. Trans parents choosing to breast or chestfeed and those choosing to suppress lactation and bottlefeed may require the support of breastfeeding counsellors or lactation professionals." ²

Amazing milk

One of the concepts La Leche League is founded on is that: human milk is the natural food for babies, uniquely meeting their changing needs. Human milk is amazing. It has everything a growing baby needs in exactly the right amounts and babies can easily digest it all. Research shows that a baby who is not fed on human milk is more likely to suffer from illnesses and diseases, both as a child and later in life. By meeting your baby's needs for warmth, food and security at your chest you give them a secure attachment so they can develop into a conﬁdent child.

Skin-to-skin

Skin-to-skin contact is beneficial for babies and parents; it simply means holding your naked baby on your bare chest. You can drape a blanket over you both for warmth. Within minutes, you will see the benefits of skin-to-skin as you and your baby relax. Your baby's body temperature, breathing, and heart rate will stabilise. Babies often latch on and nurse more efficiently during and after skin-to-skin contact.
It is a lovely way to nurture your baby even if you are not nursing.

Your milk supply

Some transgender and non-binary parents have a full milk supply. If you have had chest (top) surgery you may be able to produce some milk. Many factors will affect the amount of milk you can make.

Two reasons that a trans man might have a reduced milk supply are:
1. Milk-making tissue has been surgically removed, and/or ducts have been damaged in surgery.
2. Testosterone interferes with the hormone necessary for lactation (prolactin) and can cause a significant decrease in milk supply. However, taking testosterone would not prevent someone from using an at-chest supplementer and having a nursing relationship.

Trans women can use a protocol similar to adoptive and other non-gestational mothers and stimulate their milk supply: it is called the Newman-Goldfarb protocol. You can read more here https://laleche.org.uk/relactation-induced-lactation/ and here http://www.asklenore.info/breastfeeding/induced_lactation/protocols4print.shtml.

You can also give human milk or formula supplements using an at-breast supplementer. Your healthcare provider can help you look at your options, and your local LLL Leader can offer support with your breast or chestfeeding goals and journey.

You may find the following websites have useful information:
Breastfeeding After Breast and Nipple Surgery http://bfar.org/index.shtml?fref=gc
Low Milk Supply http://www.lowmilksupply.org/

Many parents worry about whether their baby is 'getting enough'. LLL meetings are a good place to get support from others. These LLL posts are great for checking signs your baby is feeding effectively:
https://laleche.org.uk/is-my-baby-getting-enough-milk/
https://laleche.org.uk/signs-effective-feeding-early-days-2/

Using a nursing supplementer

If your baby needs a supplement of expressed milk or formula you might want to consider using a nursing supplementer. Doing this can give your baby that extra milk while they are nursing.
Supplementers can help parents have an at-breast or at-chest relationship with their baby whether or not they are able to produce milk.

This post has lots of useful information about nursing supplementers: https://laleche.org.uk/nursing-supplementers/.

Milk sharing

Some transgender and non-binary parents use milk banks to acquire human milk for their babies. La Leche League fully supports the use of human milk for babies; we cannot facilitate or set up milk sharing networks, though your local LLL Leader can help you with contact information for non-profit human milk banks, other regulated collection centres, and formal/medically supervised or informal milk sharing networks. 3 Human milk banks provide pasteurised, screened donor milk.

There are documented benefits and risks to informal milk sharing. Benefits of human milk include, but are not limited to:

optimal nutrition

easy digestibility

immunological protection

Risks of sharing milk can include, but are not limited to:

transmission of certain infectious agents, like bacteria or viruses, some of which may be found in milk expressed by asymptomatic people

medicines and other drugs

environmental contaminants as a result of unhygienic storage and handling of unprocessed donated milk

Human Milk for Human Babies (HM4HB) is an "informed milk sharing network", and is an international organisation that many parents use to source human milk: https://www.facebook.com/HM4HBUK/

LLL Support

All parents need support and La Leche League is a great place to find it. There are over 70 LLL groups across Great Britain, most offer meetings open to all - contact your local group to find out how they can support you. Many groups also have closed Facebook groups where you can ask questions and connect with other nursing parents.

LLL meetings are held in a wide range of venues - LLLGB is not affiliated to, and does not endorse or support, any business, organisation or religion whose premises we use. https://laleche.org.uk/find-lll-support-group/?fref=gc

LLLGB also offers these services:
National Helpline: 0345 120 2918 https://laleche.org.uk/telephone-helpline/
Online Helpform support: https://laleche.org.uk/submit-help-request/
Contact us for non judgmental information and support.

Find more LLLGB support listed here:
https://laleche.org.uk/get-support/?fref=gc<

Other support

International Facebook group for 'birthing and breast or chestfeeding trans people and allies': https://www.facebook.com/groups/TransReproductiveSupport/?fref=gc&hc_location=ufi

La Leche League - Inducing lactation and relactation Facebook group

Resources

Where's the Mother? Stories from a Transgender Dad. Trevor MacDonald: Trans Canada Press, 2016

LLL article: Support for Transgender and Non-binary parents

Defining Your Own Success: Breastfeeding After Breast Reduction Surgery. Diana West: LLLI, 2001:
https://www.bfar.org/book.shtml

My Journey: Non-binary Nursing - from LLLUS
https://lllusa.org/my-journey-non-binary-nursing/

Trans breastfeeding FAQ:
http://dianawest.com/trans-breastfeeding-faq/?fref=gc

US based website Kellymom's post:
http://kellymom.com/bf/got-milk/transgender-parents-chestbreastfeeding/?fref=gc

Transmasculine individuals' experiences with lactation, chestfeeding, and gender identity: a qualitative study:
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0907-y?fref=gc

Transgender/transsexual/genderfluid Tip Sheet - General Information, LLL Canada
https://www.lllc.ca/sites/default/files/REVISED-Trans-Nursing_Tip-Sheet.pdf

Breastfeeding without giving birth, LLLI article by Aylssa Schnell
https://www.llli.org/breastfeeding-without-giving-birth-2

Language

We are aware that transgender and non-binary individuals use a variety of different terms to describe their anatomy and the acts of feeding and nurturing their babies. We have used the terms "chestfeeding" and "nursing", with the second of these capturing the nurturing relationship associated with this way of feeding a baby.

Elsewhere on the site we use 'breastfeeding', 'breastmilk' and 'mother': they reflect the founding and unchanged mission of LLLI to provide mother-to-mother support for breastfeeding. They also reflect the stated identity and valued role of the majority of people whom we support and provide information to - those who identify as breastfeeding mothers.

Whatever language you use we hope that much of the information we share is still helpful and relevant.

References
1 La Leche League International Bylaws, Section 1: General Purpose
2 http://kellymom.com/bf/got-milk/transgender-parents-chestbreastfeeding/?fref=gc
3 http://leadertoday.breastfeedingtoday-llli.org/milk-donation-policy/

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Support for Transgender & Non-binary Parents - La Leche League GB

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La Leche League is an international, nonprofit, nonsectarian organisation.1 LLLGB supports everyone who wants to breastfeed or chestfeed in reaching their goals. We do not discriminate based on sex, gender or gender identity. Trans men, trans women and non-binary individuals may choose to breastfeed or chestfeed their babies.

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These factsheets are maintained by Drugs in Breastmilk information service team of pharmacists and offer helpful information on safe medication to be taken when breastfeeding

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Drugs in Breastmilk factsheets - The Breastfeeding Network

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These factsheets have been compiled by our Drugs in Breastmilk information service team of pharmacists. If you are unable to find the information you are looking for below, or you still have questions, you can contact the team by sending a private message via our Facebook page or via email. Please provide as much information as possible (age […]

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Breastfeeding and relationships in the early days 

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Breastfeeding and relationships in the early days 

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This video looks at both the theory and practice of relationship building and responsive breastfeeding, supporting families to get their relationship with their baby off to the best start.

Hear mothers and professionals give tips and advice on what it can mean to have a close and loving relationship with your new baby.

Find more relationship building resources

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Breastfeeding and relationships in the early days video - Baby Friendly Initiative

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Baby Friendly's video on breastfeeding and relationship building covers views and tips from both mothers and health professionals.

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The importance of relationship building vide

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The importance of relationship building vide

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In this video, we look at the importance of developing close and loving relationships with babies in their early days and weeks.

Responding to babies' needs for comfort and food is hugely beneficial for brain development and makes for more confident toddlers. Parents should be supported in breastfeeding responsively and keeping their babies close to help them become happy, healthy and secure children and adults.

For more information:

Find more relationship building resources

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The Importance of relationship building video - Baby Friendly Initiative

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This video looks at the importance of developing close, loving relationships with babies in their early days and weeks.

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During pregnancy your body is preparing to give birth and your breasts are getting ready to feed your baby. If you are told you need to have a caesarean birth you may wonder if you will still be able to breastfeed as you planned. Mothers successfully breastfeed after a caesarean birth and you can expect your healthcare professionals to support you with getting breastfeeding established straight away.

Whichever way we give birth, our bodies need time to recover and to adjust to feeding a new baby. Birth by caesarean usually means a longer hospital stay, and a longer recovery time because this is major abdominal surgery so practical support from friends and family can make a big difference to you.

Before the birth
Common concerns
A good start for breastfeeding
Practical help and support

Before the birth

Whichever way you will be giving birth, find out as much as you can beforehand about labour and breastfeeding. Whilst some aspects will be out of your control, choosing your place of birth and your caregiver can reduce your chance of a caesarean.

An induced birth can lead to more interventions, increasing the chance you'll need a caesarean.

Continuous support during labour from a woman you feel comfortable with and trust can reduce the risk of a caesarean birth.

Simple things like eating and drinking, moving around and relaxation can improve your experience of labour.

Tell hospital staff beforehand that you plan to breastfeed and to emphasise:

You want to keep your baby with you, provided neither of you needs special care.

You don't want your baby to be given bottles or dummies without your permission, because this will interfere with breastfeeding.

An unplanned caesarean
A caesarean after a long or difficult labour can leave you feeling extremely tired and frustrated. However the hormones released during labour have already prepared you and your baby for breastfeeding.

A planned caesarean
Knowing in advance that you will be having your baby by caesarean can let you prepare, both emotionally and practically. When possible, going into labour first can help get breastfeeding off to an easier start. If you have had a previous caesarean, it is not always necessary to have one the next time. Discuss your options with your health professionals.

After an caesarean
Whether or not your caesarean was planned, you may still feel upset or sad about what happened and mourn the loss of the birth experience you were hoping for. It is quite understandable to feel this way and these feelings may affect the way you feel about your baby and breastfeeding at first.

Breastfeeding can give you confidence in your body's abilities. When you breastfeed, your baby needs you. The close physical contact can also help you to feel better emotionally. Breastfeeding helps your womb to contract, which will help you heal more quickly. And it's nature's way of ensuring you spend time sitting or lying down, resting and recovering.

Common concerns

IVs or drips
To make holding and feeding your baby easier, ask that your IV drip be inserted into your forearm, rather than in the back of your hand (and without the supporting board if one is used). You can request that your catheter be inserted after your spinal anaesthetic has taken effect, to make the procedure more comfortable.

The extra fluid from an IV can increase engorgement. Before breastfeeding, you can easy any swelling back by pressing your fingers around the nipple area (reverse pressure softening) and see Engorged Breasts-Avoiding and Treating for suggestions.

IV fluid will also transfer to your baby. This can lead to an artificially high brith weight which may result in a higher percentage weight loss in the early days. Weighing your baby at 24 hours old may give a more accurate baseline weight.

Anaesthetic
Any anaesthetic in your system will not be harmful to your baby. However the anaesthetic may make your baby very sleepy during the first few days-you may have to wake them up and encourage them to nurse. Keep them close and offer the breast whenever they stir.

Antibiotics and pain relief
Pain relief and antibiotics are routinely given after a caesarean. Pain relief will be essential to help you through the early days. Over the counter pain medications, such as paracetamol and ibuprofen, are considered safe for breastfeeding. If you need something stronger, then discuss this with your health care team, who can check which drugs are compatible with breastfeeding. You may need further antibiotics, but be aware that these increase the risk of a thrush infection for you and your baby.

A good start for breastfeeding

Express your milk
Separation or feeding problems are more likely if your baby is born early, if you have an induced birth, or if you have a health problem such as diabetes. It can be very helpful to express and store colostrum before the birth so that your milk will be available for your baby if separation occurs. See Antenatal Expression of Colostrum.

If your baby is a bit sleepy at first you can hand express drops of colostrum and give it on a spoon. You partner could help with this.

It can sometimes take a little longer to have a plentiful milk supply after a caesarean birth. Hand expressing frequently will encourage this process. If you baby needs a supplement offer it with a spoon, syringe, feeding cup or supplementer.

Breastfeed as soon as possible
You can breastfeed as soon as you are alert enough to hold your baby, in the recovery room or even on the delivery table. At this stage you will be free from pain as the anaesthetic will not have worn off. Although you may be lying flat on your back and may need some help positioning your baby, you don't need to be sitting up to breastfeed. Simply lying there, skin-to-skin is enough to prompt a baby to nuzzle onto your breast themself. If you are drowsy your partner can help by holding your baby close to you.

Skin-to-skin contact with your baby
It's important and never too late, to enjoy skin-to-skin contact with your baby. Tuck a blanket over both of you to keep warm. Skin-to-skin

Encourages your baby to latch on and feed frequently.

Helps colonise your baby's skin with your own individual 'good' bacteria.

Calms your baby and regulates their temperature.

Encourages bonding.

If your need for medical care prevents this happening straight away, your birth partner can step in. Babies still benefit from sking-to-skin contact even when they can't be with you.

Get comfortable for breastfeeds
Getting your baby attached well at the breast helps them to feed effectively and helps prevent nipple damage. Lying down, laid back or using the underarm position may be easiest at first. Use extra pillows for support and comfort-behind your back, under your arms or between your knees. A rolled up towel or small pillow can cover and protect your incision. . See Positioning & Attachment for tips. Be aware that pain relief can mask pain during breastfeeding. If your nipples are squashed or flattened after feeds, or look sore or damaged, seek help without delay.

Baby feeding cues
Mothers often find they need help responding to their babies' early feeding cues. If you feel groggy after birth, it helps if the people supporting you are aware of the signs your baby needs to feed. These include, in increasing urgency:

Opening their mouth, making sucking motions and turning their head (rooting) looking for the nipple.

Moving their tongue.

Furrowing their eyebrows-perhaps showing tension in their face.

Clenching and unclenching their fists.

Flexing their arms.

Moving their hands to their mouth.

Followed by restless movement.

Then crying-the last resort.

Practical help and support

It is useful to check hospital policies on visitors, so you can arrange as much help as possible. Even in hospital, it will be much easier with your partner, family member or friend to help you care for your baby. If you are on your own, ring for help from hospital staff when you need it.

Once at home, extra help will be essential. You will be recovering from major abdominal surgery and need to rest, recover and concentrate on nursing your baby. You may be advised not to drive for about six weeks. Organise as much help as possible with meals, laundry and essential housework, and with caring for any older children. Drink enough fluids to keep your urine pale, and eat a balanced diet. Simple meals will be easier to prepare.

See Supporting a Breastfeeding Mother and Adjusting to Motherhood include practical tips on making life easier after birth.

Support for breastfeeding
Try to contact an LLL Leader, attend an LLL meeting or join an LLL Facebook group before your baby arrives to establish your support network. The LLL Leaders and other mothers will be able to give you ongoing support and enouragement, along with useful practical ideas. You can find your local LLL group here.

Written by Sara Walters, Karen Butler, Sue Upstone, Bronwyn Davies and mothers of LLLGB.

Further Reading
The Womanly Art of Breastfeeding. LLLI. London: Pinter & Martin, 2010.
NICE Clinical Guidance: Caesarean Section. www.nice.org.uk/guidance/ng192

Antenatal Expression of Colostrum
Birth and Breastfeeding
Beginning Breastfeeding
Comfortable Breastfeeding
Engorged Breasts - Avoiding and Treating
Hand Expression of Breastmilk
My Baby Won't Breastfeed
Positioning and Attachment
Sleepy Baby - Why and What to do
Supporting a Breastfeeding Mother
Treating Thrush

References
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, Tx: Hale Publishing, 2010.
Impacts of Birthing Practices on Breastfeeding 2nd edition, Smith, LJ. Jones and Bartlett Publishers, 2010.

You can buy this information in a printed leaflet from the LLLGB Shop here

Updated March 2022

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Caesarean Birth and Breastfeeding - La Leche League GB

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Skin-to-skin contact - Baby Friendly Initiative

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Skin-to-skin contact is important for babies and mothers to develop close, loving parent-infant relationships and to initiate breastfeeding.

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Ineffective attachment and how to correct

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Unicef UK Baby Friendly Initiative | Poor attachment

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How to get breastfeeding off to the best start

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Published by Better Health Start for Life and the Baby Friendly Initiative and updated in 2022, this leaflet provides mothers and health professionals with key information about breastfeeding.

The leaflet is a teaching aid for health professionals when discussing the benefits and management of breastfeeding with pregnant women, and when teaching new mothers how to breastfeed. Health professionals may also find our breastfeeding assessment tools and practical skills review forms useful when talking to new mothers.
To enquire about printed copies of this leaflet, please visit the Department of Health & Social Care campaign resource centre. The UNICEF UK Baby Friendly Initiative is unable to assist with printed leaflets for this resource.

Off to the Best Start leaflet - A guide to help you start breastfeeding

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Off to the best start leaflet - Baby Friendly Initiative

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This leaflet from the Department of Health and the Baby Friendly Initiative provides key information about breastfeeding.

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How to breastfeed - The Breastfeeding Network

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Getting Started Breastfeeding should be COMFORTABLE How you sit (or lie down) and how close you hold your baby as you feed can make a difference to how well things go. Sometimes a little difference in how your baby is feeding can make a big difference to how comfortable it is for you and how [...]

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If you are exclusively expressing, please ask a member of staff for an assessment

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This checklist can be used to ensure that mothers are expressing their breastmilk effectively and to address any issues or concerns mothers may have.

For sick and preterm babies the importance of breastmilk cannot be overestimated. Breastmilk supports growth and provides protection from infection, with evidence suggesting that its use decreases the incidence and severity of the life-threatening disease necrotising entercolitis.

By providing breastmilk, a mother can be assured that she is uniquely contributing to the wellbeing and development of her baby. However, expressing breastmilk over a long period of time is extremely demanding and if a mother is to succeed she needs the support from those involved with caring for her and her baby.

Assessment of breastmilk expression checklist

Assessment of breastmilk expression - staff guidance

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Assessment of breastmilk expression checklist - Baby Friendly Initiative

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This checklist ensures that mothers are expressing their breastmilk effectively and to address any issues or concerns mothers may have.

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Tongue-tie (ankyloglossia) is a condition in which the thin piece of skin under a baby's tongue (the frenulum) is shorter than normal, meaning it may restrict the movement of the tongue. This can sometimes make it harder for a baby to breastfeed (and sometimes bottle feed). If you suspect that your baby may have a tongue tie, this should be assessed by a trained healthcare professional such as a GP, midwife, health visitor or lactation consultant.

Tongue tie can sometimes impact on a baby's ability to breastfeed effectively. It can mean that a baby may not be able to move their tongue fully up and down or side-to-side or they might not be able to stick their tongue out beyond their lower lip. If tongue tie does interfere with a baby's ability to latch and suckle at the breast it can cause:

nipple pain and trauma for mum

poor breast milk intake leading to poor weight gain

a possible decrease in milk supply over time.

Fussy, gassy baby due to poor latch and baby swallowing air when feeding

More chance of engorgement and possible mastitis due to the breasts not being emptied effectively at each feed

Sometimes, babies who have a tongue tie have no problems at all with feeding. They may still be able to go onto the breast and feed effectively - so not every case of tongue tie needs treatment and assessment by a trained health professional and someone trained in infant feeding is vital.

If the tongue tie is causing problems, it can be treated with tongue tie division, which involves cutting the short, tight piece of skin connecting the underside of the tongue to the bottom of the mouth. This must be done by a trained healthcare professional.

After having a tongue tie divided some mums find things get easier quite quickly and others find it can take a while to improve. Support from a breastfeeding practitioner to adapt positioning and attachment can be useful and your baby might need some time to practice and adapt to a slightly different way of feeding. Spending time in ski n-to-ski n and encouraging your baby to feed when calm and relaxed can also help. You can ask your health care professional about pain relief for your baby if needed.

You can find more information on tongue tie on these pages:

NHS Tongue tie page

NCT Tongue tie page

GP infant feeding network

La Leche League tongue tie page

UNICEF tongue tie page

The Association of Tongue Tie Practitioners lists tongue-tie practitioners in the UK

Links checked April 2023

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Tongue-tie (ankyloglossia) is a condition in which the thin piece of skin under a baby's tongue (the frenulum) is shorter than normal, meaning it may restrict the movement of the tongue. This can sometimes make it harder for a baby to breastfeed (and sometimes bottle feed).

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How to find a private tongue tie practitioner

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How to find a private tongue tie practitioner

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Carrying Matters - carrying is connection

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The simple act of connecting with a small person has powerful and long-lasting effects. Rosie Knowles explores why carrying matters, and how to do it well! Find out more about babywearing safety, sling education and a guide to slings

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Using straightforward language and simple illustrations to aid understanding, these infosheets on breastfeeding and bottle feeding are available in multiple languages and can be used to support parents with the basics of feeding and responding to their baby.

The infosheets are free to download and print, and are currently available in:
Please note: Following feedback, these translations were updated in 2019 to ensure the language used was as straightforward as possible.
The English versions of these resources are available below for reference:

Breastfeeding guidance: English (for reference)

Bottle feeding guidance: English (for reference)

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Foreign language resources - Baby Friendly Initiative

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These infosheets are available in multiple languages and can be used to support parents with feeding and responding to their baby.

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دليل الرضاعة الطبيعية

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دليل الرضاعة الطبيعية

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स्तनपान केलिए गाइड

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स्तनपान केलिए गाइड

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دودھ پلانے کے لیے گائیڈ

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دودھ پلانے کے لیے گائیڈ

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Breastfeeding a baby with a Cleft Lip or Palate

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Breastfeeding a baby with a Cleft Lip or Palate

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The NHS recommends exclusive breastfeeding for the first six months of a baby's life, but feeding issues caused by a cleft lip and/or palate can make breastfeeding very difficult.
At this time, it is important to remember three key things:

1. It is very unlikely that your child's cleft was caused by something you did or didn't do.

2. Many mothers and babies have difficulties with breastfeeding, regardless of whether or not there are issues like a cleft to deal with.

3. Any amount of breast milk is beneficial. If you are unable to breastfeed, you may still be able to express milk and bottle-feed your baby.

Babies with a cleft lip

Babies with a cleft lip (without a cleft palate) may be able to breastfeed. There can be difficulties with forming a seal between the breast and lip but, depending on the type and size of the cleft, the breast may be able to mould to the gap.

A hissing sound usually means air is entering the mouth, so try to re-position the baby on the breast to help them to form a vacuum. The nipple needs to stay on the back of the tongue, so it may be useful to help the baby by holding the breast in the mouth. Small changes in the vacuum will result in the nipple slowly moving towards the front of the baby's mouth which will make feeding less effective.

You may need to try several different positions over time before you find one which works, and it will help to seek support from medical professionals experienced in feeding babies with clefts, such as your Cleft Nurse Specialist.

A good flow of milk helps and this can be encouraged by massaging the breast or using a breast pump. Your midwife or a feeding specialist will be able to help you with this.

Babies with a cleft palate

Breastfeeding a baby with a cleft palate may work when the cleft is very small or narrow. The breast needs to be held well into the area where there is palate so that the baby can get a good grip and work at the breast with the tongue. A baby born with a cleft palate will need help in achieving a good 'latch on'. A nurse specialist will be able to help you with this.

If your baby is unable to suckle at the breast before they have their palate repaired at 6-12 months, it is possible, with commitment, for them to taste and lick milk expressed onto the nipple and be fed with expressed breast milk by another feeding method. Any amount of breast milk is beneficial.

For babies with a cleft palate, breast milk can be especially helpful as it does not irritate the delicate tissue in the nose and throat as much as formula milk and can help to reduce the risk of ear problems developing later on.

There are a number of alternative methods, including cup and spoon feeding, and a supplemental nursing system. Many Cleft Teams have breast pumps available for hire which will allow you to express feed your baby. Talk to your midwife or Cleft Team about this, or get in touch with a CLAPA Parent Supporter to discuss your experiences.

It is generally advised to take things a week at a time and review the situation regularly.

General breastfeeding tips

Your baby may not have a strong enough suck to stimulate the flow of milk, so you will need to help them. You can encourage the flow of milk by massaging the breast or using a breast pump. Your midwife or a feeding specialist will be able to show you how to massage your breast and hand express the milk when a breast pump is not available.

If your baby isn't able to take much milk during the feed, you may need to express more milk after feeding to ensure the breasts receive enough stimulation to keep producing milk.

Your baby will satisfy their thirst on the first suckling and their hunger on the hind milk which contains more calories. Even if you are able to breastfeed, your baby may need to be supplemented using expressed breast milk with an alternative feeding method, as breastfeeding alone may not give them enough milk.

Source(s): Range of feeding literature from Cleft Units, with assistance from Cleft Nurse Specialists in Manchester, Nottingham and South London. Stories and suggestions from parents of children born with a cleft were also used.

If you have a comment or question about the information in this page, or would like to know more about the sources of this information, please contact Communications & Information Manager Anna Martindale at [email protected] or 020 7833 4883.

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The NHS recommends exclusive breastfeeding for the first six months of a baby's life, but feeding issues caused by a cleft lip and/or palate can make breastfeeding very difficult. At this time, it is important to remember three key things: It is very unlikely that your child's cleft was caused by something you did or didn't do.

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Down syndrome is the most common chromosomal abnormality in babies. Normally, the nucleus of each cell of a baby's body contains 23 pairs of chromosomes, half of which are inherited from mum and half from dad. Down syndrome occurs when some or all of a person's cells have an extra full or partial copy of chromosome 21. Some babies with Down Syndrome may have poor muscle tone, so may find it hard to maintain attachment to the breast during a feed. Others, especially those with an associated cardiac issue, may tire very easily and not be able to take a full feed in one go.

Benefits of Breastfeeding

Breastfeeding a baby with Down syndrome is not only possible, but it also provides important benefits to both mum and baby.

1. Breastmilk boosts your baby's immune system and contains anti-infective factors including antibodies against germs that you and your baby are exposed to. This is especially important for babies with Down syndrome since they are prone to respiratory[i] and viral infections.

2. Babies with Down syndrome can have low muscle tone. The specific sucking action needed during breastfeeding will help strengthen your baby's lips, tongue, and face[ii]. This serves as a stepping stone for eating other foods and speech development[iii].

3. Breastmilk is both food and drink for your baby and it contains all of the nutrients, calories, and fluids your baby needs, but it is also much more than just nutrition. It provides your baby with comfort and warmth and the physical closeness when you are feeding helps create a special bond between you and your baby.

The first days and weeks of breastfeeding are a time for you and your baby to get to know each other and learn together how to breastfeed effectively. As you get to know your baby better, you might discover that there are some specific physical characteristics of babies with Down syndrome that may have an impact on your breastfeeding journey. Of course, every baby is unique so you might not encounter all of the challenges mentioned. If your baby has difficulties breastfeeding at first, then ask for support and remember that many mums and babies need extra help to breastfeed and that ongoing support and time can help you both learn how to breastfeed effectively.

If you are having difficulties to begin with, then you can choose to express and feed your baby breastmilk. This can help by giving you both more time to learn whilst also making sure your baby is still getting the benefits of breastmilk and it can also be useful if your baby needs to be apart from you in the early days or if they need feeding by a tube for any reason. To begin with you would need to express around 8-10 times in 24 hours, including at least once overnight as that helps build your milk supply. It can help to have your baby nearby when you express if possible or to have a photo or something that smells like your baby. You might want to hand express or use a pump, if you are still in the hospital you could ask about borrowing a hospital grade pump. We have lots more information on expressing and storing breastmilk here.

Hints and tips for breastfeeding a baby with Down Syndrome

Low muscle tone

Babies with Down syndrome can have low muscle tone and so may have trouble attaching effectively to the breast[iv] and staying there for a full feed. Some babies may also have difficulty coordinating their sucking, swallowing and breathing and may gulp or splutter as they feed. They might get less milk for their efforts and they often get tired quickly. This generally improves with practice and time. The act of breastfeeding will actually improve your baby's muscle strength. As baby gets stronger and learns to breastfeed more effectively, he will be able to drink more milk. As well as the breastfeeding positions that people commonly use there is also a position called Dancer Hand position that can sometimes help by providing your little one with gentle support for their head when they go to attach to your breast. For this position you need to have your baby sat upright on your lap facing you, cup your hand under your breast, then slide it forward so that three fingers support your breast. Make a U-shape with your thumb and first finger and use that U shape to support your baby's jaw. Ask your healthcare provider if you want to know more about this position.

Tongue thrust

If you find your baby has a tongue that sticks out more than usual it can sometimes make breastfeeding harder. You can help by trying to position your baby in a way that really encourages him to open his mouth really wide and to keep his tongue down and touching his bottom lip when he goes to attach onto your breast. You might be able to help with this by very gently pressing on his chin to open his mouth wider as he goes to latch on. There are also very simple tongue exercises that can sometimes help. Ask your health care provider if you think these might be useful for you.

Sleepy babies

Some babies with Down syndrome can be very sleepy or tire more quickly, especially if they have any issues with their heart. Positioning your baby in a comfortable and supportive arrangement can also help your baby get more milk for his efforts, better stimulate your milk supply and mean that he doesn't get tired so quickly. You can help by starting your milk flowing before you put your baby to the breast, so that he will not have to spend energy sucking without any milk coming out. Gentle hand expressing, rolling your nipple between your thumb and forefinger, gentle massage and perhaps a warm face cloth on the breast can help encourage your milk to let down.

Weight gain

Babies with Down syndrome can sometimes gain weight slower than other babies. There are specific weight charts available for children with Down syndrome so that this can be monitored carefully, especially if your baby also has other medical issues that mean they might gain weight slower than usual. All the same things apply in terms of knowing if your baby is getting enough milk, including looking at the number of wet and dirty nappies and how content your baby is between feeds. If you have any concerns about weight gain or whether your baby is getting enough milk please speak to your health care provider.

Resources

A Guide to Breastfeeding a Baby with Down Syndrome BfN Blog posts on Down Syndrome Positive About Down Syndrome Website Positive About Down Syndrome - Lived Experiences
The Breastfeeding Network

Sarah Edwards, Training Development Manager and Breastfeeding Supporter

[i] Pisacane, A., Toscano, E., Pirri, I., et al (2003), Down syndrome and breastfeeding. Acta Paediar 92(12),1479-1481.

[ii] Dowling, D., Danner, S., Coffey, P., Wellman, L. (2007), March of Dimes Defects Foundation. Breastfeeding the infant with special needs. New York: March of Dimes Foundation

[iii] Buckley, S. (2000), Speech and language development for individuals with Down Syndrome - an overview. Hampshire: The Down Syndrome Education Trust

[iv] Buckley, S. (2000), Speech and language development for individuals with Down Syndrome - an overview. Hampshire: The Down Syndrome Education Trust

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Breastfeeding a baby with Down Syndrome - The Breastfeeding Network

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Down syndrome is the most common chromosomal abnormality in babies. Normally, the nucleus of each cell of a baby's body contains 23 pairs of chromosomes, half of which are inherited from mum and half from dad. Down syndrome occurs when some or all of a person's cells have an extra full or partial copy of [...]

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Many mothers of twins or more breastfeed their babies successfully and we're here to support you.

Multiples are more likely to be born early and we know that very small or premature babies can find it difficult to breastfeed at the beginning. If you are unable to feed your babies straight away it doesn't mean that you won't be able to breastfeed.

Spending time with your babies, giving them skin-to-skin time with you or your partner and expressing breastmilk regularly, can all help babies to get going with breastfeeding. Talk to the hospital staff and your midwife about how they can support you to feed your babies in the way you want to.

To help you prepare for breastfeeding Twins Trust suggest that you:

Personal stories

Our work with peer-to-peer breastfeeding supporters has been made possible thanks to the National Lottery Community Fund.

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Many mothers breastfeed their twins, triplets or more. Twins Trust is here to support you with whichever feeding choice is best for your family.

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Alyssa Schnell, St. Louis, Missouri, USA
Alyssa Schnell is an International Board Certified Lactation Consultant (IBCLC) based in the United States. She speaks internationally about inducing lactation and relactation and specializes in helping parents who have not given birth (non-gestational parents) to breastfeed their babies. In this article Alyssa discusses how parents who have not given birth can breastfeed by inducing lactation and how La Leche League Leaders can support them.
Breastfeeding is a special gift a baby receives from their gestational parent. However, many non-gestational parents-adoptive parents, intended parents (through surrogacy), parents whose partner is birthing, and transwomen-are finding out that this wonderful experience is also available to them. Because parents who haven't given birth do not have the hormones of pregnancy to get their bodies started with making milk, they need more information and support to make breastfeeding a reality.

Why Would a Non-Gestational Parent Choose to Breastfeed or Chestfeed?

Attachment. Breastfeeding helps the parent and baby form a secure attachment, a particular concern when babies are separated from their gestational parent or gestational carrier (in surrogacy).

Nutrition. Human milk provides the optimal nutrition and necessary immunities for human babies.
Healing. Breastfeeding can help heal the heartache of infertility, and provides a biological connection between mother/parent and baby. Breastfeeding is much more than breast milk. Breastfeeding is a close, intimate, physical and emotional relationship between two or more people who love each other.

Sharing. When both parents are breastfeeding, they share the caregiving role.

Facts about breastfeeding without birthing

Women have breastfed babies they did not birth throughout history. With the easy availability and common use of bottles and infant formula in modern developed countries, culture has largely lost track of how breastfeeding can also be an option for non-gestational parents.

Non-gestational parents can start preparing for breastfeeding as soon as they decide to grow their family, after an adoption match has occurred or once their partner or gestational carrier is pregnant. They can even wait until the baby is in their arms.

The amount of milk produced when inducing lactation can vary widely. While some parents make no milk and others make all the milk their babies need, most will make a partial milk supply. Fortunately, breastfeeding is possible no matter how much or little milk is produced-even if it is none at all! Human milk feeding can be simulated with a nursing supplementer: a bag or bottle that holds human milk or formula carried to the nipple via a tiny feeding tube. Parents who are not making any milk may also choose to feed with a bottle while their baby comforts and connects with them by suckling at the (dry) breast.

Newborn babies are wired to initiate breastfeeding, but with gentle and patient encouragement, along with a few handy tools and techniques, even older babies can learn to breastfeed.

Some mothers will take medications or herbs to help them make more milk, but this is not essential. The only necessary component to induce lactation-the official term for making milk without pregnancy and birth-is to stimulate and drain the breasts. That stimulation or emptying can happen with baby breastfeeding, with an electric breast pump, or using a variety of manual techniques.

The composition of milk produced by inducing lactation is comparable to that produced following birth., The milk does not contain dangerous levels of artificial hormones-in fact, it very rarely contains any artificial hormones at all. In most cases, the only artificial hormones that are taken are estrogen and/or progesterone before there is milk production (Step 1 below.) Progesterone and estrogen levels are high during pregnancy and taking these hormones artificially may help to make the body think it is pregnant. Estrogen and progesterone play a role in breast development in pregnancy.

It is not necessary to be fertile-or even to have ovaries or a uterus-to breastfeed. The hormones responsible for milk production (prolactin) and milk ejection (oxytocin) are released from the pituitary gland located at the base of the brain.

Both parents, whether or not one has given birth, can share the breastfeeding role. This is called co-nursing.

Step 1: Preparing the Breasts for Lactation
How to induce lactation
Step 2: Starting to Make Milk Before Baby Arrives
As stated above, the primary way to induce lactation is through breast emptying: breastfeeding, pumping, or hand expression. The effectiveness of these physical techniques can be enhanced with the use of galactogogues: medications, herbs and homeopathic remedies that support the production of milk. These tools can be put together in a variety of ways to be effective and applicable to each individual parent. While the use of medications, herbs or homeopathic preparations is an individual choice, parents should always discuss their individual situation with their health care providers.
Step 3: Feeding Baby and Continuing to Grow Milk Production
Generic protocols are available (such as Dr Jack Newman's protocol) or an experienced International Board Certified Lactation Consultant (IBCLC) can work with parents to develop a personalized protocol customized to meet their specific health history, circumstances, and values. The process can be broken down into three steps:

This step mimics the hormonal and breast changes that occur during pregnancy. This step is not about making milk; it is about growing and developing the glandular breast tissue in preparation for making milk. Many parents will take hormone therapy for a period of time to achieve this. However, this step is optional.

Milk is often produced very, very slowly when lactation is induced compared with the sudden increase in milk supply between days 3-5 following birth. In order to have a milk supply by the time baby arrives, parents will often start the process of growing their milk production several weeks or months before. The main component of Step 2 for many parents is frequent pumping. Ideally, parents will express their milk as frequently as a baby nurses-just like for birthing parents, frequent breast drainage "places the order" for healthy milk production. Parents can store any milk they produce for use when baby arrives.

This is the big payoff! Baby is here and the parent can begin feeding baby their milk. This step generally involves putting baby to breast.

Not every parent's protocol will use all three steps. Each parent's needs and circumstances determine which steps will be appropriate for them. For most parents with adequate information and support, milk production begins within 6-8 weeks of beginning the process of inducing lactation.

What is the role of a La Leche League Leader?

Although extremely rewarding, inducing lactation can be a challenging breastfeeding situation. Mothers/parents need and deserve all of the support they can get. While working with an International Board Certified Lactation Consultant (IBCLC) is highly recommended, La Leche League Leaders can also play a very valuable role. As always, Leaders provide essential information and encouragement. More specifically, La Leche League Leaders may:
Alyssa Schnell has been helping parents and babies with breastfeeding for the past 17 years, first as a La Leche League Leader and now as an International Board Certified Lactation Consultant (IBCLC). Her private practice, Sweet Pea Breastfeeding Support, provides individual lactation consultations either in person or by phone or video-conference for parents throughout the United States and beyond. Alyssa is also the co-host of the Breastfeeding Outside the Box podcast, which is devoted to families breastfeeding or chestfeeding in extraordinary situations. Alyssa enjoys working with all parents and babies, but she has a special place in her heart for helping non-gestational parents to breastfeed/chestfeed their babies. She is the author of Breastfeeding Without Birthing: A Breastfeeding Guide for Mothers Through Adoption, Surrogacy, and Other Special Circumstances and is an international speaker on the topics of inducing lactation, relactation, and other related topics. Alyssa lives in St. Louis, Missouri, USA and is the proud mother of three breastfed children-two by birth and one by adoption.

Refer parents to resources on inducing lactation (see below).

Provide support for inducing lactation.

Facilitate La Leche League Group meetings where older babies who are bottle-feeding can observe breastfeeding babies, and parents can participate in a breastfeeding culture. Group meetings are also opportunities for parents to connect with other mothers who are nursing in a variety of situations.

Facilitate healthy social media information and interaction.

Share information about donor milk.

Breastfeeding without birthing may not be easy, but it is possible and it is powerful. La Leche League Leaders can be part of the team supporting these parents and their babies.

Resources for La Leche League Leaders and parents

Some notes about language: The term "gestational" is used throughout this article instead of "biological." In surrogacy, the intended mother is often the biological mother (baby is often conceived with her egg) even though she is not gestating (pregnant with) the baby. And oftentimes same-sex female couples will conceive baby via in vitro fertilization (IVF) using the egg of one parent (biological parent) implanted in the uterus of the other parent (gestational parent). This article also attempts to use gender-inclusive language such as parent versus mother and breastfeeding/chestfeeding versus breastfeeding. Some of the parents referred to in this article may be cis male, trans male, or non-binary.

Note: inducing lactation with medication should not be started unless the parent has an approximate timeline for their baby's arrival. Taking medication without a definite end could be hazardous.

Other manual approaches might include breast massage, nipple manipulation (gently pulling out and twisting of the nipple), and a partner suckling.

Kulski, J. K., Hartmann, P. E., Saint, W. J., Giles, P. F., & Gutteridge, D. H. (1981). Changes in the milk composition of nonpuerperal women. American journal of obstetrics and gynecology, 139(5), 597-604.

Perrin, M. T., Wilson, E., Chetwynd, E., & Fogleman, A. (2015). A pilot study on the protein composition of induced nonpuerperal human milk. Journal of Human Lactation, 31(1), 166-171.

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Inducing Lactation & Breastfeeding Without Giving Birth

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Breastfeeding or chestfeeding can be an option for non-gestational parents. Learn more about inducing lactation, including facts, the 3 steps, and resources.

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Unicef UK Baby Friendly Initiative | Maximising breastmilk

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Evidence suggests that autistic people may experience aspects of breastfeeding differently to non-autistic people.

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Ensure safe babywearing with RoSPA’s baby sling safety guidance. Learn how to use baby slings correctly, reduce suffocation and fall risks, and keep your baby secure and comfortable.

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Free app for all families with a Stoke on Trent postcode, until your baby is 3 months of age

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Anya is here 24/7 for your parenting & breastfeeding questions. Even at 3am. Free Premium upgrade for all parents in Knowsley.

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family hubs support children and young people from birth until they reach the age of 19 (or up to 25 for young people with special educational needs and disabilities). They bring council, health and community services together so families can access the right support at the right time.

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There are several ways in which a baby's sleep affects their own health and that of their parents. The links in the left-hand navigation provide further information on these issues.

Sudden Infant Death Syndrome (SIDS, or cot death) is perhaps the most well known of these, but sleep related accidental deaths and injuries also happen, and non-accidental harm can occur to infants in sleep-related settings. Lack of sleep related to caring for a baby can also affect parents' health, particularly in the case of depression and accidents.

SIDS is the name given to the unexpected death of an infant for which there is no known cause. Such deaths commonly occur during sleep and can happen wherever babies sleep. No sleep environment is 100% risk-free, however there are well known ways to reduce a baby's risk of SIDS. This information used to be provided to all UK parents in the Department of Health leaflet 'Reduce the risk of cot death' which has now been discontinued. Many NHS Trusts now give parents the latest Safe Sleep Guidance from the Lullaby Trust, or the UNICEF Baby Friendly leaflet 'Caring for your baby at night', but some NHS trusts and local Safeguarding Boards issue their own recommendations.

Safe sleep guidance also covers keeping babies safe from sleep-related accidents. Accidents can occur wherever babies sleep, and parents need to be aware of their baby's sleep environment. See SIDS & Safety for more information.

Babies can also be at risk when tiredness and frustration spill over into anger in situations where carers are sleep-deprived and/or infants cry inconsolably. Many parents experience momentary feelings of helplessness and desperation, especially when trying to cope alone. We provide links to strategies for coping and sources of help and support. Please note, however, that we do not cover clinical issues and a qualified health practitioner should be consulted for guidance.

For more detailed information on all these topics, see the health practitioners section.

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There are several ways in which a baby's sleep affects their own health and that of their parents. The links in the left-hand navigation provide further information on these issues. Sudden Infant Death Syndrome (SIDS, or cot death) is perhaps the most well known of these, but sleep related accidental deaths and injuries also happen, and non-accidental harm can occur to infants in sleep-related settings.