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Hand expressing breast milk is a very useful skill, it's easy to learn and it's free! This article shares tips and videos to help you get your milk flowing and the circumstances when it is particularly useful.

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Prepare the breasts

Before hand expressing breast milk, some mothers have found it can help to "prepare" the breasts (and trigger a let down) by one or more of the following ways:

1. Warmth across the breasts before expressing can help milk start to flow

2. Holding your baby skin-to-skin or lightly dressed helps to raise oxytocin levels which can help trigger the let-down

3. Massaging the breasts by gentle stroking, rolling, kneading and tapping movements with warm hands can help to get the breast ready for hand expressing breast milk. Some mothers use a soft baby brush to massage the breast. Examples of massage techniques are shown in the following video from Maya Bolman (1:03). Continue watching from 1:45 to see her suggested hand expressing technique; notice how the fingers are just behind the nipple and the helper uses one hand and then both hands.

If you can't seem to trigger a let down, practicing hand expressing after your baby has had a breastfeed and while your milk is still flowing can be helpful.

Hand expressing breast milk

Successful hand expressing involves triggering a let down of milk and then compressing the milk ducts behind the nipple to release milk. The fingers and thumb of one (or both) hands are placed around the breast behind the nipple and drawn together just as you might squeeze a tooth paste tube behind the nozzle (you don't squeeze the actual nozzle to get toothpaste out of the tube). Exactly where to place your fingers for the best effect is individual to each mother and trial and error.

Videos of hand expressing

The easiest way to explain how to hand express is to watch it being done. The Maya Bolman video above and the following three videos show slightly different tips and techniques.

Using massage

In this clip from Stanford University Jane Morton describes her preferred hand expressing technique at 7:14. She places fingers further behind the nipple than other videos might show, she reminds mothers to alternate expressing between the breasts, to take a rhythmical approach and to use hands to massage the breast.

Demonstration on a knitted breast

Unicef UK's Baby Friendly Initiative video demonstrates hand expressing breast milk on a woolly breast (two minutes 36 seconds long). The narrator reminds mothers not to let fingers slide across the breast:

One handed technique

The following short video from Ammehjelpen (Norwegian breastfeeding support) is one minute 20 seconds long, and is also recorded in Norwegian as well as English. The clip shows a one handed technique and a mother hand expressing both breasts at the same time. Moving the hands around the breast helps to stimulate and empty all the milk glands:
There are several variations to try for hand expressing breast milk. Experiment to find the technique that works for you.
When is hand expressing breast milk useful?

Hand expressing is not always needed if breastfeeding is going well, but can be useful for any of the following situations:

#1 Baby won't latch

If a baby won't or can't latch straight away after birth, or mother and baby have to be separated for medical reasons, freshly hand expressed colostrum (the first breast milk) can be fed by spoon or syringe to keep baby well fed until they can latch. Early hand expressing in the first hour after birth -and regularly thereafter-can help future milk volumes as well as stimulating the milk supply to come in as soon as possible . Typical volumes of colostrum are too small, thick and sticky to collect with a pump.

Expressing colostrum

Global Health Media's video provides tips for collecting colostrum after giving birth, and how to collect it on a spoon. The video shows suggested finger positions to use, what is happening within the breast when you express, and plenty of tips to get your milk flowing.

#2 Severe engorgement

If a mother has severe engorgement in the early days after birth, hand expressing can gently remove excess milk. Using a pump at this time can pull more fluid into the area and add to the engorgement. Engorgement or a blocked duct can be relieved at any time with hand expression too. Pumps are not always a necessary purchase! If a mother is struggling to get her milk to let down see Engorgement Relief When Milk Won't Flow.

#3 Low milk supply

If a mother has a low breast milk supply, both hand expressing and pumping are great ways to drain the breasts to stimulate them to make more milk. Hand expressing after pumping and hands on pumping together can provide as much as 48% more milk . Hands on pumping is described by Jane Morton MD from Stanford School of Medicine in this Hands on Pumping video (see 5:15).

#4 Diabetes

If a mother has diabetes, some hospitals advocate learning to hand express and collect prenatal colostrum in the weeks just before the baby is born. This provides a supplement to keep the baby fed if there should be a drop in his blood sugar or any other complications requiring supplementation. LLLGB explains:

In the first 24 hours after birth, babies of diabetic mothers risk developing low blood sugar levels (hypoglycaemia). A baby needs colostrum to maintain his blood glucose levels. Exclusive breastfeeding has been shown to reduce the risk of a baby developing diabetes later in life.

For a review of the safety issues and when it is appropriate to express colostrum during pregnancy see Expressing Colostrum Antenatally.

#5 Storing breast milk

Before hand expressing breast milk for storage, wash your hands and check that any equipment used to collect milk is clean. See How Long Does Breast Milk Last for more information on breast milk storage.

Summary

Hand expressing breast milk is a good skill to master to support breastfeeding. Hand expressing can help to build a milk supply, provide supplements for your baby, breast milk to store, and relieve uncomfortable engorgement. There are several helpful videos to explain how to hand express.

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Hand Expressing Breast Milk - Breastfeeding Support

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Hand expressing breast milk is a very useful skill, it's easy to learn and it's free! This article shares tips and videos to help you get your milk flowing and the circumstances when it is particularly useful.

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A bottle teat is not the same as a breast despite claims by the manufacturers. Breastfeeding uses a different tongue and jaw action to that needed to get milk from a bottle, and skin is not the same as silicone. Sometimes a breastfed baby may begin to fuss at the breast in preference for the faster flow of milk from the bottle (bottle preference). And some babies find it hard to switch between bottle and breast. Some babies may start using a bottle feeding suck on the breast-leading to discomfort for you and frustration for your baby (nipple confusion). This article shares ideas that may help to reduce bottle preference or nipple confusion if you need to bottle feed a breastfed baby.

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#1 Recreate a deep latch

The way a baby attaches to the breast is often called the "latch". In a comfortable or deep latch, a baby will attach to the breast with a big mouthful of breast tissue as well as the nipple so that the nipple is deep in their mouth. Recreating the wide-mouthed jaw position seen with breastfeeding is thought to help prevent nipple confusion or nipple preference. To recreate this with a bottle try:

A short or medium length teat with a medium sized base

A short or medium length bottle teat with a rounded tip and a medium-wide base can allow a baby to take most of the bottle teat in his mouth close to the screw cap. This will give him a wide open mouth around the base of the bottle teat and the tip of the teat will be deep in his mouth in the same position as the nipple during breastfeeding. The photographs below from Latching Tips show the kind of wide open mouth you can try and recreate on the base of a bottle teat.

Artificial nipples with a long narrow teat and/or a very wide base may force your baby to make a small mouth around the narrow length of the nipple similar to the mouth position when sucking on a straw. This could create bad habits with your baby's latch when they breastfeed.

Trial and error

Be aware that the branding of bottles is not very reliable. Claims that one is closer to breastfeeding than another can usually be disregarded. Look for a bottle teat that suits your baby. You may need to try a few different teat shapes to see which works best to prop your baby's mouth wide open with the bottle teat deep in his mouth. See Best Bottle for a Breastfed Baby? for more information about shapes and characteristics of teats that can support or undermine breastfeeding.

#2 Encourage rooting and gaping

Encouraging the rooting reflex and waiting for a wide gape before your baby takes the bottle teat in his mouth replicates how a baby takes a big mouth full of breast (not just the nipple). Brushing your baby's lips gently with the tip of the bottle nipple will trigger his reflex to open his mouth to search for the nipple. When he opens his mouth at its widest point, offer the teat and encourage your baby to take the entire artificial nipple into his mouth close to the cap. If the bottle nipple is too long for your baby's mouth, this could make him gag, so be guided by your baby and choose a shorter teat if needed.

#3 Switch sides

Breastfeeding usually involves switching breasts either part way through a feed or at the next feed. To replicate this you could hold your baby in the opposite arm to have the second half of their bottle or turn him on to his other side if he is side-lying (see below). This can help to maintain a baby's willingness to feed in all directions at the breast and may be beneficial for normal eye development.

#4 Mimic the first let-down

At the breast your baby usually has to wait a minute or two for the milk ejection reflex or "let-down" to trigger plentiful flowing milk. Holding the bottle horizontally so milk doesn't fill the teat for the first few sucks copies the waiting time before the let-down.

#5 Slower milk flow

Bottle teats can often provide milk faster than a breast which some babies may like-and can lead to babies preferring the bottle over the breast. If the flow is very fast however, it can also be stressful for your baby to try and keep up with the fast flow (see the stress cues discussed in #6 below). There are several ways to help avoid either bottle preference or distress from a fast flow:

Slow-flow teats

Slow-flow bottle teats will usually be closer to the rate of milk flow during breastfeeding. However, be aware that the claims and branding around bottle nipples can mean very little. A teat may be marked as slow flow but be very fast and vice versa. The rate that milk drips from the teat when the bottle is held vertical is also not a reliable guide to the rate of flow when baby sucks. Avoid a teat that delivers milk so quickly that it causes your baby to be overwhelmed causing him to gulp, choke, spill lots of milk or show other more subtle signs of stress.

Baby's body position

Milk automatically drips from most bottles when they are held upside down (vertically). A baby can't control the milk flow from a bottle if he is lying flat on his back and milk is dripping down into his mouth even when he doesn't suck. If a baby is on his back he will have to keep swallowing to keep up with the milk flow until the bottle is finished. This could be one of the reasons bottle feeding is linked with over feeding and obesity and it can be stressful for the baby. Upright positions and side-lying positions can be helpful.

Upright positions. Holding a baby so that they are either supported at a 45° angle or in more of an upright position can help them to control the flow of milk into their mouth.

Side-lying. A side-lying position can work well for a younger baby (see video below). The carer can tilt the bottle just enough to keep the artificial nipple filled with milk. As the bottle empties, take care not to hyperextend the baby's neck and check for signs that the flow of milk is not uncomfortably fast for him.
Bottle feeding a baby in a side-lying position:
Pace the feed, allow pauses

During breastfeeding, babies are in control of milk flow after the initial let-down; when they stop sucking, milk will stop flowing. It is not so easy for a bottle-fed baby to pause, take a break or decide that he is full if milk is dripping quickly from the bottle of its own accord. When the bottle is more horizontal a baby will have to suck more actively because gravity won't be helping to pour milk into his mouth. By changing the angle of the bottle at intervals, a baby can take pauses when he needs them, rather than having a continual stream of milk from start to finish. Controlling milk flow in this way is often referred to as "paced feeding" or "pacing the feed". Paced feeding can help a baby recognise when he is becoming full and prevents overfeeding (see video clip below).
Video clip showing how to pace a bottle feed:
#6 Watch baby for signs of stress

Not too fast

If the flow of milk is too fast, a baby may show signs they are stressed and the ideas in #5 above can be used to slow the flow. Signs of stress can be very subtle: for example frowning, looking wide-eyed or holding hands up with splayed fingers. Other indicators such as gulping, not pausing to take a breath, or becoming cyanosed (blue in colour) can also indicate milk may be flowing too quickly.

Not too slow

There is no need to slow the flow down unnecessarily so that your baby is frustrated- the pace can be "baby-led". In particular, slowing the flow unduly is not appropriate for underweight babies with growth faltering who may need encouragement to feed in the easiest way possible.

Help! My baby prefers the bottle

The tips above can help to reduce or avoid breastfeeding problems but sometimes you may find that your baby still starts fussing at the breast and seems to prefer a bottle. Or you may begin to notice changes to your baby's latch when you breastfeed. If your baby is fussy at the breast or refusing to breastfeed you could try:

Cutting back on using a bottle for a while to get breastfeeding back on track and see the ideas in How to Get Baby Back to the Breast

Breast compressions to increase the flow of breast milk if they are frustrated with a slower flow at the breast

If you are using a bottle to top up your baby due to low weight gain, and they are starting to fuss at the breast The "Finish at the Breast" Method of Supplementation described by Diana West and Lisa Marasco may be useful. This involves returning your baby to the breast to finish off their feed after having their top up. They then associate the breast with feeling full and may have more patience for a slower flow. Once your baby is gaining well and is stronger he may be able to take his supplement with a supplemental nursing system at the breast.

My baby has nipple confusion

If your baby's latch seems to be affected despite trying the ideas above, cutting back on bottles for a while can help to reinforce your baby's breastfeeding skills and review the principles of good attachment in Latching Tips. Alternatives to bottle feeding such as cup feeding or using a supplemental nursing system at breast or via finger-feeding can be discussed with your health professional and lactation consultant if bottles are interfering with breastfeeding.

Summary

Although some babies will happily switch between breast and bottle without any problems, bottle feeding can undermine breastfeeding if using a bottle changes the way a baby breastfeeds or if a baby begins to prefer a bottle due to a faster flow of milk. There are lots of ways to try to make a bottle feed more like a breastfeed and reduce bottle preference or nipple confusion. Cup feeding or breastfeeding with a supplemental nursing system can be alternative options to consider for supplementing a baby.

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A bottle teat is not the same as a breast despite claims by the manufacturers. Breastfeeding uses a different tongue and jaw action to that needed to get milk from a bottle, and skin is not the same as silicone.

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Holding your baby skin-to-skin both straight after birth-and later in the weeks to follow-has amazing benefits for you and your baby.

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Good for baby

Studies have shown that placed skin-to-skin on mother's chest after birth (or father's if mother isn't available), a baby has:

better oxygen levels and better breathing

a better regulated temperature and heart rate

less crying-he feels safe

lower stress hormone (serum cortisol)

better sleep-which helps brain development

more stable blood glucose levels

more self-latching (when baby attaches to the breast unaided)

better co-ordinated suckling

better weight gain

colonisation with his mother's skin flora (a good thing!)

Skin-to-skin helps breastfeeding and weight gain

Many early difficulties with latch or poor weight gain can be helped by spending more time holding your baby skin-to-skin or lightly dressed... at any time in the early weeks. In slightly laid back or reclining positions a baby can feel his tummy against his mother's body, and this helps him to use his natural instincts and feeding reflexes to latch deeply and comfortably (see video clips below). If the room temperature is not very warm, both mother and baby can be covered with a blanket. When warm, safe and content on your body, babies don't have to use excess energy for maintaining their own temperature, keeping their body systems stable or crying for attention-and they can use more of their energy to grow and gain weight.

Take off anti-scratch mittens

Letting your baby use his hands to feel your skin is important to help him find, feel, and shape the breast so take off any anti-scratch mittens. And most babies won't need a hat when they are in skin-to-skin contact .

Skin-to-skin for the premature baby

Skin-to-skin or kangaroo care-where baby is held in skin contact for long periods-can be especially beneficial to the premature baby. See Kangaroo Care for Your Premature Baby for much more information.

Good for mum

For mum, holding her baby skin-to-skin will help bonding, stimulate her mothering instincts and intuition, and help increase her confidence as a mother. Skin-to-skin contact releases prolactin and stimulates oxytocin (special hormones) which help with milk production. The senses of smell, sight, touch, taste and hearing will all be stimulated in skin-to-skin which have very positive calming effects on both mother and baby.

Separation

Separating a mother from her baby can have many subtle undesirable effects for a newborn. Nils and Jill Bergman have a great website ( kangaroomothercare.com) with lots of information on both the harms of separating mother and baby and the benefits of skin-to-skin contact. In the excerpt below Jill Bergman describes how stress hormones affect a baby when he is separated from his mother:

Excerpt From

Skin-to-Skin Contact, Jill Bergman, Breastfeeding Today, LLLI, 2011

Separation from mother is highly stressful, and is enough to make a baby physiologically unstable. He feels unsafe, his brain sends "danger" signals to the body. His brain releases the stress hormone cortisol, which increases the heart rate and breathing in a basic "fight or flight" reaction. Somatostatin is also released and acts in the gut to decrease absorption of food and thus inhibit growth. These stress hormones will continue to affect the baby while he is separated from mom. When returned to his mother, the stress hormones still take 30 minutes or even an hour to wash out of his system.

The separated baby will protest and cry to call for mom. His arms and legs will wave or jerk to get his mother to come back. The crying can also open the foramen ovale, a flap between the two sides of the heart, thus restoring fetal circulation, which now pumps deoxygenated blood to the brain. This crying increases the heart rate and blood pressure in the baby's brain, which can damage the tiny capillaries, maybe even causing an intraventricular hemorrhage (IVH).

The rest of the article has many more fascinating facts about the value of skin-to-skin and early breastfeeding. For example the hormones involved in milk production also have important roles for a baby's development. Prolactin is involved in nerve cell formation and production of a substance that helps the newborn baby's lungs to breathe better. Oxytocin doubles as a messenger in the brain while another chemical (cholecystokinin) in the milk calms the baby and helps him to self-regulate his digestion.

Self-latching and breast crawl

Giving your baby the opportunity of crawling to the breast themselves after birth while in skin-to-skin contact has been shown to be very beneficial for mother, baby and breastfeeding. When your baby is on his tummy (prone), his feeding reflexes and his hands help him move towards the breast, find the nipple and prepare him for instinctive latching. This can be repeated at any time in the early weeks not just immediately after the birth.

Skin-to-skin as soon as possible

The following video from the Global Health Media Project shows babies finding the nipple and self-latching in skin-to-skin contact just after birth (see 3:15, 5:42, 7:25 and 8:20). The clip summarises how to get breastfeeding off to a good start with early skin-to-skin contact:

Place baby skin-to-skin with his mother straight after the birth

Do not wash mother's nipples or dry baby's hands

Keep mother and baby together undisturbed after the birth

Baby-led attachment

In our second clip, a mother demonstrates sitting in a semi-reclining (or laid back) position, with her baby in skin-to-skin contact in her arms. In this video the baby latches on herself without help from her mother at 4:08, the video clip refers to this as "baby-led attachment".

Breast crawl

In the famous clip below from breastcrawl.org, a newborn baby is placed between her mother's breasts and finds the nipple herself at 4:55. In normal circumstances you won't have a film crew and medical staff around you... or be lying completely flat. Lying at a 45º angle will allow you to see your baby and help them with the breast crawl (see second clip above).

Help with latching

If you are finding it difficult to latch your baby comfortably and are finding breastfeeding painful or have sore nipples, work with an IBCLC lactation consultant to find the best position for you and your baby and see our Latching Tips.

Summary

Holding a baby skin-to-skin has many benefits for mothers and babies including helping breastfeeding get established. If mother isn't available, the baby's father or a loving family member will be a great alternative.

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Why Skin-to-Skin? - Breastfeeding Support

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Holding your baby skin-to-skin both straight after birth-and later in the weeks to follow-has amazing benefits for you and your baby.

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Cup feeding is an alternative to bottle feeding if a baby can't latch to the breast and needs to be given some milk. It can also be used for supplementing a baby who is not getting enough milk or for a baby who is separated from his mother for a while. It is thought to be a useful short-term alternative to using a bottle teat as it avoids a baby getting confused by the different sucking action required on an artificial bottle nipple (nipple preference/confusion). However, there are disadvantages as well as advantages to cup feeding. This article looks at the pros and cons of cup feeding and how to cup feed a newborn baby.

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Pros and cons of cup feeding

Advantages of cup feeding

Better oxygen saturation and heart rate. A premature baby can feed at his own pace which may improve his oxygen saturation and heart rate making him more physiologically stable

Cup feeding may help preserve breastfeeding by avoiding bottles. Studies show cup feeding premature babies instead of using bottles can increase the number of babies who breastfeed and increase the length of time they breastfeed

Cup feeding can prepare a baby for breastfeeding. Feeding technique (use of muscles) while cup feeding is thought to be closer to breastfeeding than using a bottle and may help prepare a baby for breastfeeding by encouraging the tongue to come forward for lapping/sipping

Open cups are easily available, inexpensive and very easy to clean in resource poor areas or emergencies compared with teats, bottles or feeding tubes

Suitable for very young babies. Cup feeding can begin from as early as 29 weeks gestational age.

Disadvantages of cup feeding

There is a risk of aspiration or choking if cup feeding is not done correctly

Feeds can take a long time

There can be a lot of spilled and wasted milk compared with bottle feeding or tube feeding

Long term cup feeding can dampen the sucking reflex or create a preference for the cup

Not suitable for sleepy babies as there is a risk of choking.

Can cup feeding help preserve breastfeeding?

One review found cup feeding had no significant benefit in maintaining breastfeeding after discharge from hospital and that the length of hospital stay was likely to be a lot longer with cup feeding in some settings. However more recent studies have found the opposite - more cup fed babies were exclusively breastfeeding at discharge, and beyond, with no apparent increase in hospital stay for term, late preterm and premature babies (Penny et al. 2018). The Academy of Breastfeeding Medicine states cup feeding may help preserve breastfeeding and the World Health Organisation recommends cups or spoons rather than bottles and teats for premature babies.

How to cup feed a baby

Cup feeding is best taught by a demonstration from your experienced health care professional if possible. They will advise you whether the technique is suitable for your baby. To cup feed a baby needs to be awake and alert, and in an upright position. Never cup feed a sleepy baby or a baby who is lying flat and never pour milk into a baby's mouth as these all increase the risk of your baby choking.

Cup feeding videos

Global Health Media has a lovely series of videos about breastfeeding, the first clip below (9 minutes long) discusses how to safely cup feed a small baby who isn't breastfeeding yet and includes spoon feeding, using a paladai (see below) and using a nifty cup:

Cup feeding description

The following description is summarised from the video above. Use a small cup with a smooth edge such as a medicine cup, sherry glass or shot glass-your maternity hospital may give you one. You can also buy little plastic cups specially for the purpose which can be shaped slightly during feeding. You may need a cloth under baby's chin in case any milk spills.

Half fill or two thirds fill a small cup with slightly warmed breast milk or infant formula

Ensure your baby is fully awake, alert and interested in feeding. Never cup feed a sleepy baby

If needed, wrap your baby to prevent him knocking the cup out of your hands

Sit your baby in a comfortable, upright position on your lap. Never cup feed a baby who is lying flat on their back

Rest the rim of the cup lightly on your baby's lower lip or their lower gum ridge

Tip the cup just enough so that milk reaches the rim of the cup, don't put the cup too far into baby's mouth

Your baby will quickly learn to sip or lap milk from the rim of the cup with his tongue

DO NOT pour the milk into his mouth, go slowly alwayskeeping the milk just at the rim of the cup

Leave the cup in position when baby pauses to rest between swallows and is not drinking, avoid putting pressure on the lower lip

Continue to tip the cup enough to keep the milk at the rim of cup resting lightly on baby's lower lip

Burp baby if needed during the feed.

Short film clips of cup feeding

In the following short clip from Global Health Media, a premature baby is cup feeding. Notice how the baby's tongue extends to lap the milk.

Jack Newman is a Canadian paediatrician and breastfeeding expert. Here is a clip of cup feeding from his International Breastfeeding Centre:

Using a paladai

Mothers in India have used a small spouted cup called a paladai for centuries. One study compared the use of a bottle, cup and a paladai in 100 newborn babies. Infants took the most milk in the least time and stayed calmest with the paladai . However a more recent pilot study comparing the paladai with bottle feeding in preterm infants found increased spillage, longer feed times and more stress cues .

Alternatives to cup feeding

Alternatives to cup feeding for the breastfed baby who needs supplementing include:

Supplementing at the breast. A breastfed baby who is latching well to the breast but who needs additional milk can be supplemented while they are breastfeeding by way of a small feeding tube alongside the nipple. The free end of the feeding tube is placed in a container of milk and provides milk when baby suckles with a good seal around breast and tube. For much more information about the pros and cons of this system see Supplementing at the Breast.

Finger feeding. Finger feeding is another method of providing supplemental milk to a breastfed baby by way of a feeding tube (above). In this case the feeding tube provides additional milk while the baby suckles on a clean finger. For more information on the pros and cons of finger feeding see What is Finger Feeding?

Bottle feeding. A traditional way to provide supplemental milk is by bottle and teat. Feeding from an artificial teat has a number of differences to breastfeeding which could cause nipple preference or confusion in some babies. However there are several ways to reduce the differences to help preserve breastfeeding, see Tips to Bottle Feed a Breastfed Baby and Best Bottle for a Breastfed Baby?

Summary

Used correctly, cup feeding can be a useful way to give a newborn baby supplementary milk for short term feeding. Other options for supplementary feeds include using a supplemental nursing system at the breast, or a bottle using our tips to minimise nipple confusion. Your breastfeeding specialist or health professional can help you decide which option is best for you and your baby.

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Cup feeding is an alternative to bottle feeding if a baby can't latch to the breast and needs to be

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Diary of a Lactation Failure (Or a tale of two titties)

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It's been a little over a week since we decided to try and reduce the amount of donor milk and increase Baby J's solid food intake. It's going very well! After getting over the initial hiccups (trying to figure out how to get more liquids into him because he was dealing with some constipation), we seem to have a good system going.

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...syringe/tube feeding for older babies 

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...syringe/tube feeding for older babies 

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Finger Feeding to Supplement a Breastfeeding Infant

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How to latch a baby using the exaggerated latch technique.

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The "flipple" breastfeeding technique in the koala hold

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Analgesia and Anesthesia while breastfeeding

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Analgesia and Anesthesia while breastfeeding

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Professional Medicine advice

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Training resources for breastfeeding

Advice and recommendations

Our recommendations seek to help you make a decision in an area where evidence is often sparse. Where possible, we base our advice on published literature. Where this is lacking we consider pharmacokinetic and pharmacodynamic principles; side-effect profiles; clinical use; expert advice and unpublished data. We advise based on UK practice and interpretation, and may therefore sometimes differ from other sources of information.

Our recommendations apply to full-term and healthy infants. If the infant was born prematurely, is unwell, or the mother is taking multiple medicines, contact us for further advice.

In addition, we're also currently modernising our material in this area to make it easier to use and understand. Feel free to contact us for further advice if you need help in the interim.

Search Advice and recommendations

Get in touch

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All our training and guidance to help decision making about the use of medicines in breastfeeding

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The LactMed® database contains information on drugs and other chemicals to which breastfeeding mothers may be exposed. It includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate.

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Drugs in Breastmilk factsheets - The Breastfeeding Network

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

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Wendy Jones BSc, MSc, PhD, MRPharmS

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A list of all the factsheets available on Breastfeeding-and-Medication.co.uk. But happy to answer any other questions if you email me wendy@breastfeeding-and-medication.co.uk

If you search for any word on the title the factsheet page should appear
List of factsheets Breastfeeding and Medication
If you use them a lot maybe you need the books

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A list of all the factsheets available on Breastfeeding-and-Medication.co.uk.

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Positions for Breastfeeding - Video - Global Health Media Project

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A lovely video showing different position. When you struggle with a cross cradle or rugby ball, side lying and laying back can really help! Note in some parts of the video the mother's hand in on the neck. Try to support your baby from the shoulder, to allow them to tilt the head back as much as possible for a deep latch ☺️

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The way a mother holds her baby affects how easy it is for her baby to feed effectively. This video shows basic points important for any position and then demonstrates several common positions that have worked well for many mothers and babies.

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Positions for Breastfeeding - Video - Global Health Media Project

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The way a mother holds her baby affects how easy it is for her baby to feed effectively. This video shows basic points important for any position and then demonstrates several common positions that have worked well for many mothers and babies.

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Attaching Your Baby at the Breast - Video - Global Health Media Project

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A beautiful video showing feeding cues, how to attach the baby effectively and much more!

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Good attachment will help a baby get more milk and make breastfeeding more comfortable. This video shows why good attachment is so important to breastfeeding success and what a mother can do to deeply attach her baby to her breast.

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Attaching Your Baby at the Breast - Video - Global Health Media Project

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Good attachment will help a baby get more milk and make breastfeeding more comfortable. This video shows why good attachment is so important to breastfeeding

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If your baby passes normal wet and dirty nappies then you know they are drinking well. If your baby does less or no wet/dirty nappies speak with your midwife.

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If your baby passes normal wet and dirty nappies then you know they are drinking well. If your baby does less or no wet/dirty nappies speak with your community midwife/hospital.

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How to know your baby is Breastfeeding well

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How to know your baby is Breastfeeding well

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A baby who is not feeding well will also pass less or no wet/dirty nappies. See the tab below for normal wet and dirty nappies.

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Information on how to know your baby is taking enough, effective latch, vitamin d for babies and helplines

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Advice on sterilisation, only first infant formula and paced feed with a bottle to avoid dribbling, wind and choking

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The Lived Experience - Breastfeeding a baby with Down syndrome

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The lived experience: positive about Down's syndrome

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The lived experience: positive about Down's syndrome

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Here are some real life stories of breastfeeding a baby with Down's syndrome

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The Lived Experience - Breastfeeding a baby with Down syndrome

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Down's Syndrome and Breastfeeding - The Breastfeeding Network

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Tips to breastfeed a baby with Down's syndrome

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Note in the picture babies could be sat more upright to allow their head to tilt back 👌

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We rely on the generosity of our members and supporters to fund our work. Every penny we receive goes to wherever the need is greatest.

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Note in the picture babies could be sat more upright to allow their head to tilt back👌

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

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Feeding your baby on the neonatal unit can be different to what you had planned, but you can still find the best way of feeding for you and your baby. Find out more here.

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Includes information on expressing when you have a preterm baby

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Feeding your baby on the neonatal unit can be different to what you had planned, but you can still find the best way of feeding for you and your baby. Find out more here.

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Infant milks for parents & carers - First Steps Nutrition Trust

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A simple guide on infant formula

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Infant milks for parents & carers — First Steps Nutrition Trust

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

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The Breastfeeding Network | Independent Breastfeeding Support

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The Breastfeeding Network (BfN) is an independent source of support and information for breastfeeding women and others.

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Research-based information on baby sleep for parents and practitioners, covering normal infant sleep, sleep safety, where and how babies sleep, SIDS and SUDI, parental sleep and free resources.