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Bedfordshire and Luton Children's Health Hub

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Bedfordshire and Luton Children's Health Hub

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Find information and support on our evidence based platform full of information about how to access our services and support your child's health.

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Home - Bedfordshire Luton Children’s Health

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NHS Bedfordshire and Luton Health Hub, NHS help, advice and information for local families.

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Breastfeeding Support & Social Groups are run in Children's Centres across the county, by trained staff and peer supporters. Parents giving breastmilk either directly from the breast, via a bottle or in combination with formula, or who are thinking of doing so, are warmly welcomed for support and friendship.

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The Baby Friendly Team supports infant feeding and bonding, offering guidance based on UNICEF Baby Friendly Standards.

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The Breastfeeding Support & Social Groups are run by trained staff from Health and Flying Start. Parents giving breastmilk either directly from the breast, via a bottle or in combination with formula, or who are thinking of doing so, are warmly welcomed for support and friendship.

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The Baby Friendly Team supports infant feeding and bonding, offering guidance based on UNICEF Baby Friendly Standards.

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Bump, Birth & Baby Stuff free antenatal classes

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Bump, Birth & Baby Stuff free antenatal classes

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Stay & Play sessions for emotional wellbeing support across Beds & Luton

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Stay & Play sessions for emotional wellbeing support across Beds & Luton

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Bedford Borough Children's Centre Padlet 

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Bedford Borough Children's Centre Padlet 

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Please also see individual centres Facebook pages for up to date information

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A food voucher scheme will continue to be available to families in need over the half term holiday period.

The scheme works by providing vouchers directly to families via the network of Children's Centres that are based in communities across our area.

The vouchers are £15 per child and cover the whole week.

The vouchers enable food to be supplied by a number of the major supermarket chains that operate in our communities and any families who are eligible to free school meals will be able to access this support.

Please contact your children's centre directly to make arrangements. To ensure that everyone is safe and socially distanced, please do not turn up to a centre without a prior booking. You can find contact details through the link below.

Anyone requesting a voucher will be required to provide:

their name and address

the child's name and date of birth

Looking ahead, we are exploring how we can best continue the arrangements for the Christmas period taking account of the particular circumstances created by the pandemic.
View children's centres on our Family Information Directory >>
Children's centres

Our children's centres are developed in line with the needs of the local community so no one centre is the same. Children's centres work with partners to offer a range of services to meet your child's needs all in one place.

There is a core set of services they aim to provide:

child and family health services including antenatal, postnatal, breast feeding and baby weighing sessions (drop-in)

advice on parenting and parenting programmes

information and advice to parents on childcare, early years provision and 2-year-old funded places

early education and school readiness, early communication support e.g. speech and language drop-ins

outreach and family support services including home visits

a variety of drop-in sessions

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A food voucher scheme will continue to be available to families in need over the half term holiday period. The scheme works by providing vouchers directly to families via the network of Children's Centres that are based in communities across our area. The vouchers are £15 per child and cover the whole week.

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Flying Start offer support and education for parents and carers of babies and children from pregnancy to age 5.

They offer antenatal sessions, baby groups, as well as groups for Dads, self-weigh sessions and parenting classes.

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EXTRA: Solihull Online (e-courses for parents of children 0 to 18, including those with SEND) Visit: www.inourplace.co.uk using Access Code: HATTERS

Pregnancy Groups/ Services

English language classes for pregnancy (ESOL): 6 week course for those with English as an additional language to learn how to express themselves in English to speak to midwifes/ health professionals, gaining the confidence to express their own wishes, talk about feelings, ask questions and offer suggestions

Pregnancy Club 6 week course on zoom: 6 week antenatal programme to help support pregnant women and their partners with all aspects of having a baby

Luton Bumps on Zoom: A fortnightly informal get-together for Luton Mums. Questions and Answers with our Flying Start Midwife and Staff

Keeping Baby Safe Zoom Workshop: What every pregnant or new parent needs to know in order to keep baby safe – offered as a 2 hour online zoom group session with Safe at Home

Baby Groups/Services (In Person)

Baby Sensory Group: (for pa rents of non-walkers as mat-based activity) This weekly hour-long face to face group encourages quality time for parents and baby- exploring various objects and using various senses

Parent Baby Self- Weighing: (for parents of under 2 years) 15 minute bookable appointments to self-weigh your baby on our scales. Please note this is not a health visitor clinic , a member of staff will be on hand to show you how to use the scales and how you can record your baby’s weight, however if you have any health concerns about your baby please contact our duty Health Visitor on 0300 555 0606 or text parentline 07505331866 and they will be able to help.

Click here to book a Thursday slot or a Friday slot

Baby Rhyme and Sign: (for parents of 6 to 18 months) Nursery rhymes and action songs are great fun and also help stimulate language development. Flying Start’s Sing and sign group combines the benefits of both music and signing.

Toddler/Preschool Groups/Services

Music and Rhyme time with Jolly Beans (for parents of under 5s)

Stay and Play for over 1s: Our stay and play sessions are opportunities for parents/carers to come along and meet other people with young children. A variety of age appropriate activities are available, such as messy play, soft play, stories and rhymes and lots more!

Zoom sessions for parents on Starting Solids, Sleep, Toileting, Fussy Eating, Understanding Behaviour: These workshops will be in a relaxed style- giving a great opportunity for parents to talk with others, share experiences, and support each other whilst getting some parenting support and advice.

HENRY Healthy Lifestyles on Zoom: This 8/9 week programme supports parents in ensuring a healthy start for their child. Henry helps to overcome those mealtime challenges so parents can have a happy and healthy family life

Parenting Puzzle on Zoom: This 4/5 week programme supports parents of babies and young children with a focus on the importance of attachment, empathy, positive discipline, play and communication

Dad’s Saturday Group: Monthly group f or fathers, grandfathers, stepfathers, uncles or brothers who would like to share some quality time with their child or relative under 8. Click here to book

The Early Years Alliance are also running sessions nationally (click on the name for more information/to book):

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Please do not come to our centres if you or your child have any covid-19 symptoms! Flying Start Luton Timetable Booking is required for all groups to guarantee a place (otherwise you could be turned away). All sessions are FREE unless otherwise stated. You will be

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This page gives information about the Healthy Start Voucher scheme, available to eligible parents from 10wks pregnant until their child's 4th birthday.

It also lists locations where Luton families can obtain Healthy Start Vitamins, which are recommended for pregnant and new mums, and for all babies from 6 months to 5 years old.

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Vitamin D

It's recommended that breastfed babies are given a daily supplement containing 8.5 to 10 micrograms (µg) of vitamin D from birth, whether or not you're taking a supplement containing vitamin D yourself.

Babies having 500mls (about a pint) or more of formula a day should not be given vitamin supplements as formula is already fortified with vitamins. This does not mean that breastmilk is not the healthiest way to feed baby as it contains other ingredients that formula milk cannot replicate.

Healthy Start Vitamins

Healthy Start vitamins are recommended for pregnant women and new mums and children from 6 month to 5 years. Vitamins are essential nutrients that your body needs in small amounts so that it can work properly. Even though you can get lots of vitamins from a healthy balanced diet, you still might not get everything you need at certain times in your life - such as when you're pregnant, a new mum or a small child. It is recommended that at these times you should take a supplement containing specific vitamins to make sure you get everything you need.

Healthy Start vitamins can help prevent vitamin deficiencies and maintain healthy growth and development for your child. Vitamin D is difficult to get from the diet alone and the best source is from sunlight, therefore during the winter months it is difficult to get adequate amount of vitamins D. Certain groups are at a higher risk of Vitamin D deficiency including pregnant and breastfeeding mothers, babies born with darker skin types and anyone who has little or no exposure to sunlight (for example wear concealing clothing, sun creams or stay indoors etc.)

Healthy Start vitamins are suitable for vegetarians and halal diets, and free from milk, egg, gluten, soya and peanut residues. There are a range of other vitamins available, however many of these contain a range of nutrients that are not suitable, therefore Healthy Start Vitamins are the only vitamin supplements we recommend for your child.
Women's vitamin tablets contain:

Folic acid: reduces the chance of your baby having spina bifida, a birth defect where the spine doesn't form properly

Vitamin C: helps maintain healthy tissue in the body

Vitamin D: helps your body to absorb calcium and so supports your baby's bones to develop properly. Vitamin D deficiency can lead to osteomalacia, which causes bone pain and tenderness.

Healthy Start children's vitamin drops contain:

Vitamin A: for growth, vision in dim light and healthy skin

Vitamin C: helps maintain healthy tissue in the body

Vitamin D: for strong bones and teeth. In children a lack of vitamin D can lead to rickets

Children's Vitamin Drops are £2 and Mother's Vitamin Tablets are £1. However, you may also be eligible for free vitamins through the Healthy Start scheme- see information below.

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Healthy Start Vitamins Vitamin D It's recommended that breastfed babies are given a daily supplement containing 8.5 to 10 micrograms (µg) of vitamin D from birth, whether or not you're taking a supplement containing vitamin D yourself. Babies having 500mls (about a pint)

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Total Wellbeing supports people living in Luton who want to improve their physical and emotional health. They are able to offer support during pregnancy, including with mental health and maintaining a healthy weight.

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It's never too late to quit. Stopping at any age will increase your life expectancy, provided that you stop before you develop cancer or another serious disease. Within the first 24 hours of stopping, your blood pressure and lungs will be showing improvement.

After three months your circulation and breathing should have improved noticeably.

After five years, your risk of having a heart attack falls to about half that of a smoker.

After 10 years, your risk of lung cancer falls to about half that of a smoker.

Read our Smoking Cessation FAQs.

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It's never too late to quit. Stopping at any age will increase your life expectancy, provided that you stop before you develop cancer or another serious disease. Within the first 24 hours of stopping, your blood pressure and lungs will be showing improvement. After three months your circulation and breathing should have improved noticeably.

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Active Luton’s mission is to make a positive impact on the health and wellbeing of its community, inspiring, motivating and offering opportunities for people of all ages, backgrounds and abilities to learn and take action to improve their life chances.

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We run Luton’s leading leisure centres with fully equipped gyms, swimming pools and a wide range of fitness classes. These are Inspire: Luton Sports Village, Lewsey Sports Park and Swimming Pool, Lea Manor Recreation Centre, Hightown Community Sports and Arts Centre, Stockwood Park Athletics Centre…

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Luton ‘Safe at Home’ is a child accident prevention service.
All Parents living in Luton with children under five can have a free home safety risk assessment where a qualified home safety advisor will contact you to arrange an appointment to visit you at home.  The visit takes between 1-2 hours provides friendly advice & tips on reducing the risk of accidents in the home that will help you to keep your child and family safe, including a fire safety check with advice from Bedfordshire Fire & Rescue Service.

If you are over 34 weeks pregnant or already have a child/ren under the age of 5 years you can apply online via their website.

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Safe at Home are still offering FREE Home Safety checks to all COVID-19 UPDATE
Luton households.

We encourage familiesto APPLY ONLINE via the tab - a member of the Safe at Home team will contact the parent/guardian to book an appointment with our service. *Applications from families living outside of Luton will be declined and advised to contact their own health visitor for guidance.
OUR SERVICE INCLUDES:
'Telephone' Home Safety Assessment for families with 0-5's who live in LUTON
A booking slot will be offered with a qualified safety advisor who will talk through a room-by-room safety questionnaire over the phone with parent/guardian on an agreed date/time covering each room within the home. The advisor will provide the relevant safety advice to help reduce the risk of accidental injury to under 5's and a copy of the completed questionnaire is then emailed to the parent/guardian, enabling them to make the recommended changes to improve child safety in-and-around the home.
Child Safety Equipment Installation (Face to Face)
If the household is entitled to Please free equipment fitting, once the Telephone Home Safety Assessment is completed, an installation slot will be arranged with our approved installer (Bedfordshire Fire Service). *All household members must be clear of any COVID symptoms on the day of installation, otherwise the fitting slot will need to be rescheduled. Households who are NOT eligible for free equipment will have an 'option to purchase' should they wish to do so. VIEW EQUIPMENT on the What We Offer tab

For families living in Luton we are offering a FREE Stage 1 session. Expectant or new parents can gain awareness of the Tubes of Life programme and what this means to them and their baby and importance of choosing safe and compliant nursery products. It offers an ideal opportunity for parent/guardian to ask our baby safety expert their questions and discuss any nursery product queries prior to purchasing retail goods, plus each family will receive a free complimentary gift bag which is dropped off to their doorway. Stage 1 - (Online) Keeping Baby Safe Workshop - Virtual Zoom session for families who are expecting a baby or have a new-born under 3 months TO BOOK, click apply online via tab and ADD AT THE BOTTOM OF THE FORM in the 'Any Other Information Box' a Request to book onto KBS Workshop (a choice of dates and times will be forwarded - followed by a link to join the chosen online session)

Please contact us on 07553348485 or email: ANY QUERIES: safeathome@eyalliance.org.uk Please stay safe - we look forward to hearing from you!

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Advice and Safety Equipment for Families with Children Aged 0-5 Luton 'Safe at Home' is a child accident prevention service delivered through a local multi-agency partnership led by Flying Start & Early Years Alliance in association with Public Health and Bedfordshire Fire & Rescue Service.

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NHS National Services for Mental Health Support

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NHS National Services for Mental Health Support

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If you need to speak to someone urgently you can call NHS 111 and choose option 2. Other sources of urgent support can be found via the above link.

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you are not able to speak to your local NHS urgent mental health helpline

you need help urgently for your mental health, but it's not an emergency

you're not sure what to do

111 will tell you the right place to get help if you need to see someone.

You may be able to speak to a nurse, or mental health nurse, over the phone.

A GP can advise you about helpful treatments and also help you access mental health services. You may be able to refer yourself to some services.

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Where to get urgent help for mental health

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You may need urgent help for mental health for many different reasons. Some people call it a crisis, an emergency or a breakdown. It's important to know that support is available, whatever you're going through.

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The Bedfordshire and Luton Perinatal Mental Health Team provides specialist care for people with mental health problems who are pregnant or in the first post-partum year or who are considering pregnancy. You can speak to your GP, Midwife, Health visitor or other Healthcare professional to ask for a referral, or self-refer by calling 01234 263642.

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Resources

Made for Mums

It's very common for new mums to feel overwhelmed, low and even a bit weepy in the first couple of weeks after birth. So common, in fact, that there's actually a name for it, the baby blues. And it's not surprising: You're knackered, you're sore, you're bleeding (whether you had a caesarean or not) and, instead of being able to sleep it all off, you're faced with the 24-hour responsibility of caring for a whole new - and right now very needy - person. While the weepiness and blues should be quite short-lived, it may take a while longer before you can ditch the overwhelmed bit.
Find out more

Parents in Mind

Local volunteers to support women experiencing emotional health difficulties in pregnancy.

Postnatal mental health - Talking about mental health

Sara, Holly and Kate talk about their experience of mental health problems after pregnancy and becoming mothers.

ACAS

Checking your pregnancy and maternity rights

Pregnancy Sickness Support

Our national support network is for sufferers of NVP and HG and their carers, which is growing and developing constantly and making a huge difference to women all around the country. Our leaflets and website also provide a valuable resource for those suffering. We are also working hard to raise awareness about Nausea and Vomiting in pregnancy and Hyperemesis Gravidarum with the public, the media and Health Care Professionals (HCP's) and are involved in ongoing research into the cause and treatment of NVP and HG and the psychological impact for sufferers and their families.

Guardian Society

Useful articles about perinatal health from the Guardian newspaper 2020-21

MadeForMums

At MadeForMums, we've got the best, and most honest, advice - from experts and from parents who've been there - on pregnancy, birth, babies, toddlers, and school-age children.

Parents in MIND, 1st 1000 Days New Parent Support

Our mission is to support parents through the first 1,000 days, to have the best possible experience of pregnancy, birth and early parenthood.

We do this through three interconnected aims:

Sharing knowledge - informing parents' decisions

Creating networks - forging vital friendships

Harnessing voices - changing public policy and attitudes for good.

Mind

Website with helpful and friendly information that explains postnatal depression and other perinatal mental health problems, including possible causes, treatments and support options. Also has information for friends and family, including support and advice for partners.

Action on Postpartum Psychosis

Peer led organisation with lots of helpful info on perinatal mental health illnesses

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Bedfordshire and Luton | East London NHS Foundation Trust

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It's very common for new mums to feel overwhelmed, low and even a bit weepy in the first couple of weeks after birth. So common, in fact, that there's actually a name for it, the baby blues.

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Mind are a mental health charity who provide advice and support to empower anyone experiencing a mental health problem. Their Infoline (0300 123 3393) provides an information and signposting service 9am to 6pm, Monday to Friday (exc Bank Holidays)

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We’re Mind, the mental health charity | Mind

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We're Mind, the mental health charity. We're here to make sure no one has to face a mental health problem alone.

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PANDAS is a community offering peer-to-peer support for you, your family and your network via telephone, text, social media, email and support groups. Their FREE helpline (0808 1961 776) is available from 11am-10pm every day, with a dedicated volunteer team who can offer support and advice and can help to direct you to other organisations as necessary.

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Postnatal depression (PND) is a type of depression that many parents experience after having a baby. It can affect any parent, regardless of whether they've suffered from a mental health condition before. Postnatal depression is linked directly to giving birth and is a common problem, affecting 1 in 10 women within a year of giving birth.

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Samaritans are there for anyone who's struggling to cope, who needs someone to listen without judgement of pressure. You can call them on 116 123 anytime of the day or night and if you call the number, it will not appear on your phone bill. They also offer support via email, post or in person at one of their branches.

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Samaritans works to make sure there's always someone there for anyone who needs someone. Read more.

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Understanding your mental health and well-being

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Understanding your mental health and well-being

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Having a baby is a huge life event and a time of change.

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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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Newborn babies need feeding very frequently in the early weeks, not only because their tummies are little and fill and empty quickly but also because this frequent feeding is really important in building mum's milk supply. You can feed responsively by spotting your baby's early feeding cues.

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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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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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This video on breastfeeding has tips for good attachment to help you get your baby feeding well. The video includes an animated diagram, a mum’s point of view and step-by-step instructions. It helps new mums see what good attachment looks and feels like and understand how babies feed.

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This leaflet offers advice and information for parents on getting to know their baby and setting up the foundations for a close and loving relationship.

We now know that building a strong relationship between parents and their new baby will give them the best possible start in life and will help them to grow up happy and confident. This leaflet is free to download and helps parents to develop that strong relationship, starting in pregnancy and continuing into the early days, weeks and months of a baby's life.

Health professionals may want to use this leaflet in conjunction with the Baby Friendly guide to antenatal and postnatal conversations and accompanying signature sheets.

Printed copies cost £15 per pack (1-9 packs) or £11 per pack (10 or more packs). There are 50 leaflets per pack and this price includes P&P within UK. Order using the Baby Friendly Resources order form, which you can download from our Resources page.
Please note: Orders for UK delivery only, and include postage and packaging costs. Orders may take up to 7 working days to process. The Baby Friendly Initiative reserve the right to re-print items at any time. If you are looking to order audit tools or e-learning please use our digital resources order form. Our myth buster posters show the key Happy Baby messages in bright and colourful poster form - find out more.

Building a Happy Baby: A Guide for Parents

Baby Friendly standards

Support to build a close and loving relationship is a key element of the Baby Friendly standards. Find out more about embedding our standards in your service.

Find more relationship building resources

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Building a happy baby: A Guide for Parents Leaflet - Baby Friendly Initiative

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This leaflet helps parents to get to know their baby and to set up the foundations for a close and loving relationship.

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Breastfeeding can take practice – read our guides on breastfeeding to find out what works best for you

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Our safer sleep advice gives simple steps for how you can sleep your baby to reduce the risk of sudden infant death syndrome (SIDS) which is commonly known as Cot death.

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The safest cot is a clear cot

The safest cot for a baby is a clear cot. That means removing anything that isn't essential. Babies need just two items in their cot:

It's important to remove anything that isn't essential because items such as toys, blankets and bumpers could cover their face and obstruct their breathing.

When preparing your baby's sleep space, remember:

No pillows or duvets

No cot bumpers

No soft toys or comforters

No weighted or bulky bedding

No products designed to keep your baby in one sleeping position, such as wedges or straps

No pods or nests, rolled up towels or anything soft placed on top of the mattress.

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Safer sleep overview - The Lullaby Trust

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An easy guide to practicing safer sleep for your baby and reducing the risk of sudden infant death syndrome (SIDS, or cot death).

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Building your baby's brain through experience

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Building your baby's brain through experience

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We now know that building a strong relationship between parents and their new baby will give them the best possible start in life and will help them to grow up happy and confident.

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How a child's brain develops through early experiences

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Congratulations! Your new baby is here! But what do you do with them?

Lots of people will have an opinion; family, friends, the Internet!

Figuring out what your baby needs can be overwhelming, but this video will help.

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Some parents choose to share a bed (also known as co-sleeping) with their babies. It is important for you to know how to do this safely and that there are some circumstances in which bed-sharing with your baby can be very dangerous.

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Newborn baby poo in nappies: what to expect | Baby & toddler articles & support | NCT

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Your baby’s nappy can tell you a lot - find out more here.

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Babies cry, you can cope When babies cry it can be stressful and overwhelming. Help is out there and all you need to do is ask. Latest news Testimonials

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Vitamin D drops are recommended for all breastfeeding infants as well as those who are combination feeding and taking less than 500ml infant formula per day.

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This information can also be viewed as a PDF by clicking here.
The information provided is taken from various reference sources. It is provided as a guideline. No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used. Clinical decisions remain the responsibility of medical and breastfeeding practitioners. The data presented here is intended to provide some immediate information but cannot replace input from professionals.
In 2012 the Chief Medical Officer in the UK made recommendations about supplementing all pregnant and breastfeeding mothers and children with Vitamin D. There seems to remain a lot of confusion as to who should take these supplements, why this is necessary and how to obtain them. The recommendations were updated in July 2016 in line with the SACN recommendations on vitamin D and health.

Breastfed babies from birth to one year of age should be given a daily supplement containing 8.5 to 10mcg of vitamin D as a precaution (SACN 2016)

Breastfeeding Mothers should also take a daily Vitamin D supplement of 10 µg per day

Vitamin D deficiency in the UK is a consequence of our weather and the latitude at which we live.

Breastmilk is perfect for babies

Vitamin D drops should be given to babies on a teaspoon as droppers are hard to sterilise

Healthy Start Vitamins remain an excellent, economic source of vitamin D and are provided free of charge in many areas. The daily dose of 5 drops contains 10µg www.healthystart.nhs.uk/for-health-professionals/vitamins/

Babies born to mothers with low vitamin D status are at risk of developing rickets. Taking into account that MOST of us are deficient between October and April at best and MANY of us will have low levels throughout the year, the recommendation that ALL pregnant women should take a supplement of 10 µg Vitamin D per day throughout pregnancy is sensible and cost effective (Prevention of rickets and vitamin D deficiency in Birmingham: the case for universal supplementation).

Babies born to mothers who have not taken a vitamin D supplement in pregnancy are likely to be born with low vitamin D status. Levels of vitamin D in that mother are also likely to be low and even if she begins to take a supplement herself at that time, cannot redress the baby's deficiency by breastfeeding. So the recommendation is that the baby should receive its own oral vitamin D drops containing 7-8.5µg per day from 4 weeks of birth until the age of 5 years. Waiting until the baby is 6 months may be too late to prevent development of symptoms. Mothers may also develop symptoms of deficiency themselves.

Although it was thought that levels of vitamin D stores laid down in pregnancy by a mother who has taken vitamin D supplements in pregnancy would be sufficient for a few months,
new recommendations (July 2016) are that breastfed babies from birth to one year of age should be given a daily supplement containing 8.5 to 10mcg of vitamin D, to make sure they get enough ( www.nhs.uk/Conditions/vitamins-minerals/Pages/Vitamin-D.aspx). In addition breastfeeding mothers should take a daily Vitamin D supplement of 10 µg per day - in fact as more and more conditions are linked with lack of vitamin D most of us would benefit from taking it regularly.

In children; rickets, delayed tooth eruption, increased risk of infection, decreased bone mass, hypocalcaemic seizures, delay in walking.

In adults; osteomalacia, muscle weakness, bone pain plus possible association in many other conditions.

Mothers who are diagnosed with vitamin D deficiency may be prescribed very high dose supplements. Papers looking at these doses are scarce. Hollis and Wagner (2004) concluded that "Maternal vitamin D intakes of 4000 IU/d appear to be safe and to provide sufficient vitamin D to ensure adequate nutritional vitamin D status for both mothers and nursing infants. Hollis et al 2015 that "Maternal vitamin D supplementation with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy her nursing infant's requirement and offers an alternate strategy to direct infant supplementation.

For information on high dose vitamin D prescribed for breastfeeding women see https://breastfeeding-and-medication.co.uk/fact-sheet/high-dose-vitamin-d-supplements-and-breastfeeding

Oily fish including trout, salmon, mackerel, herring, sardines, anchovies, pilchards, and fresh tuna

Cod liver oil and other fish oils

Egg yolk; 0.5 micrograms (20 IU) per yolk)

Mushrooms

Supplemented breakfast cereals typically contain between 2 and 8 micrograms (80-320 IU) per 100 g

Margarine

The average dietary vitamin D intake of young women in the UK approximates 3 micrograms per day and fewer than 1% consume more than the 10 micrograms (Williams 2007). The National Diet and Nutrition Survey of British adults suggest that if such a threshold were investigated in the UK population data, some 80-90% would be deficient (Henderson 2003).

The main source is Ultraviolet B sunlight exposure; more than 90% of mankind's vitamin D supply is derived from exposure UVB in sunlight. Deficiency of vitamin D in the UK is predominantly caused by poor weather, increasing use of high factor sunscreen (more than factor 8), and latitude: those born north of approximately Birmingham (40°N) are unlikely to be able to reach sufficient exposure.

Sunlight exposure needed is 2 hours per day (if only the face exposed), 20-30 minutes a day if the face, arms and neck are exposed without sunscreen. Sun protection factor in excess of 8 prevents absorption of the UVB sufficient to make vitamin D. Need increases for those with darker skins. In all cases it is important to avoid sunburn, particularly in babies.

Those who are eligible for Healthy Start vouchers receive free vitamin tablets and drops containing the correct dose of vitamin D for mothers and children.

Those not eligible for Healthy Start may purchase vitamin supplements form pharmacies and Health Food Stores - please check that they contain 10µg for adults and at least 7-8.5µg for children (usually 10 µg).

Vitamin D deficiency in the UK is a consequence of our weather and the latitude at which we live. The addition of vitamin D to formula milk does not make it better than breastmilk - it does not contain all the immunological properties that make breastmilk specific to cater for each baby's needs.

Some mother and infant groups have been shown to be at increased risk, including:

Babies of mothers with darker skin types

Pregnant and breastfeeding women.

Babies born in the winter months and not exposed to the sun

Babies and mothers who wear concealing clothing, preventing skin exposure to sunlight

Babies and mothers who spend a lot of time indoors or use sun creams, reducing exposure to sunlight

Babies of obese mothers (BMI >30)

Babies of mothers with gestational diabetes.

Ahmed SF et al. Recent trends and clinical features of childhood vitamin D deficiency presenting to a children's hospital in Glasgow. Arch Dis Child 2011;96:694-6 http://adc.bmj.com/content/96/7/694.full.pdf+html

American Academy of Paediatrics Prevention of Rickets and Vitamin D deficiency in infants, children and adolescents 2008 http://pediatrics.aappublications.org/content/122/5/1142.full.pdf+html

CMO Vitamin D supplements for at risk groups. dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_132508.pdf

Department of Health. Vitamin D an essential nutrient for all, but who is at risk of vitamin D deficiency? http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_111302.pdf

Henderson L, Irving K, Gregory J, et al. The National Diet and Nutrition Survey: adults aged 19 to 64 years. Vol 3. Vitamin and mineral intake and urinary analytes . London: Stationery Office, 2003: 1-160.

Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr. 2004;80(Suppl 6):1752S-1758S

Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG,Taylor SN, Morella K, Lawrence RA,Hulsey TC, Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics 2015;136 (4):

Jones W. Breastfeeding and Medication Routledge 2018

Michie C. Managing vitamin D deficiency in children. London Journal of primary care July 2010 londonjournalofprimarycare.org.uk/articles/3186685.pdf

NHS Choices. nhs.uk/news/2012/01January/Pages/vitamin-d-medical-advice-and-supplements.aspx

Prevention of rickets and vitamin D deficiency in Birmingham: the case for universal supplementation. infantfeedingwm.org.uk/documents/Website_VitD.pdf

SACN Update on Vitamin D 2007. sacn.gov.uk/pdfs/sacn_position_vitamin_d_2007_05_07.pdf

SACN Vitamin D and Health 2016 www.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf

©Dr Wendy Jones MBE, MRPharmS and the Breastfeeding Network June 2020

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Vitamin D and Breastfeeding - The Breastfeeding Network

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This information can also be viewed as a PDF by clicking here. The information provided is taken from various reference sources. It is provided as a guideline. No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used.

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Having a baby is a big life event.  It's natural to experience a range of emotions during pregnancy and after giving birth.  If however any difficult feelings start to have a big effect on your day-to day life, the way you think, feel or function, you might be experiencing a perinatal mental health problem. Please reach out and seek support.

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The period from conception to the age of 2 is an important time for child development and experiences during this time can influence the rest of a child's life. Relationships between dads and their children matter from day 1.

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Having a new baby is a wonderfully exciting time but it can also present some challenges to your relationship with your partner.

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The following link takes you to a Breastfeeding Assessment Tool. Some mothers find this a useful questionnaire to complete themselves to review how feeding is going. If anything comes up from this that you are concerned about, please do contact your midwife or health visitor for a more detailed conversation around feeding.

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Positioning and Attaching baby to your breast

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Positioning and Attaching baby to your breast

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In this video, a breastfeeding counsellor helps a mother with her positioning and attachment whilst breastfeeding.

Key to achieving the Baby Friendly standards is a workforce able to support mothers to breastfeed effectively. This video provides some guidance on this.

You can see more of the 'From Bump to Breastfeeding' DVD on the Best Beginnings website.

Video not working? Contact us

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Positioning and attachment video - Baby Friendly Initiativ

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In this video, a breastfeeding counsellor helps a mother with her positioning and attachment whilst breastfeeding. Watch to learn more.

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It can be really useful to look at what effective, active feeding at the breast looks like and compare this to just nibbling at the breast. Compare the two videos entitled 'Nibbling' and 'Really good drinking' on this link.

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Breastfeeding Videos – International BreastFeeding Centre

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A set of videos which shows how breastfeeding works, how to know if a baby is getting milk, what is a good latch, using a lactation aid, using breast compressions, tongue tie, tongue tie release, vasospasm.

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Hand expressing is a really useful technique for mums to know about for a whole range of reasons: from relieving fullness to help baby to latch, to resolving a blocked duct, to expressing for baby to take milk in a bottle.

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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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The following link from the Breastfeeding Network will give you all the information you need on storage of breastmilk.

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

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

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

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

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

Your breastmilk

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

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

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

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

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

Expressing breastmilk

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

When might I need to express?

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

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

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

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

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

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

Hand Expressing

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

Remember to wash your hands first.

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

Relax with a warm drink, music or TV.

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

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

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

Take care not to drag your skin:

Stroke with your fingertips

Roll using your knuckles.

Try using circular movements.

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

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

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

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

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

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

Good hygiene is very important:

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

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

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

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

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

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

Storing expressed breastmilk

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

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

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

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

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

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

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

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

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

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

Safe Storage of breastmilk in the home

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

Why are there variations in recommendations for storing expressed breastmilk?

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

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

Feeding baby expressed breastmilk

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

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

Defrosting frozen breastmilk

How do I defrost my milk?

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

How long can I keep defrosted breastmilk?

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

Why can't I defrost breastmilk in a microwave?

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

Travelling with expressed breastmilk

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

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

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

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

Re-heating expressed breastmilk

How do I re-heat expressed breastmilk?

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

If the milk smells sour DO NOT USE.

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

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

Finding a breast pump

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

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

References

(links checked May 2023)

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

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

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

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

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

Page reviewed and updated November 2019

Variations in Recommendations for Storing Expressed Breast Milk

Written by Anabel Hands

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

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

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

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

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

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

References

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

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

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

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

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

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

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Expressing and storing breastmilk - The Breastfeeding Network

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

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Expecting multiples and interested in breastfeeding?

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Expecting multiples and interested in breastfeeding?

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Here at Breastfeeding Twins and Triplets UK we will answer all of these questions and more. We will try to put your mind at rest whilst being honest about journey on which you are about to embark. Breastfeeding more than one baby is challenging, but it is definitely possible and a lot of mums go on to have a really enjoyable experience.

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If you are breastfeeding during pregnancy, you may be wondering what happens after your new baby is born. Nursing a new baby while an older one is still nursing is generally referred to as tandem nursing. This could be after a pregnancy and the arrival of a new baby or having adopted a new nursling while continuing to feed your older child.

Thinking about tandem nursing will likely involve considering and weighing up many variables. As a breastfeeding mother, you are aware of how important nursing is to your relationship with your older child. Deciding whether to continue breastfeeding him along with a new nursling or to wean him deserves careful consideration of both of your changing needs. Many mothers find making this decision particularly difficult. You may be drawn to both options at different times. Taking one day at a time may be helpful if you are unsure of what to do. Getting support in making your decision will give you confidence that you are doing what is best for you and your child.

If you do decide to tandem nurse, you are not alone! Many mothers have tandem nursed two, or even three, children and found that it works for their family. Children who have been tandem nursed often continue to have a special bond throughout life, and mothers report that tandem nursing can help to ease the transition of having a new baby in the family.

Why tandem nurse?

Continuing to breastfeed your toddler through the stressful and highly emotional experience of gaining a sibling can help to make the transition smoother for them. They are less likely to be jealous of the baby who is allowed to breastfeed if they can nurse alongside them. The nutrition and immunological properties of breastmilk continue to be valuable and they can help your toddler through any illness, tantrums and fussy phases ("regressions"), which can sometimes occur. Nursing your older child once the new baby arrives can ease engorgement when your milk becomes plentiful and helps protect milk production if your baby is not feeding effectively.

Breastfeeding during pregnancy

Breastfeeding during pregnancy is a special experience for both you and your nursling and recent research on the safety of nursing during pregnancy shows that there is usually no reason for concern (you can read more about this here). Your breastfeeding relationship may change throughout pregnancy to accommodate both your developing needs and the needs of your child. Around the fourth or fifth month (sometimes before), pregnancy hormones will probably cause your milk supply to reduce and its composition and taste to change. These changes may cause some children to nurse less or wean completely (you can read more about this here).

Nursing whilst pregnant continues to meet your child's nutritional and emotional needs and it can be an opportunity for you to savour your unique relationship with your older child, before your baby joins the family. However, it can also be a challenging time for you and it may invoke intense feelings. Getting support at this time may be very beneficial, and you may find talking to an LLL Leader or going to your local LLL meeting really helpful. Our Pregnant and breastfeeding? article has more information.

Preparing yourself and your toddler for a new baby

Adding a new baby to the family has a big impact, no matter if it's your second, or your tenth! Children, particularly younger ones, may not feel emotionally ready to accept this big change easily. It is a good idea to prepare your toddler and any older children by talking about a new baby coming. Reading stories together and showing them pictures of babies nursing can help them to be more accepting when their sibling arrives.

Many mothers find that they don't receive the same offers of support during second or subsequent babies as they did for their first. It is important to remember that as a mother nursing two children (or more), any support given will allow you to focus on mothering your new family. Try to get plenty of rest and eat well before the new baby comes. Actively preparing your support network before your baby arrives will make the transition easier for you all. LLL groups are a great place to meet like-minded mothers whose support can transform your mothering journey.

Labour and birth - tandem style

You may be wondering how you will be able to provide for your older child during labour and whether she will be able to nurse or not. Having a dedicated caregiver for your older child who is able to give her expressed milk (if necessary) and get her to sleep will allow you peace of mind if you are unable to provide for her during labour.

You may want to think about whether to have your older child with you during labour and birth or soon after the new baby arrives. If you are planning a hospital birth, you can inquire about access for your toddler and inform your medical team that you will want your toddler to be present during or soon after the birth. Some nursing mothers opt for a home birth, which usually allows more freedom for your older child to be included whenever you want her too.

Breastfeeding releases oxytocin and can help to progress a slow labour. However, many mothers prefer to focus on the act of birthing and choose not to have their older child with them until the new baby has arrived.

Your baby's first breastfeed is a really special time. If your older child breastfeeds at the same time, this special moment will be part of their memories too.

Any stitches you have had from a tear, episiotomy, or C-section will need to heal and you may find positioning your baby, older child or both challenging and may need a helping hand.

Premature birth or complications

When a baby arrives early or there are birth complications, it can be a really difficult and stressful time, which often involves a hospital stay and being separated from your older child. Although your newborn will need to take priority, trying to have your toddler for short visits whenever possible can be really helpful. If your newborn is unable to nurse right away, your older child can continue nursing and protect your milk production.

The early days - what to expect

When you give birth your body will continue to produce colostrum, with milk becoming plentiful after around 3-5 days. As with your previous baby, you will need to nurse at least 8-12 times per day to establish your milk production. You may worry about your newborn not getting enough colostrum if your older child is feeding too. Some mothers feed their newborn baby first or encourage the older sibling to nurse less if they feel their baby is not feeding enough. Look out for feeding cues and give your baby unrestricted access to your breasts to help ensure he gets plenty of milk. The more milk is removed, the more will be produced. Feeding cues to watch for include rapid eye movement, moving hands, squirming or rooting. Good positioning and a deep attachment at the breast will help your newborn feed effectively. Encourage your baby to finish one breast before switching to the other.

If you are expressing milk for your baby, your toddler's nursing will help your supply. Hands-on expressing while your toddler is nursing may be particularly effective.

See our page Is My Baby Getting Enough Milk for further information.

Toddler nursing like a newborn?

You may find that once your baby arrives your toddler starts nursing frequently again, just like your baby. Older siblings may enjoy increased milk supply, or simply be thinking about breastfeeding more as they see the baby breastfeeding often. If your toddler does increase his milk intake, he may lose interest in solid foods for a while as he enjoys your newly increased milk production. He may have looser stools.

If you are happy to nurse your toddler as much as he wants, it can be a lovely bonding experience for the three of you. However, if you are feeling overwhelmed by his requests or not keen on nursing so frequently, you might like to try negotiating with your toddler about when and for how long he is allowed to breastfeed. See 'Feelings' section for more ideas.

Separately or together?

You may prefer nursing your baby and your toddler separately or breastfeeding both nurslings together. Your older child can access your breast in many creative ways!

It can take a while before your body adapts to the needs of two different nurslings. Sometimes you may feel lopsided if one breast has been drained more than the other. Eventually things will settle down and you'll have your own individual rhythm. Alternating breasts for each feed helps with development of newborn vision and keeps the size of your breasts balanced. However, some mums find that giving a toddler his 'own side' works for them.

Tandem nursing positions

Just as with nursing one child, there are many different tandem nursing positions you can use which are comfortable and allow for milk to be removed effectively. You may need to experiment to find out what works for you when feeding two nurslings at the same time. Your older child might also have strong opinions about how she likes to nurse!

If you plan to tandem feed out of the house, it might be worthwhile practising a few positions at home first, so you know you can get both nurslings on and off easily. Some mothers find it easier to position the baby first and let the toddler climb on, while others prefer to position the toddler first and then add the baby.

Double cradle hold

Your toddler is positioned curled around or underneath your baby, with each child's head supported by your arms.

Double underarm (clutch or rugby) hold

Your toddler sits or semi-reclines with legs pointed away from you. Your baby is held underarm with his feet away from you. This position is good for protecting caesarean stitches or if your toddler sometimes kicks or disturbs your baby.

Double side-lying hold

Your toddler is positioned laying down next to you, then the baby is perched on top of your toddler.

There are many other variations and combinations of the above positions which you can try.

For more information about feeding positions for a single baby, see Positioning and Attachment.

Fast flow

With each pregnancy your body makes more milk and an abundant milk supply/forceful let-down can be challenging for your newborn. Your older child might oblige and deal with the fast flow; otherwise, expressing just a little milk into a towel until the flow eases may help your newborn.

Feelings

Tandem nursing is a big commitment and emotions can run high at times. You may experience huge highs, deep lows, find it too demanding, and think it is magical, all within a short space of time. It can feel as if it will be this way forever, but it might be helpful to remember that babies are small for a short period of time and the dynamics between you and your two (or more) nurslings will soon change. Having realistic expectations about what you can manage at this point in time can be helpful.

As a tandem nursing mother, you and your breasts are a focal point for nourishment and care for both of your nurslings. This can feel overwhelming and at times you may feel breastfeeding aversion or agitation. This can manifest itself in feeling 'touched out' and having the urge to limit your toddler's nursing. Your reaction may be mild or quite severe with strong urges to stop feeding your older child.

Many mothers report that the nursing agitation they feel is not an accurate reflection of their feelings about breastfeeding or their relationship with their toddler. In this case it may be helpful to do some detective work about why you may be feeling like this. You might realise that you are unwell, need more rest, are not eating well, are stressed about something, or are experiencing a bit of mother burnout. Prioritising self-care and having some time alone can really help to rebalance your mind and recharge. Carving out time for yourself, even if it is only 10 minutes, can give you the strength to manage. Taking time to rest is also important, and you can try to take advantage of daytime opportunities for a nap.

If you want to put some limits on your toddler's nursing, you might like to try negotiating with your toddler about when he is allowed to breastfeed, setting gentle limits about the length of his feeds by counting or singing, or pre-emptively offering snacks or playing games with him.

Finding support from other tandem nursing mothers gives you an opportunity to talk things through with someone else. LLL meetings are a great place to meet tandem nursing mothers.

Looking after yourself

When tandem feeding, you may be constantly thirsty, hungry and tired. It's important to look after yourself by taking every opportunity to rest together and by eating plenty of nutritious snacks and meals. Feeding both children at the same time during the day is a great opportunity to try putting your feet up and relaxing. Accepting offers of help with shopping, housework and cooking from family and friends can be extremely helpful. Taking a few moments to nurture yourself can help avoid feelings of stress or exhaustion.

Self-care is an essential part of mothering, particularly when your body is undergoing such large changes and ongoing demands.

Try to make your needs clear to your partner/support person, as they will be better able to help you if they know what you need. Trying to keep expectations realistic reduces stress for you and the rest of the family. Particularly in the early days, your priority is looking after your new baby and older child(ren), so be kind to yourself.

Eating for Three

Tandem nursing puts physical demands on your body as you produce enough milk to nourish two children. Fatigue can be a warning sign that you are not keeping up with your calorie intake requirements. It is a good idea to drink to thirst and eat as normal using your appetite as a guide.

Nighttimes

Managing bedtimes with two nurslings can be a bit tricky. If you plan to breastfeed both children to sleep you might find you can feed both simultaneously lying down, then move one child once asleep. Or it might work better to have someone else available to hold/entertain one child while you nurse the other to sleep, then nurse the second child to sleep afterwards.

It is possible to nurse both children during the night, but you may need to do some experimenting and find out which positions work for you. See our Safe Sleep and the Breastfed Baby article for more information on safe sleeping practices.

You may choose to night wean your toddler, but this might result in considerable effort and sleep-loss in the short term during the weaning period. It is helpful to consider whether night-weaning will lead to more sleep for you or if it will be more disruptive. If you do decide to night-wean, it can be helpful to have someone else put the toddler to sleep and go to them if they wake during the night.

Becoming a big brother or sister

Children react in many different ways to the birth of their new sibling. It is common for children to find it difficult to adjust to a new family member. As a tandem nursing mother, you may find that nursing your toddler (with or without baby) offers a welcome sanctuary from the stresses of the new family dynamic. Tandem nursing siblings often have an added bond as children and can have a special relationship throughout their lives.

Occupying your toddler while your baby is nursing

Keeping your toddler occupied while breastfeeding your baby may be a challenge you have not faced before. It can work well to set clear expectations about breastfeeding, so your older child understands what he is allowed to do during nursing time. Some older children react well if you give them a warning before you start breastfeeding your baby. It might also work well if you feed your baby in a sling, so your older child may not even notice your baby is nursing.

Here are some ideas to occupy your toddler while you are nursing your baby:

Have a special "breastfeeding toy box" which is only brought out when you are nursing your baby

Ensure your toddler has got a snack and drink prepared beforehand to eat while you are nursing

Share a book and a cuddle with your toddler while nursing your baby

Play verbal games with your toddler, for example "I spy"

Ask your toddler to help you out, for example bringing you a nappy, a muslin etc.

A time for weaning

For some mothers tandem nursing continues for quite a while. Others decide that weaning an older child and nurturing their relationship in a different way works better for them. If you decide to stop breastfeeding your older child, keep in mind that it may be a gradual process and one which needs gentle encouragement and patience.

Our Thinking of Weaning? article has information on weaning strategies. Talking to an LLL Leader can help you decide what is going to be best for your family.

Adopting a second nursling

Choosing to breastfeed your adopted baby is a wonderful way of bonding with her. As a mother who is already nursing another child, you are in the good position of already having a milk supply flowing. You will probably need to increase your supply to cater to your new baby's needs. See our article on Relactation and Induced Lactation for more information on how to increase your supply and how to supplement your baby if needed.

Tandem nursing your adopted baby and your toddler can create a special bond between all three of you which could last for life. However, breastfeeding your adopted baby may be challenging and you will benefit from a strong support network. Your local LLL meetings can be a great place to find this support.
Written by Bronwyn Davies, LLL West Kent, July 2018
Further Reading

Birth and Breastfeeding
Is my baby getting enough milk?
Dealing with criticism
Nipple Pain
Pregnant and Breastfeeding?
Relactation and Induced lactation
Safe Sleep & The Breastfed Baby
Still nursing?
Thinking of Weaning?
Toddlers and Food
When you don't enjoy Breastfeeding

Other articles published by La Leche League International
Breastfeeding during pregnancy and tandem nursing Setting limits when breastfeeding Hilary's adventures tandem nursing Breastfeeding during pregnancy and tandem nursing: is it safe? Recent research
Books

Adventures in Tandem Nursing. LLLI, Schaumburg, IL. La Leche League International, 2003
Breastfeeding Answers Made Simple. Morbacher, N. Amarillo, TX: Hale Publishing, 2010

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If you are breastfeeding during pregnancy, you may be wondering what happens after your new baby is born. Nursing a new baby while an older one is still nursing is generally referred to as tandem nursing. This could be after a pregnancy and the arrival of a new baby or having adopted a new nursling [...]

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Becoming a parent often puts a strain on relationships, regardless of what they were like before. This page has more information about how relationships change and also links to sources of support for people experiencing challenges.

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Becoming a parent often puts a strain on relationships, regardless of what they were like before.
Part of the problem is that you're tired and have so much less time to spend with friends, family or your partner than you did before the baby arrived.

It's a lot harder to go out together and enjoy the things you used to do. If you have a partner, they may feel left out, and you may resent what you see as a lack of support.

But the stage when babies and children take up all your physical and emotional energy doesn't last forever.

If you're having your first baby, you may feel lonely and cut off from your old life.

A partner can't give you everything you used to get from work and friends. You need other people in your life for support, friendship and a shoulder to cry on.

Take time to listen to your partner

If you have a partner, make time for each other when you can. Do little things to make each other feel cared for and included.

However close you were before the baby was born, your partner can't read your mind. Both your lives are changing, and you have to talk about it. You and your partner need to tell each other what you want and what's bothering you if you're resentful, angry or upset.

Be honest about what you need: do you need a hug or to feel understood?

It's important to talk about how you want to bring up your children. You may find you don't agree on basic matters like discipline and attitudes.

Share the housework and childcare so you can have more time together.

It's important to talk about how you want to bring up your children. You may find you don't agree on basic matters like discipline and attitudes.

Find a way of dealing with these issues without disagreeing in front of your child.

If you think a relationship is in danger of breaking down, help is available.

Help from a trained counsellor or therapist

If you'd like to talk to someone who's not a friend or family, there are lots of ways you can contact a relationship counsellor, some of them for free.

Relationships with family and friends

Bringing a baby into your life changes your relationships with family and friends, whether you're part of a couple or single.

Everyone's situation is different. For example, some mothers feel that their own mothers are taking over, whereas others resent the fact their mothers don't help them more.

It's best to be clear about the kind of help you want, rather than going along with what's offered and feeling resentful.

Your relatives are also getting used to a completely new relationship with you. They won't know what to do for the best unless you tell them.

You may find your old friends stop coming to see you, or they seem to expect you to drop everything and go out for the evening.

This can make keeping up with friends difficult, but explain to them how your life has changed. They may not understand the changes you're going through.

Keep in touch and keep some space for them in your life, as the support of friends can be really valuable.

Domestic abuse and how to get help

Domestic violence, also called domestic abuse, includes physical, emotional and sexual abuse in couple relationships or between family members.

Domestic abuse against women often starts in pregnancy. Existing abuse may get worse during pregnancy or after the birth.

Nobody has to put up with domestic abuse. It puts your health and that of your baby at risk.

There are lots of ways you can get help:

Witnessing domestic abuse can have a serious effect on children. Social workers can help you protect your child. If you wish, they can help you take steps to stop the abuse or find refuge.
Read more advice about recognising the signs of domestic violence and abuse and where to get help

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Advice for new parents on coping with changing relationships, both as a couple and with friends and family, plus what to do if you're a victim of domestic abuse.

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Relate are the UK's largest provider of relationship support and last year they helped over two million people of all ages, backgrounds, sexual orientations and gender identities to strengthen their relationships.

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The free Baby Check app features 19 simple checks that parents can do if their baby is showing signs of illness. Each check tests for a different symptom and when compiled, a score is calculated and then signposts the parent to the appropriate source of support.

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Baby Check App

Baby Check features 19 simple checks that parents can do if their baby is showing signs of illness. Each check tests for a different symptom and when completed, a score is calculated that tells parents or carers how ill their baby is. The app then lets parents know whether their baby needs to see a doctor or health professional.

Download for FREE from Google Play or the App Store.

Buy posters, business cards and other materials to help promote Baby Check to your clients and patients

Shop

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The Baby Check App helps parents decide if their baby needs to see a doctor or health professional

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Baby Buddy is a free app which provides trusted, evidence-based information and self-care tools, based on the latest research and is NHS approved. Baby Buddy aims to empower parents and care-givers by building their knowledge of the crucial first five years of their child's life, when foundations are laid.

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Information on Chestfeeding for trans or non-binary parents

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Information on Chestfeeding for trans or non-binary parents

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Chestfeeding if you're trans or non-binary

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If you are trans or non-binary and are thinking about chestfeeding your baby, find out your options and further information here.

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Twins Trust - We support twins, triplets and more...

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Supporting you through every milestone of your journey with twins, triplets or more. From being pregnant with twins, triplets or quads through to parenting twins, triplets or quads, we are here for you.

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As you approach the point of going back to work, it can be useful to consider making a plan for how breastfeeding can continue. The attached resource may help.

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Published by the Department of Health and the Baby Friendly Initiative, this leaflet provides mothers with information about continuing to breastfeed when going back to work or study.

Going back to study or work may be the first time you have been separated from your baby for long periods. Continuing to breastfeed helps to keep the close relationship you've built up, providing your baby with extra comfort and security for as long as you both want.

You don't need to stop breastfeeding just because you're returning to study or work. Many women find ways to continue breastfeeding their baby - and employers have certain obligations towards breastfeeding women.

The last section in this leaflet sets out how employers can make it easier for you to do so - show this leaflet to your employer.

Visit ACAS to find out more about pregnancy and maternity rights, as well as breastfeeding at work.
Please note this leaflet is currently unavailable

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Breastfeeding at study or work - Baby Friendly Initiative

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This leaflet provides mothers with information about continuing to breastfeed when going back to work or study.

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All babies go through developmental leaps. Being aware of what is going on for your baby developmentally may help you to understand why they need more cuddles and comfort, milk and nutrition from one week to the next.

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Our sanity saving, all explaining apps. The must have 'original', our AudiBook app and our newest Milestone Memories app.

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First Steps Nutrition Trust feels passionately about the need for better information and support for good nutrition and good food from pre-conception to five years.

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First Steps Nutrition Trust is an independent public health nutrition charity. We endeavour to fill practical and policy-relevant information gaps and provide resources for health workers supporting eating well from pre-conception to five years.

Our Mission

To influence policies which enable the safe, appropriate and optimal feeding of infants and young children in the UK, and to protect them from commercial interest.

To ensure that the importance of good nutrition from pre-conception to age five remains on everyone's agenda.

To provide conflict of interest-free information on infant milks marketed in the UK, and to promote better regulation and marketing of breastmilk substitutes.

To provide resources for health workers to support them in their work with pregnant women and young families.

Our Resources:

Are put together by nutrition experts and are regularly updated.

Can be used in Unicef UK Baby Friendly Initiative accredited settings.

Are available as free pdf downloads for use by anyone promoting better public health on a not-for profit basis.

Everyone who works at First Steps Nutrition Trust feels passionately about the need for better information and support for good nutrition - and good food - from pre-conception to five years.

First Steps Nutrition Trust is supported by generous individual donations and conflict of interest free grants. First Steps Nutrition Trust does not work with organisations or individuals that work with, or take funding from, the breastmilk substitute industry and we reserve the right not to sell them our subsidised resources.

First Steps works with and supports a number of organisations including Unicef UK Baby Friendly Initiative, the Baby Feeding Law Group, the Obesity Health Alliance, the Children's Food Campaign and the APPG on Infant Feeding and Inequalities.

First Steps Nutrition Trust host and regularly update their partner site infantmilkinfo.org which contains comprehensive information about infant milks (for 0-12 month olds) available on the UK market.

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

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The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour.

Keep up your normal daily physical activity or exercise (sport, running, yoga, dancing, or even walking to the shops and back) for as long as you feel comfortable.

Exercise is not dangerous for your baby. There is evidence that active women are less likely to experience problems in later pregnancy and labour.

Exercise tips for pregnancy

Do not exhaust yourself. You may need to slow down as your pregnancy progresses or if your maternity team advises you to. If in doubt, consult your maternity team.

As a general rule, you should be able to hold a conversation as you exercise when pregnant. If you become breathless as you talk, then you're probably exercising too strenuously.

If you were not active before you got pregnant, do not suddenly take up strenuous exercise. If you start an aerobic exercise programme (such as running, swimming, cycling or aerobics classes), tell the instructor that you're pregnant.

Remember that exercise does not have to be strenuous to be beneficial.

Exercise tips when you're pregnant:

always warm up before exercising, and cool down afterwards

try to keep active on a daily basis - 30 minutes of walking each day can be enough, but if you cannot manage that, any amount is better than nothing

avoid any strenuous exercise in hot weather

drink plenty of water and other fluids

if you go to exercise classes, make sure your teacher is properly qualified and knows that you're pregnant, as well as how many weeks pregnant you are

you might like to try swimming because the water will support your increased weight. Some local swimming pools provide aqua-natal classes with qualified instructors. Find your local swimming pool

exercises that have a risk of falling, such as horse riding, downhill skiing, ice hockey, gymnastics and cycling, should only be done with caution. Falls carry a risk of damage to your baby

Exercises to avoid in pregnancy

do not lie flat on your back for long periods, particularly after 16 weeks, because the weight of your bump presses on the main blood vessel bringing blood back to your heart and this can make you feel faint

do not take part in contact sports where there's a risk of being hit, such as kickboxing, judo or squash

do not go scuba diving, because the baby has no protection against decompression sickness and gas embolism (gas bubbles in the bloodstream)

do not exercise at heights over 2,500m above sea level - this is because you and your baby are at risk of altitude sickness

Exercises for a fitter pregnancy

If you are pregnant, try to fit the exercises listed in this section into your daily routine. These types of exercise will strengthen your muscles to help you carry the extra weight of pregnancy. They'll also make your joints stronger, improve circulation, ease backache, and generally help you feel well.

Stomach-strengthening exercises

As your baby gets bigger, you may find that the hollow in your lower back increases and this can give you backache. These exercises strengthen stomach (abdominal) muscles and may ease backache, which can be a problem in pregnancy:

start in a box position (on all 4s) with knees under hips, hands under shoulders, with fingers facing forward and abdominals lifted to keep your back straight

pull in your stomach muscles and raise your back up towards the ceiling, curling your trunk and allowing your head to relax gently forward. Do not let your elbows lock

hold for a few seconds then slowly return to the box position

take care not to hollow your back: it should always return to a straight/neutral position

do this slowly and rhythmically 10 times, making your muscles work hard and moving your back carefully

only move your back as far as you can comfortably

Pelvic tilt exercises

stand with your shoulders and bottom against a wall

keep your knees soft

pull your tummy button towards your spine, so that your back flattens against the wall: hold for 4 seconds then release

repeat up to 10 times

Pelvic floor exercises

Pelvic floor exercises help to strengthen the muscles of the pelvic floor, which come under great strain in pregnancy and childbirth. The pelvic floor consists of layers of muscles that stretch like a supportive hammock from the pubic bone (in front) to the end of the backbone (spine).

If your pelvic floor muscles are weak, you may find that you leak urine when you cough, sneeze or strain. This is quite common, and there is no reason to feel embarrassed. It's known as stress incontinence and it can continue after pregnancy.

You can strengthen these muscles by doing pelvic floor exercises. This helps to reduce or avoid stress incontinence after pregnancy. All pregnant women should do pelvic floor exercises, even if you're young and not suffering from stress incontinence now.

How to do pelvic floor exercises:

make yourself comfortable by sitting or lying down with your knees bent

squeeze in and tighten the muscles around your back passage as if you were trying to stop yourself peeing and farting

breathe in as you squeeze in and tighten the muscles, and then breathe out while relaxing the muscles

at first, try to do this exercise quickly

then do it slowly, holding the squeezes for as long as you can before you relax: try to count to 10

try to do 3 sets of 8 squeezes every day: to help you remember, you could do a set at each meal

As well as these exercises, practice tightening the pelvic floor muscles before and during coughing and sneezing.

Find out more about incontinence.

Find out more about keeping fit and healthy after you've had your baby.

How and when should I do pelvic floor exercises?

In this video, a midwife explains how to do pelvic floor exercises and when you can practise them.

Need activity ideas for the rest of the family?

For ideas to help get your family more active visit the Better Health - Healthier Families website.

Please bear in mind that the activity plans are not designed for use during pregnancy but can be useful for your partner, children and other family members.

Video: What can I do during pregnancy to make birth easier?

In this video, a midwife describes things women can do during pregnancy to help make giving birth easier.

Get Better Health: Start for Life pregnancy and baby emails

Sign up for Better Health: Start for Life weekly emails for expert advice, videos and tips on pregnancy, birth and beyond.

Community content from HealthUnlocked

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Find out about the benefits of exercise in pregnancy, including which kinds of exercise you can do, such as yoga and swimming, and which you should avoid.

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Antenatal Class: Baby Brain Development, Coping with a Crying Baby and Postnatal Wellbeing

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Antenatal Class: Baby Brain Development, Coping with a Crying Baby and Postnatal Wellbeing

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1: Brain development, crying, postnatal wellbeing

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Antenatal Class: Womb to World, Skin to Skin

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Antenatal Class: Womb to World, Skin to Skin

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Antenatal Class: Bathing your baby, Nappy changing

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Antenatal Class: Bathing your baby, Nappy changing

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Antenatal Class: Where to get help and support

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Antenatal Class: Where to get help and support

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We detected a high number of errors from your connection. To continue, please confirm that youâ€™re a human (and not a spambot).

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Resources about infant feeding in other languages

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Resources about infant feeding in other languages

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Available in

Arabic

Bengali

Hindi

Lithuanian

Mandarin

Polish

Romanian

Slovak

Turkish

Ukrainian

Urdu

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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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Information for parents and carers of new babies

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Information for parents and carers of new babies

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CCS padlet with information for families with babies aged 6wks and up

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CCS padlet with information for families with babies aged 6wks and up

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Expecting multiples and interested in breastfeeding?

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Expecting multiples and interested in breastfeeding?

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Here at Breastfeeding Twins and Triplets UK we will answer all of these questions and more. We will try to put your mind at rest whilst being honest about journey on which you are about to embark. Breastfeeding more than one baby is challenging, but it is definitely possible and a lot of mums go on to have a really enjoyable experience.

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Twins Trust aims to provide multiple families with the information and support they need to enable them to thrive. They offer help, information and tips online, over the phone and via email. They also run a unique Family Support service which helps families in desperate need.

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Twins Trust - We support twins, triplets and more...

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Supporting you through every milestone of your journey with twins, triplets or more. From being pregnant with twins, triplets or quads through to parenting twins, triplets or quads, we are here for you.

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When you're expecting twins or triplets, it's important that you attend all your appointments because of the increased risks with this type of pregnancy.

Your antenatal team should be experienced in caring for women having twins or triplets.

Check-ups and scans in a twin pregnancy

The number of tests and scans you'll be offered will depend on the type of twins or triplets you're having.

Women with multiple pregnancies should be offered an ultrasound scan at around 11 to 14 weeks. It's important to attend this appointment.

This is the best time to find out what type of placenta and membranes your twins have (chorionicity) and check your dates.

You can also have a nuchal translucency test for Down's syndrome done at the same time if you wish.
Find out more about screening for Down's syndrome
You'll also be offered a scan, called an anomaly scan, around 18 to 20 weeks 6 days to check that your babies are developing normally.

Different types of twins

For medical purposes, there are 3 types of twins. These apply to triplets too, although a triplet pregnancy will be more complex than a twin one.

The 3 types are:

dichorionic diamniotic (DCDA) twins - each has their own separate placenta with its own separate inner membrane (amnion) and outer membrane (chorion)

monochorionic diamniotic (MCDA) twins - share a single placenta with a single outer membrane and 2 inner membranes

monochorionic monoamniotic (MCMA) twins - share both the inner and outer membranes

All non-identical twins are DCDA, and a third of identical twins are DCDA.

The other two-thirds of identical twins are MCDA, and just 1 in 100 identical twins are MCMA.

The percentages of identical and non-identical twins born in the UK are not routinely recorded, but according to the Multiple Births Foundation about a third of twins are identical.

What extra care may I need?

If your babies are MCDA, you can expect more scans and monitoring, as this type of twins has the highest risk of twin-twin transfusion syndrome (TTTS), which is an abnormality of the placenta.

You may be referred to a regional centre for foetal medicine to be seen by a specialist doctor.

If your babies are MCMA, you'll also have frequent scans. With this type of twins there's often some cord entanglement, which can cause complications.

These types of twins are rare, and you can expect to receive specialist care and close monitoring.

If your babies are DCDA, the risks to their health in the womb are much lower. You'll usually be scanned every 4 weeks.

It's important to attend all your appointments so any problems can be picked up early and treated if necessary.

Risks in twin pregnancies

While most multiple pregnancies are healthy and result in healthy babies, there are more risks to be aware of when you're pregnant with 2 or more babies.

If you're pregnant with more than 1 baby, you're at higher risk of pregnancy complications, such as anaemia, pre-eclampsia and gestational diabetes.

Make sure you go to all your antenatal appointments so any problems can be picked up early and treated if necessary.

Premature birth

Twins and triplets have a higher risk of being born prematurely (before 37 weeks) and having a low birthweight of under 2.5kg (5.5lb).

Most twins and triplets are born prematurely.

Around 6 in 10 twins are born before 37 weeks. Almost 8 in 10 triplets are born before 35 weeks.

Planned birth

If you are expecting twins or triplets, you will be offered a planned birth at:

37 weeks for twins with a placenta each

36 weeks for identical twins sharing a placenta

35 weeks for an uncomplicated triplet pregnancy

32-33 weeks for MCMA twins

It can be dangerous for twin and triplet pregnancies to carry on after the planned birth dates. Plans for the birth will be discussed with you taking into account your needs and preferences.

If you turn down the offer of a planned birth, you will be offered weekly appointments with an obsetrician and weekly ultrasound scans plus a foetal growth scan every 2 weeks.

Your obstetric team will work closely with you throughout your pregnancy and after your babies are born to help make sure you and your babies are safe and healthy.

Twin-twin transfusion syndrome

Twin-twin transfusion syndrome (TTTS) affects identical twins who share a placenta (monochorionic).

The risk is higher for MCDA twins, but it can happen in MCMA twins, too.

It's caused by abnormal connecting blood vessels in the twins' placenta.

This results in an imbalanced blood flow from 1 twin (known as the donor) to the other (recipient), leaving 1 baby with a greater blood volume than the other.

TTTS affects 10 to 15% of monochorionic twins and can have serious consequences.

You'll need to discuss your individual case with a doctor, as what works in one TTTS pregnancy may not be appropriate in another.
Go to the Twins Trust website for more information on TTTS

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When you're expecting twins or triplets, it's important that you attend all your appointments because of the increased risks with this type of pregnancy. Your antenatal team should be experienced in caring for women having twins or triplets. The number of tests and scans you'll be offered will depend on the type of twins or triplets you're having.

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It's important to understand your birth options if you're expecting more than 1 baby.
Twins and triplets are more likely to be born early and need special care after birth than single babies.

Your birth choices with twins

It's a good idea to discuss your birth options with your midwife or consultant early on in your pregnancy.

You'll normally be advised to give birth in a hospital, as there's a higher chance of complications with twins.

There are usually more health professionals at a multiple birth - for example, there may be 2 midwives, an obstetrician and 2 paediatricians (1 for each baby).

For more information on who's who, read about the antenatal team.

The process of labour is more or less the same as for 1 baby, but your maternity team will usually advise you to have your babies electronically monitored because of the higher risk of complications.

This means attaching belts with sensors (1 for each twin) to your bump. You'll still be able to move around into different positions.

Once your waters have broken, your midwife may ask your permission to attach a clip attached to a wire to the first baby's head to get a more accurate measure of their heartbeat.

You'll be offered a drip in case it's needed later - for example, to restart contractions after your first baby is born.

Triplets or more babies are almost always delivered by a planned caesarean section.

Can you have a natural birth with twins?

Lots of women think they have to have a caesarean section with twins, but in fact, many twin births are vaginal

If you're planning a vaginal delivery, it's usually recommended that you have an epidural for pain relief, but you can discuss this with your midwife.

If there are any problems, it's easier for your antenatal team to deliver your babies quickly if you have already got an epidural in place.
Find out more about the signs and stages of labour
You're more likely to have a vaginal birth if the first twin is in a head-down position.

But there may be medical reasons why a vaginal birth is not recommended.

If you have had a caesarean section before, for example, it's not usually recommended that you have a vaginal birth with twins.

As with any vaginal birth, you may need an assisted birth. This is where forceps or vacuum delivery are used to help deliver your babies.

Once the first baby is born, your midwife or doctor can check the position of the second baby by feeling your tummy and doing a vaginal examination. They may also use an ultrasound scan.

If the second baby is in a good position, it should be born soon after the first, as your cervix is already fully dilated.

If your contractions stop after the first baby is born, the doctor or midwife may discuss giving you hormones via a drip to restart them.

Caesarean section and twins

In the UK, more than half of twins and almost all triplets are delivered by caesarean section is a common method used during twin and triplet births.

You may choose to have a planned caesarean, or your doctor may recommend a caesarean, if:

the first baby is lying feet, knees or buttocks first (breech)

1 twin is lying sideways (transverse)

you have a low-lying placenta

your twins share a placenta

you have had a difficult delivery with a single baby before

As with any pregnancy, if you plan a vaginal birth, you may still end up needing an emergency caesarean.

In a small number of cases, some women deliver 1 twin vaginally and then need a caesarean section to deliver the second twin.

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What to expect when your twins or triplets are born, including your birth choices and what happens if your babies are premature.

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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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Your dog doesn’t think, understand and communicate in the same way we do. Children should never be left unsupervised with any dog, whether at home or out on a walk – regardless of the breed or how well they know them.

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Creating a dog- and child-friendly home

Keep dog toys out of your dog's reach so they learn they can only play at the invitation of an adult. Make sure your children tidy their toys away so your dog knows not to play with them.

Teach your children to respect your dog's physical and emotional welfare. They shouldn't tease your dog, pull their fur or tail, or take their food away from them.

Always make sure your dog has a safe area where they can have some quiet time alone away from the children.

Dogs and toddlers

Your dog still needs peace and quiet sometimes; allow him a place to escape to. If friends' children come to visit make sure the dog can escape to his safe den if he needs to.

Toddlers won't be able to read a dog's body language and toddlers are quite unpredictable for the dog. Beware of a sudden grab, impulsive hug or a twisted ear. Toddlers can easily lose their balance and fall on a sleeping dog! Don't expect your dog to put up with pulled ears just because he is tolerant.

Dogs are fight or flight animals. They will usually try to get away if unhappy, but if this is not an option then fight is what's left to them. Try not to let things get this far, signs of an unhappy dog include; yawning, lip licking, ears back, trying to get away, growling, snapping and showing teeth.

Teach your children from day one that the dog is not a toy. Children should never approach a sleeping, eating, unwell or tired dog. The dog and the child need to respect each other's space.

Teach your dog manners so that when your toddler starts to crawl/walk, the dog doesn't try and barge through doorways or upstairs first.

Help them stay safe around dogs

Many children love seeing dogs when they're out and about - but sometimes dogs can mistake their friendliness for aggression. Teach them these simple rules to help keep your children safe:

Always ask the owner before approaching, stroking or playing with a dog

Never rush up to a dog, be calm and make slow movements so you don't frighten him

Hold out your hand and let him come to you. If he doesn't want to come, leave him alone

Don't stare directly into a dog's eyes

If a dog growls at you or seems aggressive, stay calm and slowly walk away

If a dog is eating, drinking, sleeping or tied up, you should leave him alone

If you'd like more help keeping your children safe around your dog, we run family dog workshops near you.

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Keep dog toys out of your dog's reach so they learn they can only play at the invitation of an adult. Make sure your children tidy their toys away so your dog knows not to play with them. Teach your children to respect your dog's physical and emotional welfare.

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A safer world for all our children

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Free educational resources

Looking for free educational resources to help keep children safe? Download and share our free safety fact sheets, use our eye-catching materials to create a colourful display or run a safety workshop for parents with our session plans.

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Child Accident Prevention Trust | A safer world for all our children

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Safety advice Many accidents are a part of growing up. Children need to explore and experiment. But some children suffer the pain of serious accidents that can alter the course of their lives forever. Most of these serious accidents are completely preventable by making simple solutions or changes to routines.

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Tips as to how to keep your family safe around dogs

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Tips as to how to keep your family safe around dogs

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The Dog Safety Code encourages everyone to be alert, aware and - most importantly - safe around dogs.

We are a nation of dog lovers and dogs are often part of the family, so it is vital that both parents and children are equipped with the knowledge they need to enjoy spending time with dogs safely.

We know that sometimes dog bites can happen because of certain circumstances or because we miss important signals from dogs. Being dog safe and following the Dog Safety Code can help to prevent that from happening.

Images kindly provided by CattleDog Publishing, a division of Veterinary Information Network, Inc www.cattledogpublishing.com
PRACTICAL TIPS FOR CHILD SAFETY AROUND DOGS
It is important that families are equipped with the knowledge and skills they need to enjoy spending time with dogs safely. Close supervision of children and dogs is key.
Be alert:

Close supervision is the most important thing to keep children safe.

Watch, listen and remain close when your child and dog are together. Never leave them alone together

If either your dog or child seems unhappy, positively and calmly separate them. You can throw your dog a treat or toy, or lead your child away.

Be aware:

Understand your dog's body language so you can spot signs they feel uncomfortable or stressed.

When you know you'll be distracted during busier times, use safety gates to keep children and dogs separate or, take your child or dog with you.

Be Safe:
Trigger times - teach your child to leave your dog alone when they are:

Sleeping - no-one likes to be woken up suddenly.

Eating or having a treat - they might think you're going to take their food.

Have a toy or something else they really like - they might not want to share

For more practical tips read the Child Accident Prevention Trust's dog safety fact sheets: https://capt.org.uk/dogs-and-children Spread the word about #DogSafety
We want as many people as possible to display and share dog safety resources to get the #DogSafety message out there.

Download and share the digital version of the D og Safety Code

Download and share the digital version of the Do g Safety Code (triangle version)

Download and share the printable version of the Dog Safety Code

Download and share the printable version of the Dog Sa fety Code (triangle version)

Download and share the GIF version of the Dog Safety Code

Download and share the Safety around dogs factsheet

Download and share the Your dog and your new baby factsheet

Download and share the Instagram post for Dog Safety

Download Be Alert for Child Safety Image - PNG

Download Be Aware for Child Safety Image - PNG
Want More Information? CFSG Dog Safety Library Dogs and Children | Top tips to keep them safe and happy together (capt.org.uk) Dogs and children: living safely together | Dogs Trust The Kennel Club - Safe and Sound PDSA - Canine communication: recognising stress in your dogs PDSA - Children and dogs: How to keep them happy and safe PDSA - Paws for posties RSPCA - Dogs and children RSPCA - Keeping children safe around dogs RSPCA - Six Golden Rules for keeping your child safe and your dog happy RSPCA - How to help your dog behave well RSPCA - Aggression in dogs Blue Cross - Be Safe with Dogs: A guide for families Dogs Trust - Safety Dogs Trust - Building confidence around dogs Merseyside Dog Safety Partnership - Public resources Know the signs
Download Be Safe for Child Safety Image - PNG

Download the Dog Safety Poster

Dogs will show signals through their body language to you. Below you can see some of the most used signals dogs give us to show us if they are worried, scared or need some space.

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The Dog Safety Code encourages everyone to be alert, aware and - most importantly - safe around dogs. We are a nation of dog lovers and dogs are often part of the family, so it is vital that both parents and children are equipped with the knowledge they need to enjoy spending time with dogs safely.

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The Breastfeeding Network Drugs in Breastmilk service

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The Breastfeeding Network Drugs in Breastmilk service

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This service is a fantastic resource which anyone can contact with queries about whether medications are safe for breastfeeding. They also have lots of factsheets on their website (https://www.breastfeedingnetwork.org.uk/drugs-factsheets/) about common medications.

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Bedfordshire Hospitals NHS Foundation Trust is dedicated to supporting all parents, protecting breastfeeding, and encouraging all families to develop close and loving relationships with their newborn baby.

Please navigate through our pages below to find out more.

The Luton & Dunstable Hospital is currently working towards gaining full Baby Friendly Initiative Accreditation.
Please note that during the COVID-19 pandemic some services may have been amended or suspended. Your midwife, health visitor or infant feeding supporter will advise you accordingly.

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Feeding your newborn baby - Bedfordshire Hospitals NHS Trust

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Bedfordshire Hospitals NHS Foundation Trust is dedicated to supporting all parents, protecting breastfeeding, and encouraging all families to develop close and loving relationships with their newborn baby. Please navigate through […]

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Bedfordshire Hospitals NHS Foundation Trust

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Bedfordshire Hospitals NHS Foundation Trust, Incorporating Bedford Hospital and Luton & Dunstable University Hospital

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The No Panic Helpline - 03007729844 everyday 10am-10pm 365 days of the year.
No Panic offers advice, support, recovery programs and help for people living with phobias, OCD and any other anxiety-based disorders

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No Panic specialises in self-help recovery and our services include

Providing people with the skills they need to manage their condition and work towards recovery, enabling them to lead more fulfilled lives.

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No Panic specialises in self-help recovery and our services include Providing people with the skills they need to manage their condition and work towards recovery, enabling them to lead more fulfilled lives.

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Mental health service run by and for lesbians, gay, bi-sexual, trans and queer people

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The Bedfordshire Wellbeing Service offers a range of free and confidential talking therapies and specialist support to help you feel better.

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We can deliver therapy digitally so you can get the help you need now. We are evolving and adapting with the help of our service users to deliver an efficient service. If you are unable to email you can call 01234 880400. You can still self-referral by clicking "Get Started". We are currently prioritising all NHS and Care Workers.

We can deliver therapy digitally so you can get the help you need now. We are evolving and adapting with the help of our service users to deliver an efficient service. If you are unable to email you can call 01234 880400. You can still self-referral by clicking "Get Started". We are currently prioritising all NHS and Care Workers.

Webinar

Coping with Long Term Conditions in Times of Uncertainty

We recognise that individuals with Long Term Conditions have been impacted severely from COVID-19.

Join our free NHS mental health webinar where you will learn new tools & techniques to help you manage your mental wellbeing during stressful times.

Before the session you will be asked to complete our "Quick Stress Check" online via email.

For more information go to our Events page.

Webinar

Pregnancy & Motherhood in Uncertain Times

This session will be a one off free webinar delivered by one of our Psychological Wellbeing Practitioners (PWP).

You will learn new tools and techniques to help you manage your mental wellbeing during stressful times.

Before the session you will be asked to complete our "Quick Stress Check" online via email.

For more information go to our Events page.

Webinar

Men's Mental Health Webinar

This webinar session will be delivered digitally by one of our Psychological Wellbeing Practitioners (PWP) and your attendance will be completely anonymous.

All you need is either a mobile telephone, laptop or desktop computer with speakers.

You will learn new tools and techniques to help you manage your mental wellbeing during stressful times.

Before the session you will be asked to complete our "Quick Stress Check" online via email.

Go to our Events page for more details

Announcement

Long Term Condition Focused Cognitive Behavioural Therapy

The Bedfordshire Wellbeing Service provides support for individuals who have been diagnosed, whether recently or longstanding, with a Long Term condition (LTC). Individuals with an LTC commonly experience mental health distress such as Depression and Anxiety. We have therapists who have completed specialist training to support individuals with an LTC. Please see below for an understanding of some of the conditions we offer support for:

- Diabetes
- COPD/ Respiratory Conditions
- Cancer
- Persistent Physical Pain
- IBS

Support is offered through 1-1 digital therapy, online computerised therapy and LTC focused groups.

For more information go to our How We Help page.

Webinar

Managing Mental Health in Times of Uncertainty

This webinar is suitable for anybody struggling with low mood or anxiety specifically around current circumstances.
The content will include the facts about Coronavirus, understanding worry, low mood and anxiety and a selection of brief practical strategies you can learn to tackle these difficulties.

The webinar can be viewed using a computer/laptop, tablet or mobile device. The webinar will be a presentation with a selection of slides - attendees only need to watch and listen.

Through talking therapies we will help you get to the root of your problems and to manage and overcome your difficulties.

Once I'd made up my mind to get help, the rest was really straight forward and the help I received was life changing.

To get in touch by phone, please call us on 01234 880400 Monday to Friday.

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We can deliver therapy digitally so you can get the help you need now. We are evolving and adapting with the help of our service users to deliver an efficient service. If you are unable to email you can call 01234 880400. You can still self-referral by clicking "Get Started".

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Stop smoking in pregnancy or afterwards with Total Wellbeing in Luton

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Stop smoking in pregnancy or afterwards with Total Wellbeing in Luton

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If you live, work or are registered with a GP in Luton we can offer FREE stop smoking medication and support.

Just text 'QUIT2022' to 60066.
When you stop smoking, you may:
· Start to breathe more easily and cough less

· Improve your blood circulation, making exercise easier

· Reduce stress

· Improve your sex life and fertility

· Have better skin and reduce wrinkles

· Improve your sense of overall smell and taste

· Get whiter teeth and fresher breath

· Live longer and reduce your risk of serious illness

· Protect your friends and family from smoking-related harm

With the help of our free service, one of our dedicated workers will support and encourage you to find a strategy that works for you. We can also help you choose a stop smoking medicine or e-cigarette and make sure you feel confident in dealing with the challenges that may present themselves in achieving a smoke-free life. You can even drop into Cloudies Vape Shop in High Town and ask about signing up to our programme. The team there will sign you up and support you in your community.
Smoking during pregnancy
Carbon monoxide is especially risky to pregnant women, babies and children. It is found in cigarette smoke, including breathing in 'second hand' smoke. Inhaling carbon monoxide starves the body of oxygen which is needed for your baby's growth and development in the womb.

Stopping smoking during pregnancy brings immediate health benefits to you and your baby and reduces:

· complications during pregnancy, labour and birth

· stillbirth

· premature birth and babies being born underweight

· cot death
You're up to three times more likely to succeed with expert advice and support. We're ready when you are. GET IN TOUCH
Start feeling the benefits and stop smoking for good.

Text QUIT2022 to 60066

Tel 0300 555 4152

Email [email protected]

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If you live, work or are registered with a GP in Luton we can offer FREE stop smoking medication and support. Just text 'QUIT2022' to 60066.

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Support to stop smoking in Beds Borough & Central Bedfordshire

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Support to stop smoking in Beds Borough & Central Bedfordshire

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Quitting smoking has so many benefits and no drawbacks, and we know you've got what it takes to quit this Stoptober. This year we have even more choices to help you on your way to a smoke free future. From the 1st October the stop smoking service can provide e-cigarettes to help you make the [...]

From the 01st October 2022 the Stop Smoking Service will be providing free e-cigarettes to help people to quit smoking there are many mixed messages about them so here's some facts and information when thinking about using one. E-cigarettes, also referred to as vapes, are electronic devices that heat a solution (e-liquid) and allow the [...]

The Titan Primary Care Network is organising an event with the purpose to help educate the local population, create awareness of local services and provide interactive stations to aid in varying aspects of health and wellbeing. The Titian team are keen to ensure that the focus of the event remains heart failure , cancer [...]

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Quitting smoking has so many benefits and no drawbacks, and we know you've got what it takes to quit this Stoptober. This year we have even more choices to help you on your way to a smoke free future. From the 1st October the stop smoking service can provide e-cigarettes to help you make the [...]

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This website has links to the NHS Stop Smoking app which can help you quit smoking and start breathing easier.

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If you smoke, you might be more at risk of having high blood pressure. If left untreated, high blood pressure can increase your risk of a heart attack or stroke.

High blood pressure does not usually have any symptoms, so the only way to know if you have it, is to get a check. If you are 40 or over, live in England and haven't had a check in the last 6 months, you can get your blood pressure checked for free at your pharmacy today.

If your blood pressure is high, then it can be managed through lifestyle changes or medication.

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When you stop smoking, good things start to happen to your health. Get free support from the NHS to become smoke free and help build a smokefree generation.

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British Lung Foundation Stopping Smoking information

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British Lung Foundation Stopping Smoking information

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Evidence suggests smokers are three times more likely to quit successfully if they use NHS support. On this page, we explain the different ways you can stop smoking, what to do when you're ready to quit, and further information and support available to you.

It can be very hard to change a long-term habit, whether it's what you eat, how much you exercise or smoking. You don't have to do it on your own. With support from friends, family and professionals, you're more likely to be successful.

On this page:

Smoking cessation (stop smoking clinics)
You're around three times more likely to stop successfully if you use a combination of stop smoking treatment and specialist help.
You can start your stop smoking attempt with your GP. They will be able to give you a prescription to reduce nicotine cravings, as well as nicotine replacement therapy (NRT) such as patches and gum. Your GP should also be able to advise on using e-cigarettes, which can be an effective quitting tool, despite not being risk free themselves.

Your GP will also be able to refer you to local specialist stop smoking services. But you can also contact your local stop smoking service yourself, for support in your stop smoking journey. Using aids prescribed by your GP alongside the behavioural support offered by stop smoking services is the most effective way to quit.

If you have a long-term lung condition, like chronic obstructive pulmonary disease (COPD) or pulmonary fibrosis, your doctor should offer you support in stopping smoking every time you meet them.

Find information on specialist stop smoking services near you on the NHS website. The NHS also has detailed information about what to expect from a stop smoking service, which you might find useful to read through. Depending on where you live in the UK, sessions may happen remotely, by phone or video call, or in person at GP surgeries or pharmacies. You may be offered support through an app, text messages or another digital platform in addition to help you stop smoking. There are plenty of apps available to help you stop smoking - search online for one that suits you.

Go smokefree with your mobile phone

Download the free Smokefree app. It's a four-week programme of practical support, encouragement and tailored advice.

Stop smoking treatments

Nicotine replacement therapy

Nicotine replacement therapy (NRT) comes in different forms and helps you to overcome urges to smoke. It's available on prescription from your GP or local stop smoking service, or to buy from a pharmacy. All the therapies give you a low level of nicotine, without the tar, carbon monoxide and other poisonous chemicals that are in tobacco smoke.

Therapies include patches, gum, sprays, lozenges, and inhalators (a device to inhale something). Patches release nicotine slowly, whereas other therapies act more quickly. For most people the best approach is to combine two sorts of NRT. Usually this means a patch to provide a background level of NRT and a faster-acting product, such as gum, inhalator or nasal spray to use when you get cravings. People usually take NRT for 8-12 weeks before gradually reducing the dose and stopping. Ask your GP, pharmacist or stop smoking service for help to select the best combination for you.

E-cigarettes are also a form of nicotine replacement treatment, as the vapour usually includes nicotine. Evidence suggests that they are at least as effective at helping people quit smoking as other NRT products, but people have individual preferences.

Other stop smoking medications

Medication is available on the NHS to help you quit smoking: buproprion (Zyban) and varenicline (Champix). Champix is currently unavailable in the UK. Both can double your chances of stopping. Talk to your GP about stop smoking medication.

For advice on stop smoking treatments speak to your GP, pharmacist or local stop smoking service.

How will I benefit from stopping smoking?

Fill in our online questionnaire to remind yourself why you want to quit and how you're going to do it. You can print it out so you can keep it somewhere you can see it.

According to the National Centre for Smoking Cessation and Training, there are many immediate benefits to stopping smoking (quick wins). They include improved lung function, fewer flare-ups in COPD, and improved sense of taste and smell. Read more about why you should stop smoking.

I'm ready to stop smoking - what should I do?

When you're ready to stop smoking - have a plan. Our top tips:

Go to see your GP and ask for a prescription for medication to help you to quit smoking, as well as a referral to your stop smoking service. They'll be able to discuss with you the range of things you can try to help you quit, and which might be the best method for you. With this help you're three times more likely to quit successfully.

Pick a date to stop and decide you'll be a non-smoker from that day. Tell your family and friends and plan something to do to take your mind off it.

Ask your friends and family for support. If someone close to you is thinking of stopping, why not stop at the same time so you can support each other?

Think of situations where you're likely to be tempted and come up with ways to overcome the urge. For example: 'If I'm with friends who are smoking, I'll leave the room or use my vape.'

If you find yourself struggling, go back to the stop smoking services for help. There are also stop smoking apps available that some find helpful for additional support.

Keep your hands and mouth busy - when you're out, try putting your drink in the hand that usually holds a cigarette and drink from a straw.

A craving can last five minutes - so think of five-minute strategies. If you find a certain time of day or place hard, try a new routine.

Make a list of your reasons for quitting - read it when you need motivation.

Call yourself a non-smoker and think of yourself as one.

Think about the possible withdrawal symptoms and how you will cope.

Reward yourself when you're doing well, but don't beat yourself up if you're struggling. If the method you're using isn't working for you, try something else. Don't quit quitting!

We were going away after Christmas. I decided that would be a good time to stop, as I would be away from the places that I usually smoked. Going out of the back door to smoke became just a natural habit.

Just before we went away, I had my last cigarette - and I've never looked back. Judith

Your personal quit plan

Get a free personal quit plan from the NHS website.

Further information and support

England - Better health: Quit smoking
0300 123 1044 Lines are open 9am - 8pm weekdays, 11am -4pm at the weekend.

Scotland - Quit your way
0800 84 84 84 Lines are open 8am - 10pm weekdays, 9am-5pm at the weekend.

Wales - Help me quit
0800 085 2219 Lines are open Monday to Thursday, 8am -8pm, Friday 8am - 5pm and Saturday 9am - 4pm.

Northern Ireland - Want to Stop For advice or to find your local stop-smoking service go to their website or text 'Quit' to 70004.
Read next: vaping and e-cigarettes Read next: how will I benefit from stopping smoking?

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How can I stop smoking? - British Lung Foundation

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Evidence suggests smokers are three times more likely to quit successfully if they use NHS support. On this page, we explain the different ways you can stop smoking, what to do when you're ready to quit, and further information and support available to you.

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We all need good mental health and wellbeing – it's essential to living happy and healthy lives. This website covers 7 areas of life where simple changes can make a big difference. Why not start today?

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What is good mental health?

Looking after your mental health is not something we should just do if we are struggling, or feeling low, anxious or stressed. It's actually something we should think about all the time and really invest in, just like with our physical health.

Staying on top of our mental wellbeing is good for us now but also helps us deal manage difficult times in the future. Over time, it can also reduce our risk of physical health problems.

There are lots of things we can do to look after our mental health and wellbeing every day - make a start with these 7 top tips.

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Top tips to improve your mental wellbeing - Every Mind Matters

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Good mental health is essential to living happy and healthy lives. See 7 areas of life where simple changes can make a big difference. Why not start today?

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This questionnaire asks how you a series of questions about how you are feeling in a series of questions and helps you to find appropriate support as needed. If you would like more support please call the Health Hub on 0300 555 0606 or email on ccs.bedsandlutonchildrenshealthhub@nhs.net and a member of the Health Visiting team will contact you.

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If you're 16 or over, this depression and anxiety self-assessment quiz can help you better understand how you've been feeling recently.

With each question, think about how you've been feeling over the last 2 weeks.

If you're struggling, it's best to speak to someone.

You can call Samaritans free on 116 123 if you want to talk to someone now.

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Depression and anxiety self-assessment quiz

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If you're 16 or over, this depression and anxiety self-assessment quiz can help you better understand how you've been feeling recently. With each question, think about how you've been feeling over the last 2 weeks. If you're struggling, it's best to speak to someone.

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Perinatal mental health symptoms checker

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Perinatal mental health symptoms checker

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Signs you might need support for your mental health during or after pregnancy.

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The Free Mindfulness Project is home to a growing collection of free-to-download mindfulness meditation exercises.

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The aim of The Free Mindfulness Project is to provide easy and free access to mindfulness meditation exercises by inviting the wider mindfulness community to share their resources here. The focus of this site is mindfulness as practiced in mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT) and other closely related approaches.

If you would like to access the collection of mindfulness exercises, go to the section. Free Resources

For opportunities to practice mindfulness live, go to the online mindfulness section .

Our sister is Words to Sit With : a home for contemporary, free-to-share mindfulness poetry.

If you have a few moments, why not ask yourself;

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Welcome Welcome to The Free Mindfulness Project - Home to a growing collection of free-to-download mindfulness meditation exercises. The aim of The Free Mindfulness Project is to provide easy and free access to mindfulness meditation exercises by inviting the wider mindfulness community to share

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The NBH is open 9.30am to 9.30pm every day of the year. It is staffed by trained volunteers and offers friendly, non-judgemental, independent, evidence based breastfeeding support and information to anyone in the UK who needs it.

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National Breastfeeding Helpline - Helpline

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This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website.

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Find out how to eat a healthy diet in pregnancy, including plenty of fruit and vegetables, and cutting down on sugar and saturated fat.

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Bedfordshire Maternity services would like to hear your views

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Bedfordshire Maternity services would like to hear your views

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Bedford Maternity Voices. 803 likes · 12 talking about this. We are a group made up of local NHS maternity staff and parents who are working together to improve our maternity services in Bedford...

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This website from the Health & Safety Executive in Ireland has lots of information about child safety around many different types of pets.

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Pets can play a role in helping your child develop. Learn about health and safety risks from pets and teaching your child to be safe around them.

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Early Days Booklet - Luton & Bedfordshire

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Early Days Booklet - Luton & Bedfordshire

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The Early Days booklet is full of information to support you with feeding and caring for your baby, as well as sources of support.

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Find out what food and drink you can have and what you should avoid or be careful with during pregnancy, such as some cheeses, meats, fish, eggs, nuts, caffeine and alcohol.

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Vital information for all parents to know .

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You, your child or someone you look after:

feels very unwell or like there's something seriously wrong

has not had a pee all day (for adults and older children) or in the last 12 hours (for babies and young children)

keeps vomiting and cannot keep any food or milk down (for babies and young children)

has swelling or pain around a cut or wound

has a very high or low temperature, feels hot or cold to the touch, or is shivering

Do not worry if you're not sure if it's sepsis - it's still best to call 111.

They can tell you what to do, arrange a phone call from a nurse or doctor, or call you an ambulance.

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You, your child or someone you look after: feels very unwell or like there's something seriously wrong has not had a pee all day (for adults and older children) or in the last 12 hours (for babies and young children) keeps vomiting and cannot keep any food or milk down (for babies and young children) has swelling or pain around a cut or wound has a very high or low temperature, feels hot or cold to the touch, or is shivering Do not worry if you're not sure if it's sepsis - it's still best to call 111.

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Makes Milk podcast by Emma Pickett IBCLC

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Makes Milk podcast by Emma Pickett IBCLC

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A companion to your infant feeding journey, this podcast explores how to get breastfeeding off to a good start (and how to end it) in a way that meets everyone's needs. Emma Pickett has been a Board Certified Lactation Consultant since 2011. As an author (of 4 books), trainer, volunteer and breastfeeding counsellor, she has supported thousands of families to reach their infant feeding goals. Breastfeeding/ chest feeding may be natural, but it isn't always easy for everyone. Hearing about other parents' experiences and getting information from lactation-obsessed experts can help.

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A companion to your infant feeding journey, this podcast explores how to get breastfeeding off to a good start (and how to end it) in a way that meets everyone's needs.Emma Pickett has been a Board Certified Lactation Consultant since 2011. As an author (of 4 books), trainer, volunteer and breastfeeding counsellor, she has supported thousands of families to reach their infant feeding goals.Breastfeeding/ chest feeding may be natural, but it isn't always easy for everyone. Hearing about other parent's experiences and getting information from lactation-obsessed experts can help.

A companion to your infant feeding journey, this podcast explores how to get breastfeeding off to a good start (and how to end it) in a way that meets everyone's needs.Emma Pickett has been a Board Certified Lactation Consultant since 2011. As an author (of 4 books), trainer, volunteer and breastfeeding counsellor, she has supported thousands of families to reach their infant feeding goals.Breastfeeding/ chest feeding may be natural, but it isn't always easy for everyone. Hearing about other parent's experiences and getting information from lactation-obsessed experts can help.

Thankyou

Thanks for making this podcast. I am five months into my breastfeeding journey and have found it so helpful. It has kept me company during the night feeds and wakings and I've learned so much! Fantastic guests and insights shared!

Beautiful resource

I absolutely LOVE this podcast and Emma's instagram. We're five months into our breastfeeding journey with my first baby and I am so enjoying learning all about this huuuge topic with the help of Emma's lovely voice, clear explanations and super interesting guest speakers. Thank you, Emma.

Loved it!

I cried the whole way through the first episode which says it all really! It made me feel proud, validated, lucky and so many more emotions! Thank you.

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‎Makes Milk with Emma Pickett on Apple Podcasts

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A companion to your infant feeding journey, this podcast explores how to get breastfeeding off to a good start (and how to end it) in a way that meets everyone's needs.Emma Pickett has been a Board Certified Lactation Consultant since 2011. As an author (of 4 books), trainer, volunteer and breastfee...