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💤Current guidance recommends infants remain in a room with a parent for all sleep until 6 months.

💤Safe sleep research recommends that babies sleep on a clear, firm, flat surface, on their back and with no blankets, pillows or soft toys in their sleep space.

💤If you would like to co sleep, this can be done safely by following the Safe Sleep 7.

💤Whilst research is still only in its first stages, initial evidence suggests sleep training (methods such as cry it out, graduated extinction or self soothing) can lead to sustained increased stress levels for babies. The long lasting effects of this are as yet unknown and as a result these methods are not recommended by professional health bodies.

You can find and read the guidance at the links below:

https://www.nhs.uk/conditions/baby/caring-for-a-newborn/helping-your-baby-to-sleep/

https://www.lullabytrust.org.uk/safer-sleep-advice/

https://www.basisonline.org.uk/sleep-training-research/

https://www.basisonline.org.uk/things-to-consider-potential-costs-of-sleep-training/

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Free to download app from The Red Cross with lots of resources and links for child health;

Android: https://play.google.com/store/apps/details...

Apple:

https://apps.apple.com/.../baby-and-child.../id646471621

Additional weblink for those without app access: https://www.redcross.org.uk/.../learn-first-aid-for...

https://www.nhs.uk/conditions/baby/first-aid-and-safety/

https://www.sja.org.uk/.../how-to-do-cpr-on-a-baby/...

.

https://www.nct.org.uk/local-activities.../baby-first-aid

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This is a PDF download for the Little Orange Book, a compilation document of common childhood illnesses and injuries (birth to 5 years) and their appropriate treatments. It also includes indicators for when you should call NHS 111, your GP or 999.

The Little Orange Book

https://www.stockportmedicalgroup.nhs.uk/.../poorly.../...

.

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If You Think Baby Could Be Seriously Unwell

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If You Think Baby Could Be Seriously Unwell

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Things to asses if you think your baby could be seriously unwell;

Temperature*

Breathing*

Skin colour

Drowsy or hard to wake

Inconsolable crying

Vomiting

Dry nappies

Not feeding as normal

* There are multiple things to look for in these categories, please see more specific info here https://www.nhs.uk/.../is-your-baby-or-toddler-seriously.../

Where to get help;

During the daytime in the week call your GP

Evenings and weekends call NHS 111

Under 6 months phone assessment may not be suitable so Out of Hours GP, Urgent Care or A&E may be more appropriate

CALL AN AMBULANCE IF;

Baby stops breathing

Baby will not wake up

Has a spotty, purple or red rash that does not disappear when pressed against with a glass

Has a febrile seizure (fit) for the first time, even if they appear to recover

Has a severe allergic reaction (anaphylaxis)

May have been seriously injured

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When do babies start teething?

Some babies are born with their first teeth. Others start teething before they are 4 months old, and some after 12 months. But most babies start teething at around 6 months.

Teething symptoms

Baby teeth sometimes emerge with no pain or discomfort at all.

At other times, you may notice:

their gum is sore and red where the tooth is coming through

they have a mild temperature of less than 38C

they have 1 flushed cheek

they have a rash on their face

they're rubbing their ear

they're dribbling more than usual

they're gnawing and chewing on things a lot

they're more fretful than usual

they're not sleeping very well

Things you can do to help

Teething toys - teething toys can be given as something baby can chew safely. They can be used from birth and can be cooled in the fridge for additional relief.

Paracetamol and ibuprofen can be given once baby is over 12 weeks (do not give children under 16 years aspirin)

From 6 months soft foods such as melon, or foods with a large solid surface such as a mango pit can be given as a natural teether

Teething gels - there is a lack of evidence to suggest teething gels are effective and natural remedies are suggested before teething gel is given. If you do decide to use teething gel, ensure you are using an infant specific gel.

Teething powders and granules can be used from 12 weeks.

Other remedies - a damp cloth or metal spoon can be given after being cooled in the fridge as an alternative teething toy.

Never put teething toys in the freezer, or give frozen foods that may come into direct contact with baby's gums. This can cause freezer burn to the gums and can cause significant pain and blistering.

Giving frozen breastmilk isn't recommended before 6 months. If you choose to give it once baby reaches 6 months, ensure it is given inside a silicone feeder or similar to avoid freezer burn on baby's gums.

Caring for baby's teeth

Register baby with a dentist and make their first appointment as soon as their first tooth comes through. You should also begin brushing with a flouride toothpaste as soon as their first tooth breaks through.

https://www.nhs.uk/.../teething/baby-teething-symptoms/

https://www.nhs.uk/.../tips-for-helping-your-teething-baby/

https://www.nhs.uk/.../looking-after-your-babys-teeth/

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A normal temperature in babies and children is about 36.4°C, but this can vary slightly. A high temperature or fever is usually considered to be a temperature of 38°C or above.

To take your child's temperature:

Hold them comfortably on your knee and put the thermometer in their armpit – always use the thermometer in the armpit with children under 5 years.

Gently, but firmly, hold their arm against their body to keep the thermometer in place for however long it says in the manufacturer's instructions – usually about 15 seconds. Some digital thermometers beep when they're ready.

The display on the thermometer will then show your child's temperature.

There are a few things that can slightly alter the reading – for example, if your child has been:

wrapped up tightly in a blanket

in a very warm room

very active

cuddling a hot water bottle

wearing a lot of clothes

having a bath

If this is the case, allow them to cool down for a few minutes, but do not let them get cold or shivery, then take their temperature again to see if there's any change.

Types of thermometers;

Digital thermometers - these allow you to take a temperature reading from under the armpit and are most accurate in children and young babies

In-ear (tympanic) thermometers – these allow you to take a temperature reading from the ear and are quick but expensive; they can give misleading readings if you do not put them in the ear correctly, which is more likely to happen with babies because their ear holes are so small

Strip-type thermometers – these are held against the forehead and are not an accurate way of taking a temperature. They show the temperature of the skin, rather than the body

You should never use an old-fashioned glass thermometer containing mercury. These can break, releasing small splinters of glass and highly poisonous mercury. They're no longer used in hospitals and you cannot buy them in shops.

If your child is exposed to mercury, get medical advice immediately.

https://www.nhs.uk/.../how-to-take-your-babys.../...

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Go to A&E if baby has;

Hit their head AND

Been knocked out but have now woken up

Vomited (been sick) since the injury

A headache that does not go away with painkillers

A change in behaviour, like being more irritable or losing interest in things around you (especially in children under 5)

Been crying more than usual (especially in babies and young children)

Problems with memory

A blood clotting disorder (like haemophilia) or you take medicine to thin your blood

Had brain surgery in the past

Your child could have concussion. Symptoms usually start within 24 hours, but sometimes may not appear for up to 3 weeks.

CALL 999 FOR AN AMBULANCE IF;

Baby hit their head AND

Been knocked out and has not woken up

Difficulty staying awake or keeping their eyes open

Has a fit (seizure)

Fallen from a height more than 1 metre or 5 stairs*

Problems with their vision or hearing

Has a black eye without direct injury to the eye

Has clear fluid coming from their ears or nose

Is bleeding from their ears or has bruising behind their ears

Numbness or weakness in part of their body

Problems with walking, balance, understanding, speaking or writing

Hit their head at speed, such as in a car crash, being hit by a car or bike or a diving accident

A head wound with something inside it or a dent to the head

Also call 999 if you cannot get to A&E safely.

* Recent advice given via NHS 111 was to visit A&E if baby falls from a height longer than their own length of they measure less than 1m tall - ie. if baby is 57cm long and falls more than 57cm visit A&E - as there may well be underlying injuries such as fractures that can be asymptomatic.

https://www.nhs.uk/conditions/head-injury-and-concussion/

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Signs of dehydration in a baby may include:

a sunken soft spot (fontanelle) on top of their head

sunken eyes

few or no tears when they cry

not having many wet nappies

being drowsy or irritable

When to call 111:

Your child seems drowsy

Your child seems confused and disorientated

Dark yellow pee or your baby has fewer wet nappies

Your baby is breathing quickly or has a fast heart rate

Your baby or child has few or no tears when they cry

Your baby has a soft spot on their head that sinks inwards (sunken fontanelle)

These can be signs of serious dehydration that need urgent treatment.

https://www.nhs.uk/conditions/dehydration/

The Capillary Refill Test (CRT) should be used by a medical professional as part of baby's assessment. If you notice this has not been done, you can ask your health care professional to do one, it should look something like as follows;

Use the finger as the preferred measurement site.

Press for 5 seconds using moderate pressure.

Ideally, measure at room temperature (20–25°C) irrespective of the child’s body temperature. Allow time for skin temperature to acclimatise if the child has recently been moved from a warmer or colder environment.

Use a timer (for example, a watch) to count the seconds it takes for the finger to regain its original colour.

An abnormal CRT in infants and children over 7 days of age is 3 seconds or more; a normal CRT is 2 seconds or less. A CRT measurement of between 2 and 3 seconds may be considered ‘borderline abnormal’, but some healthy children may have CRT as long as 2.5 seconds.

IT IS IMPORTANT THIS IS CARRIED OUT BY A HEALTHCARE PROFESSIONAL AND NOT DONE YOURSELF DUE TO VARIENCES IN BODILY LOCATION AND REFILL TIME BEING EASILY MISINTERPRETED

https://bjgp.org/content/66/652/587

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Perinatal mental health (PMH) problems are those which occur during pregnancy or in the first year following the birth of a child. Perinatal mental illness affects up to 27% of new and expectant mums and covers a wide range of conditions.

If left untreated, mental health issues can have significant and long-lasting effects on the woman, the child, and the wider family.

Postnatal Depression (PND):

It's a common problem, affecting more than 1 in every 10 women within a year of giving birth. It can also affect fathers and partners

Signs that you or someone you know might be depressed include:

A persistent feeling of sadness and low mood

Lack of enjoyment and loss of interest in the wider world

Lack of energy and feeling tired all the time

Trouble sleeping at night and feeling sleepy during the day

Finding it difficult to look after yourself and your baby

Withdrawing from contact with other people

Problems concentrating and making decisions

Frightening or intrusive thoughts – for example, about hurting your baby

Many women do not realise they have postnatal depression because it can develop gradually

https://www.nhs.uk/.../post-natal-depression/overview/

Postnatal Anxiety (PNA):

Lots of people are aware that you can become depressed after having a baby. But many people also experience anxiety during pregnancy and after giving birth. In fact, it is common to experience depression and anxiety together.

Signs and symptoms of PNA;

Effects on your body:

a churning feeling in your stomach

feeling light-headed or dizzy

pins and needles

feeling restless or unable to sit still

headaches, backache or other aches and pains

faster breathing

a fast, thumping or irregular heartbeat

sweating or hot flushes

finding it hard to sleep, even when you have the chance

grinding your teeth, especially at night

nausea (feeling sick)

needing the toilet more or less often

changes in your sex drive

having panic attacks.

Effects on your mind;

feeling tense, nervous or unable to relax

having a sense of dread, or fearing the worst

feeling like the world is speeding up or slowing down

feeling like other people can see you're anxious and are looking at you

feeling like you can't stop worrying, or that bad things will happen if you stop worrying

worrying about anxiety itself, for example worrying about when panic attacks might happen

wanting lots of reassurance from other people or worrying that people are angry or upset with you

worrying that you're losing touch with reality

worrying a lot about things that might happen in the future

rumination – thinking a lot about bad experiences, or thinking over a situation again and again

depersonalisation – feeling disconnected from your mind or body, or like you're watching someone else (this is a type of dissociation)

derealisation – feeling disconnected from the world around you, or like the world isn't real (this is a type of dissociation).

Treatment options for PND and PNA include;

Self-help – things you can try yourself include talking to your family and friends about your feelings and what they can do to help, making time for yourself to do things you enjoy, resting whenever you get the chance, getting as much sleep as you can at night, exercising regularly, and eating a healthy diet

Talking therapy – a GP may be able to recommend a self-help course or may refer you for a course of therapy, such as cognitive behavioural therapy (CBT)

Medication/antidepressants – these may be recommended if your depression is more severe or other treatments have not helped; your doctor can prescribe a medicine that's safe to take while breastfeeding (please see the fact sheet link in the breastfeeding guide)

https://www.england.nhs.uk/mental-health/perinatal/

https://maternalmentalhealthalliance.org/

https://www.rcpsych.ac.uk/.../menta.../post-natal-depression

https://www.mind.org.uk/.../postnatal.../perinatal-anxiety/

https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.centreformentalhealth.org.uk/sites/default/files/publication/download/CentreforMH_MaternalMHBriefing_3.pdf&ved=2ahUKEwiw-q2PrI-CAxVsWEEAHbEZD904ChAWegQIBxAB&usg=AOvVaw1DJgedgWViWfR9zpJRdM_2

https://pandasfoundation.org.uk/

https://www.mums-aid.org/

https://www.help4mums.co.uk/the-big-mental-health-charities

https://mothersformothers.co.uk/

Instagram pages;

https://instagram.com/maternalmentalhealthwellbeing?igshid=MzRlODBiNWFlZA==

https://instagram.com/the_postpartum_therapist?igshid=MzRlODBiNWFlZA==

https://instagram.com/mmhalliance?igshid=MzRlODBiNWFlZA==

https://instagram.com/mindcharity?igshid=MzRlODBiNWFlZA==

https://instagram.com/parenthoodinmind?igshid=MzRlODBiNWFlZA==

https://instagram.com/natashawilliamspsychotherapy?igshid=MzRlODBiNWFlZA==

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Signs Your Baby is Well Attached and Getting Enough Milk

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Signs Your Baby is Well Attached and Getting Enough Milk

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Signs your baby is well attached;

👶🏼 Your baby has a wide mouth and a large mouthful of breast.
👶🏼 Your baby's chin is touching your breast, their lower lip is rolled down (you can't always see this) and their nose isn't squashed against your breast.
👶🏼 You don't feel any pain in your breasts or nipples when your baby is feeding, although the first few sucks may feel strong.
👶🏼 You can see more of the dark skin around your nipple (areola) above your baby's top lip than below their bottom lip (this will be dependent on your areola size).

Signs your baby is getting enough milk:

✨ Your baby starts feeds with a few rapid sucks followed by long, rhythmic sucks and swallows with occasional pauses.
✨ You can hear and see your baby swallowing.
✨ Your baby's cheeks stay rounded, not hollow, during sucking.
✨ They seem calm and relaxed during feeds.
✨ Your baby comes off the breast on their own at the end of feeds, or fall asleep doing non-nutritive suckling (flutter suckling)
✨ Their mouth looks moist after feeds.
✨ Your baby appears content and satisfied after most feeds.
✨ Your breasts feel softer after feeds.
✨ Your nipple looks more or less the same after feeds – not flattened, pinched or white.
✨ You may feel sleepy and relaxed after feeds.

Other signs your baby is feeding well:

✅ Your baby gains weight steadily after the first 2 weeks – it's normal for babies to lose some of their birth weight in the first 2 weeks.
✅ They appear healthy, active and alert when they're awake.
✅ From the fourth day, they should do at least 2 soft, yellow poos the size of a £2 coin every day for the first few weeks. After 6 weeks it can be normal for breastfed babies to go up to 10 days between poos, this is fine so long as they do not seem uncomfortable or like they are straining.
✅ From day 5 onwards, wet nappies should start to become more frequent, with at least 6 heavy, wet nappies every 24 hours. In the first 48 hours, your baby is likely to have only 2 or 3 wet nappies.

It can be hard to tell if disposable nappies are wet. To get an idea, take an unused nappy and add 2 to 4 tablespoons of water. This will give you an idea of what to look and feel for.

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Common reasons many women incorrectly assume they have a low supply;

💧 Breasts stop feeling 'full' and 'empty' - this is a good and normal stage of breastfeeding. It means your supply has regulated.

💧 Baby is crying, fussing, hitting the breast, repeatedly latching and unlatching, rubbing their face on the breast - these are common stimulation behaviours and are how baby encourages your breasts to meet their demands for milk.

💧 Baby does not want to be put down after feeding - especially in the first 12 weeks, your baby does not realise they are separate from you and will want to remain close to you a lot of the time. A sling or baby carrier can be helpful so you are still able to do daily activities.

💧 Not actively leaking (especially after 6 weeks) or not able to feel a 'letdown' - not all women leak milk, once your supply is well established you may find you no longer leak in between feeds or from the opposite breast during feeds. Some women do not ever feel their letdown, so long as baby is showing signs from the above list in the 'signs your baby is getting enough milk' section there is no cause for concern.

💧 Not able to pump enough/as much as before - pumping is not a reliable indicator of supply and even a hospital grade pump is not as effective as baby at removing milk from the breast.

Things that can indicate a low supply:

👶🏼 Slow or no weight gain - once baby returns to their birth weight they should more or less follow the curve of their centile for weight gain. A plateau or drop in weight gain can indicate a low supply or ineffective milk transfer.

👶🏼 Decrease in nappy output - after day 4 babies should have at least 2 soiled nappies in 24 hours, with poo around the size of a £2 coin, and 6 heavy wet nappies.

👶🏼 Lethargic with no interest in looking at or exploring new things when awake.

If you suspect you have a low supply, seek help from a trained feeding specialist, these include;

💕 a member of the infant feeding team at your local hospital

💕 an IBCLC

💕 a trained breastfeeding peer supporter at an in-person support group

💕 online or over the phone with someone from The National Breastfeeding Helpline

https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/enough-milk/

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Breastmilk works on a supply and demand basis; the more you remove, the more your body produces. Therefore, the most effective way to increase your supply is by removing milk from your breasts, ideally by latching baby, but if this is not possible then by pumping or expressing.

Things to try alongside latching or expressing:

💦 Skin to skin

💦 Warm bath or shower before feeding/expressing

💦 Gentle breast massage before feeding/expressing

💦 Breast compressions during feeding/expressing

Things to avoid:

🚫 Foods advertised as 'lactaion aids' (eg. Cookies, supplement powders, teas etc) - there is no evidence to suggest these are effective

🚫 Fenugreek - this has been shown to decrease supply in many women

Domperidone

This is a prescription medication that can help to increase milk supply in some women, whilst they are taking the tablets. It is not suitable for everyone, e.g. it is not safe for those with certain heart conditions. Because of this, doctors are currently discouraged from prescribing domperidone to anyone. However, the NHS states that domperidone may be appropriate in some cases, such as if baby has required an extended stay in the NICU or if you have been unable to latch baby or pump due to birth complications, so if you would like to try it, it’s worth discussing with your GP, and taking along some information for them to read.

The most important thing to do to increase milk supply is to remove more milk from your breasts, so don’t worry if you can’t or prefer not to take domperidone.

https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2020/04/Unicef-UK-Baby-Friendly-Initiative-education-refresher-sheet-3.pdf&ved=2ahUKEwjH5KTw1ZCCAxWlTEEAHa1wDo0QFnoECAwQBg&usg=AOvVaw0A8K5o89LbTa8ngpxGvn97

https://www.laleche.org.uk/how-to-increase-your-milk-supply/

https://www.laleche.org.uk/my-baby-needs-more-milk/

https://www.nhs.uk/start-for-life/baby/feeding-your-baby/breastfeeding/breastfeeding-challenges/milk-supply/

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The milk-making glands in your breasts are divided up into segments, similar to an orange. Narrow tubes called ducts carry the milk from each segment to your nipple.

If one of the segments is not drained properly during a feed (perhaps because your baby is not attached properly), this can lead to a blocked duct. You may feel a small, tender lump in your breast.

Things that may help include:

🩷 feeding as normal from both breasts

🩷 ice packs or cool compresses can reduce inflammation and swelling

🩷 gentle sweeping massage towards the armpit to help drain excess fluid (not milk), this should be with pressure no greater than you would use to stroke a cat

❌ avoid wearing tight or restrictive clothing or bras

❌ avoid too much heat as this can increase swelling and inflammation

❌ avoid pumping or expressing more than normal - you cannot 'pump out' mastitis and encouraginh your supply can make the swelling worse

Mastitis (inflammation in the breast) happens when a blocked duct is not relieved.

If you do not deal with the early signs of mastitis, it can turn into an infection and you'll need to take antibiotics.

Symptoms of mastitis include:

💥 a breast that feels hot and tender

💥 a red patch of skin that's painful to touch

💥 a general feeling of illness, as if you have flu

💥 feeling achy, tired and tearful

💥 a high temperature

If you think you're developing a blocked duct or mastitis, try the following:

💧 Carry on breastfeeding as normal from both breasts

💧 Check your baby's positioning and attachment. Contact a breastfeeding specialist to watch a feed.

💧 Let your baby feed on the tender breast first.

💧 If the affected breast still feels full after a feed, or your baby cannot feed for some reason, express your milk by hand.

💧 Cool compresses can help reduce swelling and inflammation

💧 Get as much rest as you can. Go to bed if you can.

💧 Take paracetamol or ibuprofen to relieve the pain.

If a mastitis infection is not treated, it can lead to a breast abscess, which may need an operation to drain it.

This can also develop if the mastitis does not respond to frequent feeding plus a course of antibiotics.

❗If you feel seriously unwell, dizzy, confused, develop nausea, vomiting or diarrhoea or slurred speech along with the symptoms of mastitis you need to seek urgent medical attention. These can be signs that mastitis is developing into sepsis. If severe, this is a medical emergency which needs urgent hospital admission and IV antibiotics ❗

https://www.nct.org.uk/baby-toddler/feeding/common-concerns/inflammation-milk-ducts-also-known-blocked-ducts

https://www.nhs.uk/conditions/mastitis/

https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/breast-pain/

https://llli.org/breastfeeding-info/mastitis/

https://www.nhs.uk/conditions/breast-abscess/

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Breastfeeding can continue for as long as both you and baby want to do so (the current WHO recommendation is to 2 years and beyond), however, if you decide you want to stop feeding there are some things to consider that will make the transition easier.

❗Before 12 months it's important that any dropped breastfeeds are replaced with a formula feed to maintain sufficient nutrition alongside weaning onto food from around 6 months, this can be given either by bottle or open cup. You can find information about formula/bottle/cup feeding in the additional posts in the feeding guide❗

✨ Stop feeding gradually with a few days in-between each dropped feed to allow your body time to adjust supply. This will help avoid mastitis and ease and engorgement you may feel. For those who are exclusively breastfeeding this may take a few weeks.

It may also help to spread out the feeds you drop to avoid having all remaining feeds at one end of the day. For example, if you feed 8 times in 24 hours you may choose to drop them in the following order, with a few days adjustment period in between;
Feed 1, feed 5, feed 2, 6, 3, 7, 4 and 8.

Maintaining the last feed as the one before bed can be a nice way to keep the comfort and closeness of breastfeeding for as long as possible as often this last feed of the day is for both comfort and food.
You may choose to keep one or two feeds for a longer period (for example a feed overnight, before bed, or first thing in the morning), or move to combi feeding with both formula in a bottle/cup and breast.

✨ If you feel engorgement after dropping a feed you can gently relieve the fullness with some hand expression, it's best to avoid fully pumping though as this will stop your supply from fully adjusting. Added to this post is an image for self/home help if you begin to experience any symptoms of mastitis or blocked ducts to try and ease it before antibiotics are required.

✨ You may leak for a prolonged period after stopping feeding, particularly if your child becomes upset or you are around babies crying. This is completely normal and it will ease and stop over time but can take months, or sometimes even years, to fully stop.

✨ You may feel down, weepy, emotional or depressed after stopping feeding due to the drop in hormones as milk production stops. Although this can be a difficult thing to experience it is normal for many feeding parents and should ease over a few weeks. If you find the feelings are prolonged or become more intense you may want to seek help from your GP.

You can read more about these feelings and the hormonal changes associated with stopping feeding here;
https://www.laleche.org.uk/after-weaning-what-next/

Other helpful links;

https://www.laleche.org.uk/thinking-of-weaning/

https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding/how-to-stop/

https://www.nct.org.uk/baby-toddler/feeding/practical-tips/how-do-i-stop-breastfeeding

https://kellymom.com/ages/weaning/wean-how/depression-and-weaning/

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The Breastfeeding Network - Drugs in Breastmilk Information Service

The Breastfeeding Network (BfN) has employed pharmacists specifically to compile guidance on various drugs, medications, treatments etc and their safety and usability when breastfeeding.

You can find their Facebook page here
The Breastfeeding Network Drugs in Breastmilk Service

And their website with each guide here
https://www.breastfeedingnetwork.org.uk/drugs-factsheets/

If you are unable to find the information you are looking for on the website, or you still have questions, you can contact the team by sending a private message via their Facebook page or via email (druginformation@breastfeedingnetwork.org.uk). Please provide as much information as possible (age of baby, dose, frequency and name of medication or drug). All enquiries are answered as soon as possible by a registered pharmacist volunteers. In an emergency situation, please do not wait for a reply, but access help from a trained healthcare professional.

The guides currently cover the following topics and can all be viewed either online or downloaded as a pdf.

Alcohol
Anaesthetics
Antibiotics
Anticoagulants
Antidepressants
Antihistamines
Anxiety
Asthma
Beauty Treatments
Bipolar Disorder
Caesarian Section
Chickenpox
Codeine
Colonoscopy
Computed Tomography (CT) Scans
Constipation
Contraception
Cough and Cold Remedies
COVID
Cow's Milk Protein Allergy (CMPA)
Cracked Nipples and Moist Wound Healing
Creams and Ointments applied to the skin
Cystitis
Day Surgery
Decongestants
Dental Sedation
Dental Treatments
Depression
Diarrhoea (acute)
Differential Diagnosis of Breast Pain
Domperidone
Ectopic Pregnancy
Eczema
Emergency Hormonal Contraception
Endoscopy
Eye Infections
Flu Injections
Foot Problems
Haemorrhoid (piles) and Anal Fissure Treatment
Hayfever
Headlice Treatment
Herbal Medication
Indigestion
Influenza
Irritable Bowel Syndrome (IBS)
IVF/Fertility Drugs
Lactose Intolerance
Local Anaesthetics
Measles Vaccine
Miconazole gel and Oral Thrush
Migraines
MRI Scans
Obsessive Compulsive Disorder (OCD)
Painkillers/Analgesics
Podiatry - local anaesthetics
Prednisolone
Raised Cholesterol
Reynauds Phenomenon
Reflux
Shingles
Silicone Breast Implants
Smoking and Smoking Cessation
Sore Throats
Steroid Injections
Threadworms Treatment
Thrush (or the breast/nipple)
Thyroid Medication (under and over active)
Travel Sickness
Vaccinations
Vaginal Thrush
Vitamin D
Vomiting
Whooping Cough (pertussis) vaccine
X-rays

# data[].attributes.body
https://www.breastfeedingnetwork.org.uk/

https://www.laleche.org.uk/

https://abm.me.uk/

https://www.nationalbreastfeedinghelpline.org.uk/

https://maddiesmiracle.org.uk/

https://www.familiesandbabies.org.uk/?fbclid=IwAR2ExMY6IvlkhdhM7MCObxIS69BU8iQQNip_reK9LgPgTH_FXkCq4A7R_Hg

Facebook Pages and Groups

https://www.facebook.com/NationalBreastfeedingHelpline

https://www.facebook.com/LucyWebberIBCLC

https://www.facebook.com/groups/BFYummyMummy/?ref=share

https://www.facebook.com/groups/bflsuk/?ref=share

https://www.facebook.com/TheBreastfeedingNetworkUK

https://www.facebook.com/BreastfeedingNetworkDrugsInBreastmilk

https://www.facebook.com/lalecheleagueinternational

https://www.facebook.com/AssocBfMothers

https://www.facebook.com/groups/breastfeedingwithCMPA/?ref=share

https://www.facebook.com/groups/1488142001470120/?ref=share

https://www.facebook.com/groups/1490285441069342/?ref=share

Instagram pages

https://instagram.com/lucywebberfeedingsupport_ibclc?igshid=MzRlODBiNWFlZA==

https://instagram.com/lucy.ruddle.ibclc?igshid=MzRlODBiNWFlZA==

https://instagram.com/thebreastfeedingnetworkuk?igshid=MzRlODBiNWFlZA==

https://instagram.com/thebreastfeedingmentor?igshid=MzRlODBiNWFlZA==

https://instagram.com/lyndsey_hookway?igshid=MzRlODBiNWFlZA==

https://instagram.com/kathrynstaggibclc?igshid=MzRlODBiNWFlZA==

https://instagram.com/the_breastfeeding_wardrobe?igshid=MzRlODBiNWFlZA==

https://instagram.com/thelactationcorner?igshid=MzRlODBiNWFlZA==

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🍴Current guidance and research states "There are 3 clear signs, which, when they appear together from around 6 months of age, show that your baby is ready for their first solid foods, alongside breast milk or first infant formula."
(NHS Start for Life)
These signs are;
👌🏻 Can sit with good trunk and head control with minimal support
👌🏻 Can coordinate hands to pick up and bring food to their mouth
👌🏻 Have lost 'tongue thrust' reaction so are able to swallow food rather than spit or push it out with their tongue

🍴Unless explicitly advised by a dietician or infant nutritionist, early weaning (before 6 months) can lead to gastrointestinal issues later in life, such as coeliac disease and IBS, in addition to an increased risk of excess weight gain, allergies and intolerances, eczema and asthma.

🍴Baby Led Weaning (BLW) is a relatively new approach to weaning and was officially coined by UK nurse Gill Rapley. While there is little research available due to how new the approach is, available research shows there is no more of a risk of choking with BLW than with traditional puree weaning. Studies indicate that there is a decrease in the risk of choking in older babies where BLW has been followed from the start of weaning, it is suggested that this is due to an increase in oral control in those babies who followed a BLW approach from the beginning.

🍴Foods to avoid during weaning;
- Honey
- Added salt and sugar
- Whole nuts
- Marshmallows
- Popcorn
- Excess saturated fat
- Mould-ripened or blue veined cheeses such as brie, camembert or roquefort
- Raw or undercooked eggs
- Rice milk
- Raw jelly cubes
- Raw shellfish
- Shark, marlin or swordfish

You can read more information about weaning at the links below;

https://www.nhs.uk/start-for-life/baby/weaning/how-to-start-weaning-your-baby/

https://www.drianhayltd.com/post/weaning-before-6-months

https://solidstarts.com/readiness/ (American guidance but contains relevant research)

https://www.nhs.uk/start-for-life/baby/weaning/what-to-feed-your-baby/from-around-6-months/

https://solidstarts.com/baby-led-weaning/ (American research but the most recent and relevant study)

https://www.nhs.uk/conditions/baby/weaning-and-feeding/foods-to-avoid-giving-babies-and-young-children/

https://m.youtube.com/watch?si=42gNCxexEewVBhcf&fbclid=IwAR0kE0_wsbWSZe3ZKcWpUG08e2JIRtQMPUyujMdiQFDzzu7P2wwAgGENLZY&v=Fj9pKYiWxMU&feature=youtu.be

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Common allergens include:

🛑 Cow’s milk e.g. cow’s milk, yoghurts, butter, most margarines, cakes and biscuits made with cow’s milk or butter, baby jars or packet food containing milk as an ingredient.
🛑 Gluten containing cereals including wheat, barley and rye. e.g. breads, biscuits (these may also contain cow’s milk), pasta, breakfast cereals, gravies or sauces thickened with wheat flour.
🛑 Eggs e.g. eggs, quiche (will also contain cow’s milk and wheat), some mayonnaises, baked egg in cakes. Under a year old (unless the egg is stamped with a Lion mark) eggs must be provided fully cooked.
🛑 Fish e.g. all kinds of fish such as tuna, cod, salmon etc. or shellfish such as crab, lobster, prawns, shrimps.
🛑 Soya products e.g. soya yoghurts or puddings, soya flour (found in most kinds of bread), soya cheese.
🛑 Nuts e.g. smooth peanut butter/ nut butters, ground nuts. Whole nuts should not be given to children under the age of 5 due to the risk of choking.
🛑 Sesame e.g hummus and tahini.

If your baby has already been found to be allergic to a food e.g. cow’s milk, soya, we would suggest some extra guidelines when you introduce some other foods.
Avoid the food that you already know your baby is allergic to. For example, if your baby has reacted to cow’s milk, do not give any foods containing cow’s milk.
Your dietitian will give you more information on how to do this.

https://www.mkuh.nhs.uk/patient-information-leaflet/weaning-a-baby-with-a-food-allergy-intolerance

Evidence has shown that delaying the introduction of peanut and hen's eggs beyond 6 to 12 months may increase the risk of developing an allergy to these foods.

How to tell if your child has a food allergy:
Allergic reactions usually happen quickly within a few minutes of exposure to an allergen.

They can cause:

❗sneezing
❗a runny or blocked nose
❗red, itchy, watery eyes
❗wheezing and coughing
❗a red, itchy rash
❗worsening of asthma or eczema symptoms

Most allergic reactions are mild, but occasionally a severe reaction called anaphylaxis or anaphylactic shock can occur. This is a medical emergency and needs urgent treatment - call 999.

https://www.nhs.uk/conditions/baby/weaning-and-feeding/food-allergies-in-babies-and-young-children/

Links and resources:
https://www.allergyuk.org/resources/weaning-support-pack/

https://www.nhs.uk/start-for-life/baby/weaning/safe-weaning/food-allergies/

https://www.anaphylaxis.org.uk/living-with-serious-allergies/infant-weaning/

https://www.nct.org.uk/baby-toddler/your-babys-health/what-watch-out-for/food-intolerances-babies

https://www.google.com/amp/s/www.thechildrensdietitian.co.uk/blog/introducing-common-food-allergens-safely-during-weaning?format=amp

https://www.food.gov.uk/research/food-allergy-and-intolerance-research/eat-study-early-introduction-of-allergenic-foods-to-induce-tolerance

https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.bsaci.org/wp-content/uploads/2020/02/pdf_Early-feeding-guidance-for-HCPs-2.pdf&ved=2ahUKEwjol8fOso-CAxUkW0EAHWZxDAQ4FBAWegQIBRAB&usg=AOvVaw0tEemaLyZ7S5sllqGfFd76

Instagram pages:

CMPA Parents Together -
https://instagram.com/cmpa_parents_together?igshid=OGQ5ZDc2ODk2ZA==

The Dairy Free Kids -
https://instagram.com/thedairyfreekids?igshid=OGQ5ZDc2ODk2ZA==

The Allergy Mum's Club -
https://instagram.com/allergymumsclub?igshid=OGQ5ZDc2ODk2ZA==

# data[].attributes.body
https://www.aims.org.uk/general/rights

https://birthrights.org.uk/factsheets/

https://www.gov.uk/browse/childcare-parenting/pregnancy-birth

https://maternityaction.org.uk/know-your-rights/

https://www.themindfulbirthgroup.com/parents/blog/exploring-free-birth-unassisted-birth-in-the-uk/

https://www.acas.org.uk/your-maternity-leave-pay-and-other-rights

https://pregnantthenscrewed.com/

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Where You Deliver

There are several options to choose from depending on your location and the services available in your area. Options include:

Labour ward of your local hospital - access to all pain relief options, immediate access to theatre and consultants/obstetricians.

Midwife Led Unit (MLU) in your local hospital - Midwife led care, a more hands-off approach, access to most pian relief options including a birthing pool, usually located next to the labour Ward for quick access to theatre in an emergency.

Birth Centre - Similar to an MLU but often a stand alone unit, access to most pain relief options including a birthing pool, may require a hospital transfer in case of emergency

At home - The least medicalised option, access to a birthing pool, gas & air, pethidine or diamorphine, may require a hospital transfer in case of emergency

--------------------------------------------

Induction

There are very few scenarios in which induction is medically necessary. Inductions are routinely offered to all pregnant women who reach 40 weeks gestation, however, you are under no obligation to accept.

Types of induction you may be offered;

Membrane Sweep (AKA stretch & sweep) - involves the insertion of gloved fingers into the vagina and through the cervix where a sweeping motion is made to attempt to separate the membranes and induce labour.

Propess Pessary - involves the insertion of a vaginal pessary attached to a string (much like a tampon) which remains in place for 24 hours, releasing synthetic hormones to encourage labour to start.

Prostin Gel - involves the insertion of a gel into the back of the vagina which releases synthetic hormones over 6 hours. Usually multiple doses are required.

Balloon Catheter - involves the insertion of a small plastic balloon into the cervix which is then filled with saline solution to manually inflate the balloon and stretch the cervix. It will be left in place for several hours to manually encourage dilation.

Osmotic dilator (AKA cervical rods) - involves the insertion of thin rods into the vagina and through the cervix, these absorb fluid from surrounding tissue with the aim of softening the cervix. They will be left in place for several hours.

Artificial Rupture of Membranes (AKA breaking of waters) - involves the insertion of a small hook-ended tool into the vagina and through the cervix which is used to attempt to create a hole in the membranes surrounding baby.

IV Drip - involves the administration of artificial oxytocin via a drip in the arm. This makes the uterus contract frequently and strongly.

Additional information can be found here: https://www.tommys.org/pregnancy-information/giving-birth/inducing-labour/what-happens-during-induction-labour

--------------------------------------------

Pain Relief

There are many options for pain relief in labour, both medical and non-medical. As with all labour and birth care, any medical options require informed consent prior to administering.

Non-Medical options:

TENS Machine - a mild electrical current transmitted through pads placed on the skin.

Water - a birthing pool, shower or bath. Warm water can soothe pain and accommodate multiple birthing positions.

Birthing Comb - utilising acupressure points in the hand by squeezing a wooden comb during surges.

Visualisation & Breathing Techniques (Hypnobirthing) - using self hypnosis to enter a state of deep relaxation. Breathing techniques used to remain calm and ride through surges.

Movement and Positioning - allowing your body to move naturally and remaining gently active and upright during labour can ease discomfort.

Aromatherapy, Acupressure, Massage, Reflexology - there are many benefits to holistic medicine approaches to managing pain during labour.

Medical options:

Entonox (Gas & Air) - a combination of oxygen and nitrous oxide gases which are breathed through a mouthpiece during surges. It has a short effect and does not cross the placenta, it can be used for the duration of labour and birth.

Painkillers (Opiod Drugs) - Pethidine, diamorphine and meptid given by injection into the thigh. Some hospitals offer remifentanil, a strong, short-acting painkiller given via a drip that you can control yourself using a machine.

Epidural - Epidural analgesia is a local anaesthetic injected into the space between two spinal vertebra. It usually removes all pain and most feeling from the waist down.

The combined spinal epidural (CSE) injection contains a low dose of pain-relieving drugs and works more quickly than an epidural alone.

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Pregnancy & Birth podcasts
The Midwives Cauldron
Evidence Based Birth Podcast
The Great Birth Rebellion
The Better Birth Podcast
28ish Days Later
The Birth-Ed Podcast
Makes Milk
Tipping The Balance
The Obs Pod
The Birth Activists
When Push Comes to Shove
The Birth Hour
Pinter & Martin Radio (24h station)
Rockstar Birth Radio
Taking Back Birth
The Birthful Podcast
Midwife Pip Podcast

Parenting podcasts
Dadvengers
Music, Football and Fatherhood
Happy mum, Happy baby
The Longest Shortest Time
Mindful Mama podcast
Motherhood Sessions
Positive Parenting podcast
The Motherkind Podcast
Dr Becky's The Good Inside
Crib Notes - Things Parents Google at 3am
Scummy Mummies
The Parent Hood
Not Another Mummy Podcast
Growing Paynes
NewlyDads
Blended
SEND Parenting
Raising Mums

# data[].attributes.body
https://evidencebasedbirth.com/ebb-113-the-evidence-on-vbac/

https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70406

https://www.sarawickham.com/tag/vbac/

https://www.rachelreed.website/blog/vbac

https://themidwivescauldron.buzzsprout.com/1178486/episodes/10779155-vbac-vaginal-birth-after-caesarean-an-interview-with-dr-hazel-keedle

https://www.thevbaclink.com/top-10-podcast-episodes-to-help-you-vbac/

https://www.thevbaclink.com/blog/

https://open.spotify.com/show/1JWTixw8ipdduCl0jn146z

https://www.melaniethemidwife.com/podcasts/the-great-birth-rebellion/episodes/2148668424