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Breastfeeding Reflux Stomach Acid & Gut Bugs | Carol Smyth

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A few weeks ago I wrote an article on reflux and breastfeeding, and the need to look for a cause for reflux in your breastfed baby. This is a companion article to that one, looking at the role of stomach acid in our bodies. It seems that reflux is so frequently diagnosed (and often misdiagnosed) and acid suppressing drugs are now so prevalent that acid itself is being seen as an issue by some mums. I wanted to write a little about what stomach acid is, what is does and the relationship between breastfeeding, acid and our gut health. If you haven’t already read the previous blog, please do so as it looks at the NICE guidance regarding acid suppression treatment and root causes of reflux.

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Particularly those babies born by cesarean as the IV fliud the mother is given 2hrs before the baby's birth also goes to the baby.  Meaning they are born with extra fluid that they pee/poo out within the first 24hrs

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When you baby is weight by your Midwife/Health Visitor take a photo of the numbers on the scale, particulalry the baby's birth weight

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If for a parenting decision check that you feel you have got breastfeeding working

Buy the pump that does what you want it to do. Not one a friend recommends or the most expensive

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Comparison of Baby Feeding Methods Workloads

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Comparison of Baby Feeding Methods Workloads

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This is something added to BF rather than part of BF so can be more succesfull if BF has got going.

Avoid using a second hand pump even with new tubing and collection bottles. There is built in obselecence and they are designed for 'one' pumping journey.

Buy a pump that does what you want it to do. Not your friend's recommendation or the most expensive.

Wearable pumps are generally not as effective as traditional pumps

Get fitted to have the correct flange size (trumpet). A correct fit = greater comfort and more milk expressed

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In this post, I delve into the complexities of selecting an appropriate breast pump, emphasizing that the choice should align with your specific needs and circumstances. I discuss various types of pumps, including hospital-grade, personal-use double electric, single electric, manual, and wearable models, highlighting their suitability for different situations. Additionally, I stress the importance of proper flange fitting to ensure comfort and efficiency during pumping sessions. By understanding these factors, you can make an informed decision that best supports your breastfeeding journey.

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Are glass bottles better than plastic bottles?

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Not sure what the best bottle is for your baby? Learn more about glass versus plastic bottles, and other types of baby bottles.

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Baby bottle ranking - straight from the bottle wizard herself! 🍼✨ If your breastfeed baby is refusing the bottle, please do this before you buy every bottle from the store → I wrote a blog post about how to choose the right bottle for exactly this situation. Comment BOTTLE BLOG and I’ll send it over. #bottlerefusal #babybottles #lactationsupport #ibclc | Rachel O’Brien, IBCLC | Facebook

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Baby bottle ranking - straight from the bottle wizard herself! 🍼✨ If your breastfeed baby is refusing the bottle, please do this before you buy every bottle from the store → I wrote a blog post about…

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What to eat and drink - Breastfeeding - Best Start in Life - NHS

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See what food and drink you should try to avoid when breastfeeding.

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This information can also be viewed as a PDF by clicking here.
Breastfeeding mothers can have occasional, small amounts of alcohol but should not drink regularly or heavily (e.g. binge drinking) without considering how to limit the baby's exposure. If you drink any alcohol DO NOT bed share with your baby or fall asleep in the sofa/chair. If you do binge drink, your baby should be cared for by an adult who has not had any alcohol. It is not necessary to express breastmilk to clear it of alcohol.

Never share a bed or sofa with your baby if you have drunk any alcohol. Doing this has an increased association with sudden infant death syndrome (SIDS).

Alcohol passes freely into breastmilk reaching approximately maternal levels BUT maternal blood levels have to reach 300mg/100ml before mild sedation is reached in the baby (this compares with a level of 80mg/100ml needed to fail the police breath test in England, Wales and N. Ireland; 50mg/100ml Scotland.

To reduce exposure of the baby to alcohol, avoid breastfeeding for 2-3 hours after drinking.

Peak levels in the milk appear after 30-90 minutes but this does not mean that social drinking of small amounts of alcohol mean that you cannot breastfeed.

Excess levels of alcohol in milk may lead to drowsiness, deep sleep, weakness and decreased growth in the infant. Reduction of let-down is reported when the mother drinks heavily. Alcohol may reduce the baby's sucking time at the breast but not the volume of milk consumed.

It is not necessary to express breastmilk to clear it of alcohol; as the mother's blood levels fall, the level of alcohol in the breastmilk will decrease.

Binge drinking (more than 6 units of alcohol in one period), may make you less aware of your baby's needs. If you have drunk enough alcohol to make you feel disorientated or cause vomiting you should not be caring for your baby without supervision from a sober adult. You should ideally express for comfort and to maintain your supply - although this may be the last thing on your mind!

Chronic consumption of alcohol is more likely to cause harm than occasional social drinking.

NB It is vital that mothers who have been drinking alcohol should never let themselves be in a situation where they might fall asleep with the baby; on a bed, chair or settee (this would also apply to other carers who have been drinking alcohol). The place of sleep is a bigger risk than the fact that the mother has been drinking unless her consumption has been very high.

Drinking alcohol reduces the ability of the mother to be aware of her baby's needs, whether she is breastfeeding or not. It is safest to ask someone else to care for the baby.

Other websites

NHS Breastfeeding and drinking alcohol. - Your pregnancy and baby guide www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-alcohol/

Guidelines from the NHS

Anything you eat or drink while you're breastfeeding can find its way into your breast milk, and that includes alcohol.

If you regularly drink as much as 14 units per week, it's best to spread your drinking evenly over 3 or more days.

If you wish to cut down the amount you drink, a good way to help achieve this is to have several drink-free days each week.

Fourteen units is equivalent to: 6 pints of average-strength beer, 10 small glasses of low-strength wine

Use Alcohol Change's alcohol calculator to check your units: https://alcoholchange.org.uk/alcohol-facts/interactive-tools/unit-calculator
©Dr Wendy Jones MBE, MRPharmS and the Breastfeeding Network March 2021

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Alcohol and Breastfeeding - The Breastfeeding Network

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This information can also be viewed as a PDF by clicking here. Breastfeeding mothers can have occasional, small amounts of alcohol but should not drink regularly or heavily (e.g. binge drinking) without considering how to limit the baby's exposure. If you drink any alcohol DO NOT bed share with your baby or fall asleep in [...]

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GOLD Learning on Instagram: "Do you know how to properly fit for flange size? Amber Clark brings you this essential info so you can best support families in the NICU who are navigating pumping! Register on the GOLD Neonatal website to access this presentation in our Breastfeeding in the NICU: From Milk to Milestones Lecture Pack.
#GOLDNeonatal2026"

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7 likes, 2 comments - goldlearning on May 25, 2026: "Do you know how to properly fit for flange size? Amber Clark brings you this essential info so you can best support families in the NICU who are navigating pumping! Register on the GOLD Neonatal website to access this presentation in our Breastfeeding in the NICU: From Milk to Milestones Lecture Pack.
#GOLDNeonatal2026". 

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Breastfeeding a Baby with Downs Syndrome

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Breastfeeding a Baby with Downs Syndrome

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A booklet full of information

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Breastfeeding after 12 months and dental decay — Emma Pickett IBCLC

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Continuing to breastfeed after the first few months can bring some challenges. Sadly, one of the biggest struggles can be dealing with the lack of education in wider society. You might imagine that at least parents are safe when talking to those who are medically trained but unfortunately there are

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Feeding the Late Preterm Baby (36+ weeks gestation)

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Feeding the Late Preterm Baby (36+ weeks gestation)

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Measuring for a correct pump flange/funnel fitting

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Measuring for a correct pump flange/funnel fitting

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Remember that babies have to learn the sensation of hunger. Many of these signs are instinctive rather than the baby being hungry.

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Feed Your Way - Making Nottingham a breastfeeding-friendly city

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Feed Your Way - Making Nottingham a breastfeeding-friendly city

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Some people find it difficult or scary to feed their baby when they’re out and about. This is perfectly normal. It’s an experience that every breastfeeding parent goes through. Most of the families we spoke to said that breastfeeding in public gets easier over time.

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13 reactions · 3 comments | ✨Dummies/ Pacifiers✨

They are a tool to soothe. Maybe you want to try using on car journeys or because your baby has reflux (due to maybe oversupply, or a tongue function issue causing aerophagia) and is in a cycle of feeding, refluxing and feeding to soothe but they're screaming at getting more milk. Offering one to calm then removing can give you both a moment to regulate. Or perhaps your baby is having milk via a bottle (formula or breastmilk). 
 
Choosing a pacifier
✖️ Bulb shape keeps posterior tongue down 
✖️ Flattened or "orthodontic" does not encourage cupping of tongue 
✔️ Evenly cylinder shaped ones encourage the tongue to be used more optimally. 

*However your baby's current tongue function may mean that a less optimum shape works better for them. If this is the case really be mindful to keep frequency and duration to a minimum. Soothe and remove* 

Risks: 
 • missing feeding cues (delayed feeds can contribute to weight gain & supply issues)
 •using before breastfeeding is established (often around 4-6 weeks) can impact feeding
 • Disorganised tongue function
 • Impact microbiome due to bacteria/ biofilm forming, be sure to follow cleaning instructions and guidance for replacing every few weeks. [1]
• Using > 6 months can impact oral function/ speech and language development 

Benefits: 
• Research indicates reduces SIDS risk (thought to be due to the sucking action which occurs anyway at breast/ chest feeds of course) 
• Support for baby and mother/ caregivers when caring for an unsettled baby for whom direct feeding is not soothing

Alternatives:
Other non nutrative sucking (NNS) methods.
 •Offer a clean finger to suckle, nail bed facing tongue 
• Offering the non lactating (or low supply) breast/ chest.
Try offering NNS when skin to skin so that they calm on you. This boosts your confidence in settling and gives you both oxytocin boost.

[1] 📘Why Breastfeeding Matters Charlotte Young 

✨Did you use/ are you using a dummy for your little one(s)? ✨

#ibclc #pacifier #dummy #soother #tonguefunction #tonguetie #oralfunction #reflux #breastfeeding #chestfeeding #newborn #infantfeeding #peersupport #bottlefeeding | Naomi Trousdell IBCLC

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✨Dummies/ Pacifiers✨

They are a tool to soothe. Maybe you want to try using on car journeys or because your baby has reflux (due to maybe oversupply, or a tongue function issue causing aerophagia)...

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How a Caesarean Birth Affects the Baby's Weight

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How a Caesarean Birth Affects the Baby's Weight

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Checking your browser before accessing pmc.ncbi.nlm.nih.gov ...

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As part of World Autism Acceptance Week, BfN and National Breastfeeding Helpline Helper Katrona draws on her own experiences to share some information about breastfeeding when you are on the autistic spectrum. The term autistic will be used here instead of a person with autism because many people with autism (including the author) see it as part of who they are and not just something they have and therefore is their preferred term.
Thanks to the media, when people think of autism, they often think of stereotypical autism - male, non-verbal, rocking back and forth or stimming (repetitive movement) or being a savant (having special skills, like Dustin Hoffman in the film Rain Man).

Autism is not an illness, it just means that your brain works in a different way from the general population. It can mean that you have difficulty with social interactions and communication - it is said that up to 93% of communication is through body language, so it can be hard when you are depending on the 7% verbal component to understand what people are meaning when they speak. Sensory issues - your senses are too high or dulled meaning you experience touch, sight, sound too intensely or have trouble recognising and feeling changes in them. Autistic people often like order and certainty in life, have black and white thinking and can find comfort when the world follows logical rules.

Like myself, many females who are diagnosed with autism are diagnosed at a later stage of life instead of childhood, usually after they have had their own children.

So what has this to do with breastfeeding?

Well first of all females can be autistic, have children and breastfeed. Due to diagnosis criteria and the fact that from an early age girls learn to mask (changing your behaviour to fit in to what society deem socially acceptable) instead of a diagnosis of autism they are misdiagnosed with anxiety or depression. This may mean any challenges faced when breastfeeding are not addressed

The challenges faced by autistic breastfeeding mothers vary and can include:
Sensory issues
Feeling "touched out" and "touch overload" being misinterpreted as a feeding aversion.

Interpreting touch as pain or having less sensation of pain and not realising damage is being done to the nipples.
Communication
Phrases like "you are looking for three dirty nappies a day and five wet nappies" - does this mean if my baby is peeing ten times a day or pooping after every feed is it a problem? Vague terms like "some mums may find" and "heavy nappies" can be confusing and cause over worry and anxiety.

Trouble taking in large amounts of instructions at one time or focusing on breastfeeding and reading detailed studies and both cause confusion.
Changes
There is a lot of uncertainly with babies, they don't do what the books say they will, they change their routines and when your life is easier if there is an order to it and predictability, dealing with a new born can be very overwhelming. The lack of sleep and uncertainty can disrupt coping methods and exasperate the effects that autism can have on your life.

These can all be negative when breastfeeding with autism but there are plenty of positives as well. Breastfeeding can cut down on anxiety and worry - there is no need to measure formula out, make sure bottles are properly sterilised. Can help with mother/baby bonding by bringing a sense of normality to the mother, being able to do what neurotypical mothers do, and not feeling so different. Cuts down on sensory overload - the easiest way to settle a crying baby is to stick it on your breast, stops crying instantly, no need to wait for a bottle to be prepared.

Most of the challenges can be overcome or lessened by good communication with health care providers and supporters, thinking about the individual problems and finding new strategies and coping methods to address them. Many autistic women can be very determined, some may say stubborn but they know how much they can deal with and put up with. Understanding this and remembering if goals need to change, like the introduction of formula top ups, can be really upsetting to autistic mums but having research which they can read and study further can really help.

Some simple things like checking communication is going both ways, and finding strategies for coping, no matter how unusual they are can make a big difference to an autistic person's breastfeeding journey.

Some links for more information and support:
The National Breastfeeding Helpline

Breastfeeding mums on the Autistic Spectrum Facebook page
Breastfeeding with a disability Facebook page
The Curly Hair Project
National Autistic Society - Autistic Women & Girls
Share this post:

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Breastfeeding If You Are On The Autistic Spectrum - The Breastfeeding Network

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As part of World Autism Acceptance Week, BfN and National Breastfeeding Helpline Helper Katrona draws on her own experiences to share some information about breastfeeding when you are on the autistic spectrum. The term autistic will be used here instead of a person with autism because many people with autism (including the author) see it [...]

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Burping may lead to increased spit up

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I found burping my babies to be highly satisfying. A little jiggle, a little pat, and suddenly, a big, funny jolt of air comes flying out of a tiny, floppy baby. There's lots of burping methods - the over-the-shoulder jiggle, the propped-up-on-the-lap pat, even the face-down-on-the-knees position - and they all lead to this amusing outcome.

I will not weigh in on burping methodology here. Instead, I am going to back up a step further. At the risk of losing all credibility with grandmas, I am prepared to argue that you might not need to burp your baby at all. Despite the immense joy and amusement burping brings, there's scant scientific evidence that burping after meals actually does anything helpful for babies.

Researcher and mother Bhavneet Bharti found it challenging to burp her infant after every single feeding, particularly at night. "Similarly, I heard stories of many more exhausted mothers and other caregivers spending hours patting their babies in the middle of the night, trying to wait for the elusive sound of the burp," says Bharti, of the Postgraduate Institute of Medical Education and Research in Chandigarh, India. She looked for studies that supported this age-old practice. To her surprise, she found none.

That led her and her colleagues to put this common practice to the test. The researchers enrolled 71 mother-newborn pairs. Half of the mothers received advice about immunizations, breastfeeding and other health issues, but none about burping. The other half of the mothers was instructed on how to burp their babies. Over the next three months, the moms kept track of their babies' colic episodes (excessive crying, inconsolability or other signs of discomfort) and spit-ups, tallying each event every 24 hours.

The results, published in Child: Care, Health and Development in 2015, were striking: Burped babies didn't cry less than ones that weren't burped. And the burped babies actually spit up more: They spit up about eight times a week, on average, compared with 3.7 times a week for unburped babes.

That's an interesting result, given how entrenched burping advice is. The American Academy of Pediatrics advises parents to burp their babies, as do many other doctors, nurses, lactation consultants and parenting websites. Yet the recommendation isn't particularly rooted in evidence. Bharti's study "is a clever and well-done study of a 'wellness practice' that many people take for granted, but - as I would certainly agree with the authors - has rarely, if ever, been truly shown to have benefits," says Jenifer Lightdale, a pediatric gastroenterologist who specializes in fussy infants and reflux at theUniversity of Massachusetts Medical School in Worcester.

Babies can appear to be uncomfortable as they're trying to burp spontaneously. Scrunched up faces may have prompted parents to rub, jiggle or pat the burp up. Bharti doesn't take issue with this occasional gas-shifting assistance. "It is not the practice of an intuitive occasional burp by the caregivers, but the ritual after every feed that is being questioned," she says.

The study is too preliminary to conclude that burping is actually behind the increased numbers of spit-ups. The study was small, relied on mothers' memories for their tallies and may have been influenced by cultural factors specific to the suburb of the northern Indian city of Chandigarh, where the study was based. And researchers didn't track how often the babies in each group were actually burped. Yet it's intriguing to wonder whether burping might cause more spitting up for some babies, Lightdale says.

When talking with her patients' parents, Lightdale doesn't actually recommend burping. "It's not that I counsel against it," she says. "Rather, I would consider the recommendation to burp a baby to be less medical advice, and more an infant feeding practice that is passed down across generations, and that humans universally seem to assume is useful for infants." Her patients have come from all over the world: China, Nigeria, Brazil, France, the Philippines, Canada, India, Germany, Iceland, Russia and the United States. And she'd be hard pressed, she says, to think of any culture that doesn't burp their babies.

Maybe baby burping's ubiquity means that there's something to it. It's quite possible, likely even, that folk wisdom reflects a benefit that went undetected in this study. But it's also possible that parents burp babies because we think it makes our babies feel better, and that's something that makes us feel better. Plus, little baby burps are funny.

While we wait for larger, more rigorous trials of burping infants, which in reality may never materialize, we will have to settle for ambiguity. "It is a fun exercise to question why exactly we do this, and whether the practice is actually accomplishing what we think it is," Lightdale says.

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I found burping my babies to be highly satisfying. A little jiggle, a little pat, and suddenly, a big, funny jolt of air comes flying out of a tiny, floppy baby. There's lots of burping methods - the over-the-shoulder jiggle, the propped-up-on-the-lap pat, even the face-down-on-the-knees position - and they all lead to this amusing outcome.

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51K views · 1.9K reactions | The Koala Hold is a game changer! This an upright breastfeeding position where baby sits facing you, straddling your thigh or perched on your hips, and arms wrapped around you like a little koala hug. 🐨🤍
To try it:
Sit baby upright with their tummy against yours
Let them straddle your thigh or sit on your hip
Support their head and neck
Bring baby to the breast for a deep latch (chin in, nose clear)
This position can be especially helpful for babies with: ✨ reflux
✨ ear infections
✨ tongue-tie
✨ low muscle tone
✨ or when moms have a fast let-down
The upright position uses gravity to help baby manage milk flow and swallow more comfortably. Plus, it encourages eye contact and bonding and it really does feel like one long baby hug. 🥹
💾 Save this for your next feed so you can try the Koala Hold later.
#momtips #breastfeedingtips #breastfeedingpositions #postpartumjourney #breastfeedingmom | Legendairy Milk

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The Koala Hold is a game changer! This an upright breastfeeding position where baby sits facing you, straddling your thigh or perched on your hips, and arms wrapped around you like a little koala…

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What is a nursing strike?

If a baby who has been quite happily breastfeeding suddenly starts to refuse the breast it could be a "nursing strike". Sometimes this can be mistaken for the baby wanting to stop breastfeeding, but a baby who is ready to wean usually does so over a period of time. In nursing strikes the baby seems unwilling to feed even though he appears really unhappy about it.

Something happens which makes your baby not want to feed and it can take time and patience to help them return to the breast. Nursing strikes are nearly always a temporary reaction to something which has happened and the cause may never be discovered. ¹

What might cause a nursing strike?

The term nursing strike relates to an older baby who suddenly refuses to feed. If you have a newborn baby who is not feeding, please refer to our article about When my baby won't breastfeed for more information.
Sometimes the cause is physical:

The baby might have a stuffy nose or earache which is making feeding uncomfortable.

They might have a sore throat or mouth. Some mothers have found a little injury such as a cut in their baby's mouth or an ulcer which hadn't been noticed.

Hand, foot and mouth disease or chickenpox can cause a nursing strike as it is so uncomfortable to feed.

They could have sore gums from teething, a thrush infection or even a urinary tract infection.

They may be uncomfortable from a vaccination.

They might be frustrated at a low milk supply or a change in milk taste due to something the mother has ingested. An oversupply of milk could also sometimes scare a baby who finds the flow overwhelming.

Sometimes the cause is emotional:

A common cause of a sudden nursing strike is the baby being startled in some way while nursing, perhaps by a loud noise or by a mother involuntarily exclaiming when the baby bites.

A mother may have been feeling stressed because of moving house, having visitors, travelling or dealing with a family crisis and put off nursing and the baby senses her distraction.

A mother has changed her deodorant, soap, body lotion or perfume and so smells "different" to her baby.

A new job may have meant a change in nursing habits or the baby being left with another carer for longer periods of time. Attempts to regulate nursing or offering too many bottles or dummies could also contribute to a baby refusing to breastfeed.

What can help end a nursing strike?

If illness or injury might be the cause, then consulting a doctor about medication could be useful.

Some babies will nurse, sometimes reluctantly, at night. Trying to nurse the baby in their sleep or when they are sleepy can work: it keeps them fed and helps with your milk supply.

Trying to force your baby to feed won't work and a baby will often get upset if a mother tries. Although it's hard, being relaxed and offering cuddles and skin-to-skin contact helps keep you feeling close.

Sing or rock the baby with your shirt open so perhaps they will relax and instinctively latch on.

Sitting in a quiet room with dimmed lights and no distractions may help.

Try taking a bath together.

If you can get help around the house and with other children it means you can spend more time just relaxing with the baby.

Try nursing somewhere different, while walking around, using a baby sling, sitting in the car, outside or at a friend's house. You can also try a completely different position such as facing you or vertical. Some mothers have tried facing away from a room so that the baby can see what is happening while nursing.

Rocking, dancing or doing the "baby bounce" (starting small but getting bouncier and bouncier) while holding him in a nursing position might help. Some babies love this, others don't.

Stimulate your let-down and get your milk flowing before offering the breast so the baby gets an immediate reward. You can also offer the baby something else to suck before offering to nurse so he is in "sucking" mode!

If the baby continues to get upset when offered the breast it is sometimes necessary to stop offering for a day or two and let things settle down. You can then make it clear that your breast is available without forcing the issue. See the section below on milk supply for suggestions on preventing a drop in your milk production.

If a baby has a sore mouth, some mothers have found offering breastmilk ice lollies before a feed can help to numb the mouth and make nursing more comfortable. Expressed breastmilk can also be frozen in cubes and offered in a clean cloth/muslin to suck on. This can be useful for a teething baby. Other mothers have offered a child analgesic as appropriate before trying to nurse.

Sometimes these ideas will need to be repeated for a few days before things get back to normal.

Here are a couple of unusual ideas to try

One solution that has worked for some mothers is to sit on an office chair, holding the baby in your lap but not at your breast. Ask someone to spin the chair around; not too fast but until you feel a little dizzy, and then offer the breast. It seems that being a little disorientated stimulates a natural instinct to go to the breast.

Something which has also worked is for the mother to pretend to nurse a doll or cuddly toy, causing the baby to want his comfort back from the intruder!

What about my milk supply during a strike?

It's natural to want to give the baby lots of other food and drink while they aren't nursing. As as long as they are healthy, continue to offer their usual food and water but don't rush to replace all their nursing needs with extra food immediately. Pumping or hand expressing will maintain your milk supply and help prevent you from getting uncomfortably full, which might lead to plugged ducts or mastitis.

If the nursing strike continues for more than a day you can offer expressed milk in a cup, eye-dropper, feeding syringe or spoon. It is best to avoid bottles as they can cause nipple confusion.

Nursing strikes are distressing for mother and baby

It can be really upsetting and frightening to have a baby who has suddenly lost their main food source, their biggest comfort and a lovely way to fall asleep. You want to comfort your baby but they turn away. It can help to remember that your baby isn't rejecting you. They don't understand why breastfeeding is uncomfortable, they just think it is causing discomfort and they are scared to try it again, even if the original problem is sorted out.

Almost all nursing strikes are temporary and end happily, although not necessarily quickly. Some mothers have reported nursing strikes that lasted almost three weeks, but more often the baby goes back to breastfeeding in a few days.

Even if your baby doesn't immediately return to the breast you can continue to offer for as long as you want to. If it really does turn out to be the end of breastfeeding, allow yourself to be sad and grieve for its sudden ending. Breastfeeding ideally continues until both the mother and baby are ready to stop, but sometimes the baby makes the decision for you both in spite of a mother's efforts. (For more on how it feels after your baby weans, you may find this article helpful: After weaning - what next?)

Note: If you have a newborn baby who is refusing to feed this is not a nursing strike.
See these posts for help or get support from an LLL Leader:

My Baby Won't Breastfeed
Sleepy Baby: Why and What To Do
Jaundice
Beginning Breastfeeding
Is My Baby Getting Enough Milk?

Written by Anna Burbidge for LLLGB, 2017

1 The Womanly Art of Breastfeeding 8 th Edition, pages 407-409.

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What is a nursing strike? If a baby who has been quite happily breastfeeding suddenly starts to refuse the breast it could be a "nursing strike". Sometimes this can be mistaken for the baby wanting to stop breastfeeding, but a baby who is ready to wean usually does so over a period of time.

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Your body has created and grown your baby.    Now how your body continues to grow your baby after they are born

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Your body has created and grown your baby.    Now how your body continues to grow your baby after they are born

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There is a vast selection of bottles and teats available online or in the High Street. Many of them claim to be closer

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There is no need to buy these in anticipation 

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- These are NOT to be used for the prevention of nipple damage

Their miss use can lead to:-

Continued nipple pain

Nipple tissue damage

Blocked ducts

Mastitis

As with any breastfeeding aid they are not required by all and if used, appropriate use is important

https://breastfeeding.support/treatments-sore-nipples/

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There is a lot of confusion and poor breastfeeding advice arising from the idea that there are two sorts of breast milk-namely foremilk (watery, low calorie) and hindmilk (high fat, high calorie). And, depending where you live, the confusion may go one step further, you may hear about three kinds of milk; watery soup, dinner and pudding.

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All breast milk is good

As a result of not understanding that all breast milk is good, and not really understanding how breastfeeding works, mothers are being told to stay on one breast per feed or feed from one breast for random blocks of time to "get to the hindmilk". After all, the watery soup is no more than water and without that fatty pudding a baby can't gain weight, right? Wrong. Even if that was right, why stop short of offering the "three course meal" from the second breast? Especially if a baby is having trouble gaining weight.

This article

This article looks at how babies grow, how breastfeeding works, the facts about foremilk and hindmilk, and how staying on one breast to get to the hindmilk can sabotage a breast milk supply.

How babies grow

Babies grow and gain weight from drinking lots of breast milk. All breast milk is good, it is a nutritious and complete diet and babies need plenty of it. As a rough guide babies need about 800ml or 27 fluid ounces per day in the first six months. Whether it is foremilk or hindmilk or in-the-middle-upside-down-milk, babies need lots of milk to grow.

Quantity not quality

It is the volume of breast milk that is the important factor determining a baby's weight gain not the fat content in a particular feed. Kelly Bonyata explains:

The research tells us that baby's milk intake (the volume of milk - not the amount of fat in that milk) is the only thing that has been correlated with infant growth in exclusively breastfed babies. [...] average fat content of human milk is highly variable, but has not proven to be significant when calculating baby's total energy intake or weight gain.

Whether it is foremilk or hindmilk or in-the-middle-upside-down-milk, babies need lots of milk to grow. Click To Tweet

How breastfeeding works

Your breasts make milk on demand; so that the faster your baby drinks the available milk, the faster your breasts will make more milk to replace it, indefinitely. Breasts gauge demand by their degree of fullness:

Whenever a breast is full, milk production slows down

Whenever a breast is emptied regularly, milk production increases

Storage capacity

The ideal way to make plenty of breast milk in the volumes your baby needs, is to feed your baby as often as he wants-letting him finish the first breast before offering the second side. Only your baby knows when one side is empty and whether he needs one breast or two, because breasts vary in how much milk they can hold (storage capacity). Storage capacity is explained more fully in One Breast or Two per Feed:

Breasts vary in their breast milk storage capacities. Where one mother's baby might only want one breast per feed and not be hungry for two hours, another may need both breasts per feed and be hungry again in an hour. Let your baby decide how many breasts he wants at a particular feed by looking for his feeding cues and offering him plenty of opportunities to breastfeed.

Ignoring your baby's cues and keeping to one breast to reach the hindmilk i.e. keeping your baby on one breast after he has emptied it, means the opposite breast gets little drainage, and slows down milk production. It's like trying to build a milk supply by only pumping from one breast instead of pumping from both breasts.

If you have a low storage capacity then keeping to one breast is potentially denying your baby half his milk or more. Your baby may need the "hindmilk" from both breasts.

Increasing milk supply

If your baby falls asleep after less than ten or twenty minutes into a feed, breast compressions (gently compressing and releasing the breast during a feed) can get him to start sucking again by simulating another let-down of milk. By offering the other breast when the first is finished, and repeating breast compressions if needed, your baby will get the correct balance of foremilk and hindmilk automatically. Using both breasts when needed (and sometimes three or four!) will drive up and maintain your supply.

But what about foremilk and hindmilk?

Foremilk and hindmilk are the names given to subtle differences between breast milk at the start and at the end of a breastfeed.

Foremilk describes the breast milk at the start of a breastfeed, it has a lower fat content, but has plenty of lactose the principal sugar in breast milk, not to mention all the other great ingredients in breast milk. Lactose is important for developing the brain and central nervous system, and provides 40% of a baby's energy needs. Lactose helps with calcium and iron absorption and, along with other oligosaccharides (short chain carbohydrates) promotes the growth of friendly bacteria such as Lactobacillus bifidus to fight pathogens. As the breastfeed progresses, the fat content of "foremilk" steadily increases.

Hindmilk is the name coined for the breast milk towards the end of a feed as the breast empties. There is less of it but it has a higher fat content and all the other nutritious ingredients found in milk.

All milk is good

There aren't two distinct types of breast milk with one being inferior to the other, it is a continuum of subtle changes. Hindmilk is released with every milk ejection (let-down). By the time feeding finishes on the first breast, the first milk from the second breast will contain more fat compared to the start of the feed on the first breast. The more frequently you breastfeed, and the emptier the breasts become; the higher the fat concentration in all the breast milk.

Quantity not quality

Remember, weight gain depends on the quantity of milk not just the fat content in the last few drops. Kelly Bonyata's analogy with a hot water tap is useful. When you turn on the tap (start feeding) the water starts cold (low fat milk) but as it continues to run (as the feed progresses) the water gets warmer and warmer (higher fat). If you turn the tap off and on again quite soon, the water will still be warm (high fat milk will still be present at the start of the next feed). And you don't need to run your tap for 30 minutes or an hour to get to the warmer water (if you do, call an engineer!)

What is foremilk hindmilk imbalance?

If a mother has lots of milk, more than her baby can comfortably handle, her supply will usually adjust downwards over time to meet her baby's actual needs. In the mean time some babies may get an excess of lactose rich foremilk. This is sometimes referred to as foremilk hindmilk imbalance. Babies may also get foremilk hindmilk imbalance if a mother has a robust supply and continually takes her baby off the breast before he has finished feeding i.e. switches sides too soon.

Temporary lactose intolerance

In these situations the baby can find it difficult to digest all the abundant lactose in the plentiful foremilk causing temporary lactose intolerance or lactose overload. They may be fussy and uncomfortable with copious green, frothy and foamy nappies. The sheer volume of milk and high sugar content often means babies gain weight very well with foremilk hindmilk imbalance-even though they aren't getting their "pudding". However occasionally some babies may not gain enough weight in this situation. Advice to stay on one breast per feed or for a block of time can be very helpful with true foremilk hindmilk imbalance to ensure babies get a good proportion of higher fat milk. See Lactose Intolerance in Babies for further information and consult your breastfeeding specialist.

Confusion about green nappies

Health visitors who are already hooked on the idea of staying on one breast to get to the hindmilk may think this is an absolute certainty if you mention your baby has lots of green nappies. However the frequent scant green nappy of a baby not gaining weight is NOT the same as the copious frothy green nappy of a baby with lactose overload. Staying on one breast is not the answer for a baby with green "starvation stools". See your IBCLC lactation consultant for further information if you are not sure what your baby's nappies mean or whether block feeding is a good idea for your baby.

I kept to one breast per feed and my baby gained weight just fine!

Keeping to one breast may work perfectly if your storage capacity suits this regime. But be guided by your baby and his weight chart, not by any pre-set rules or clock-watching instructions to reach that elusive hindmilk at the bottom of the barrel.

My baby isn't gaining weight

When a baby isn't gaining weight they most likely need more milk, not more time on an already empty breast which will further reduce a mother's supply. An extra 7-8 ml of high fat milk from the same breast is no substitute for the extra 70-80 ml of fore-hind-and-in-the-middle-milk they might need from the other breast. Check with your IBCLC lactation consultant for the reasons for low weight gain for your baby and see Baby Not Gaining Weight. For increasing milk supply see How to Make More Breast Milk.

Supplements are sometimes needed

If you have been following the advice to "stay on one breast to get to the hindmilk" for quite some time, your milk supply may be quite low. If your baby has not been gaining weight properly, or has been losing weight, he won't be able to wait while you build your supply. He may need supplements ( donor milk or formula) to build back his body weight so that he is strong enough to drive your milk supply all by himself.

Summary

Confusion about how breastfeeding works is causing some health professionals to unwittingly sabotage breastfeeding by recommending staying on one breast to get to the hindmilk: either as a general rule or as specific advice when a baby is not gaining weight. It is not helpful to think of breast milk as two or three different kinds of milk. All breast milk is good and babies need lots of it to grow. Breasts have different storage capacities and what works for one mother and baby may not work for another. Contact your breastfeeding specialist for tailor made recommendations for your unique situation. And forget about foremilk and hindmilk.

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There is a lot of confusion and poor breastfeeding advice arising from the idea that there are two sorts of breast milk-namely foremilk (watery, low calorie) and hindmilk (high fat, high calorie). And, depending where you live, the confusion may go one step further, you may hear about three kinds of milk; watery soup, dinner and pudding.

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Sliced Bread - Baby Sleep Products - BBC Sounds

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Can any nests or docks, gadgets or blinds, really help babies sleep better?

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Stopping the milk coming in or stopping breastfeeding 

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Stopping the milk coming in or stopping breastfeeding 

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5.4K views · 11 reactions | How to stop the milk supply ‘coming in’ #formulafeeding #infantfeeding #pregnant #pregnancy #breastfeeding | The Eco Midwife

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How to stop the milk supply ‘coming in’ #formulafeeding #infantfeeding #pregnant #pregnancy #breastfeeding

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Olivia Hinge on Instagram: "How to do lymphatic massage to reduce the swelling in your breast tissue that can stop your milk flowing out freely. For use when you're engorged/have mastitis/blocked duct

Step away from heavy massage and heat

#mastitis #blockedducts #soreboob #milkbleb #pluggedducts #ibclc #breastfeedingproblems #breastfeeding #lactationconsultant #breastfeedingmom"

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703 likes, 56 comments - olivia_lactation_consultant on May 25, 2022: "How to do lymphatic massage to reduce the swelling in your breast tissue that can stop your milk flowing out freely. For use when you're engorged/have mastitis/blocked duct

Step away from heavy massage and heat

#mastitis #blockedducts #soreboob #milkbleb #pluggedducts #ibclc #breastfeedingproblems #breastfeeding #lactationconsultant #breastfeedingmom". 

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The starting point for knowing feeding is going ok

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Research has shown babies both weight can be elicited but the maternal IV fluids in labour.

(As a record take a picture of the numbers on the scales)

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Everyone is different but wearable pumps have not been found to be the most efficient 

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DIY Supplemental nursing system | My Site

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Kaya Thorpe IBCLC (2022) - revised December 2025 by Lucy Lowe IBCLC

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Why are Babies So Gassy? How much is normal and how much is a problem? | Carol Smyth IBCLC & CBT

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Sometimes there is just a straight up mis-interpretation of a baby behaviour. Newborn babies can really only do 2 core trunk movements - they can scrunch themselves inwards (flexing) or they can straighten /arch (extend), and they will do these movements for lots of reasons - to move position, to communicate they want to move, to say they want to swap sides, they want to feed, they want a nappy change, and on and on it goes. Several times I’ve seen a baby pulling knees up to start a breast crawl from the position they are in (they will then cry if they don’t get to the breast), which was misinterpreted as wind.

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I have been trained to fit Pump Flanges - Vikki Kidd

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I have been trained to fit Pump Flanges - Vikki Kidd

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Expressing Breastmilk - Patient Information Video

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This video was produced in collaboration with University Hospital Southampton as part of a project funded by NHSE South West. The project focuses on equity of access to appropriate equipment for expressing maternal breastmilk.

This video is designed to help breastfeeding parents to express breastmilk. The topics covered include:

The importance of correctly fitted equipment.
How to measure your nipple for flange sizing.
How to tell if you have the correct or incorrect fit. 
Variations in sizing depending on type or brand of breast pump.
How to prepare for expressing breastmilk.
How to assemble and use a breast pump.
Troubleshooting common issues in expressing breastmilk.

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Weaning from feeding with nipple shields 

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Weaning from feeding with nipple shields 

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Nipple shields can be a useful gadget to help a baby breastfeed in some situations. But what if a mother is ready to stop using them but her baby isn't? While simply removing the nipple shields might work for some babies, other babies refuse to close their mouths properly ( latch) on a naked breast and get very upset if they can't feel the shield that they are used to. This article shares tips and ideas for weaning from a nipple shield and is a companion article to Nipple Shields Good or Bad? and How to Get Baby Back to Breast.

Top tips

Ensure your baby is not too hungry when he practices breastfeeding without nipple shields so he is calm.

Avoid your baby becoming too frustrated or upset. If a baby is getting very upset with the idea of latching without the shield, continue the feed as normal with the shield in place and try again at another feed or on a different day. It is important that breastfeeding doesn't become a source of conflict and stress.

Try to stay relaxed. Babies are very in tune with their mothers and if mum feels anxious about latching, baby may also feel anxious. Help your baby stay calm with eye contact, smiling at him, and talking to him.

A note on flat or inverted nipples

If the reason you have been using nipple shields is due to having flat or inverted nipples, it can help to evert your nipples and shape the breast before your baby latches without the shield. Everting your nipples-coaxing out an inverted nipple or making a soft, flat nipple erect-helps your baby feel the nipple on his palate to stimulate the suckling reflex. And shaping the breast or flattening it slightly-just as you would flatten a big sandwich full of salad before you take a bite-helps your baby get a big mouthful of breast and nipple (a good latch). Pumping just before latching can be useful to bring out the nipple with the bonus that milk will be flowing ready to reward your baby if he latches. See more tips in Breastfeeding With Inverted Nipples and Flat Nipples and see Latching Tips for more information about getting a good latch and shaping the breast to help with this.

Ideas for weaning from a nipple shield

#1 Try breastfeeding without the shield (it may work!)

Some babies will be able to make the change from shield to naked breast without too much difficulty. Try our step by step guide.

Step by step

Evert your nipples if you have soft, flattish nipples by rolling your nipples between your fingers, by holding a cold cloth against them or using a breast pump for a few minutes.

Get your milk flowing prior to latching so your baby can get an instant reward of milk (use a breast pump or hand express to trigger the let-down).

Shape the breast as needed with your fingers to help your baby get a bigger mouthful of breast tissue. See Latching Tips for more information.

Try to relax. Babies can pick up on any tension so try to relax your shoulders, smile, hum a tune or even stand and sway gently from side to side for the latch.

Bring your baby to the breast just as you would with the nipple shield in place. Some mothers find the cross cradle hold can give more control for the latch-one hand supports baby's back and shoulders and one hand shapes the breast if needed. But use any position that feels comfortable, see Breastfeeding Positions for Newborns.

Wait for the moment baby opens his mouth wide then bring him quickly and confidently towards the breast. If he hesitates at the moment he feels skin, try rocking him gently and singing or talking to distract him. Maintaining eye contact, smiling and praising him may also help.

Using breast compressions will keep the milk flowing so your baby gets the idea that milk can come from skin as well as silicone. See What is Breast Compression? for more information about this technique.

Repeat. Once you have had one successful latch for part or a whole feed you can build on this by repeating the steps each time you breastfeed.

If your baby cries and refuses to latch, feed as usual with the nipple shield and try one of the other steps below at the next feed or the next day.

#2 Start the feed with the shield as normal... then remove it

A variation of #1 is to start a breastfeed with the shield in place, then remove it part way through the feed.

Step by step

Start breastfeeding with the nipple shield in place.

Once milk is flowing well, and your baby has had a little breast milk to take the edge off his appetite, break your baby's latch from the breast by slipping a finger between his gums.

Remove the shield and quickly bring baby back to the breast. Shape the breast if needed to help your baby get a bigger mouthful (see Latching Tips).

Some swaying and gentle humming or singing may distract your baby enough that they do not notice that the shield has gone. Try to keep your own body relaxed rather than tense so your baby also stays relaxed.

Use breast compressions if needed to keep milk flowing at a faster pace.

If your baby refuses to latch back on finish the feed with the shield and try again another time or try one of the other steps below.

#3 Try skin-to-skin time

If simply offering your baby a breast to latch instead of a nipple shield, or slipping off the shield mid-feed doesn't go well, help your baby associate the naked breast as a safe and comforting place to be without pressure to latch. Familiarise your baby with the feeling of skin by holding your baby in skin-to-skin contact between your breasts or in a laid back position where your baby is on his tummy, lying on your tummy. See our article Why Skin-to-Skin? for an explanation and videos of how reclining breastfeeding positions and skin-to-skin contact (take off those scratch mittens!) are more likely to help a baby's latching instincts. Given the right opportunity your baby may latch on his own.

Step by step

Relax together skin-to-skin or lightly dressed, or try taking a warm bath together with low lighting.

Don't worry too much if baby doesn't latch, the goal is for him to feel happy, safe and loved while he explores the smell, taste and feel of your skin.

A fairly full breast will reward baby if he latches but ideally your baby will not be too hungry during skin-to-skin time to avoid him getting frustrated.

A little finger feeding prior to latching can help some babies-the skin of the finger is closer to the feeling of a breast than silicone. And finger feeding promotes the same tongue function needed for breastfeeding. See our article on finger feeding if this is something you are interested in learning more about.

If baby does attempt to latch, shape the breast to help them as needed, smile and praise them gently.

If your baby gets hungry but will not latch, feed him as usual with the shield in place to avoid him getting upset with the breast.

#4 Try latching when your baby is sleepy or in light sleep

Many babies will breastfeed in light sleep so this can be a good time to try a feed without the nipple shield because they will be less aware of the different sensation in their mouth.

Step by step

Pick a moment when your baby is in light sleep and cradle him in a breastfeeding hold with his cheek in contact with the breast.

When he opens his mouth to search for the breast, bring him in close and try the breast shaping, swaying, humming techniques described in #1 and #2 above if needed.

If your baby latches, breast compressions can keep milk flowing.

Alternatively start the feed with the shield and when baby becomes sleepy, slip off the shield and see if he will latch again to the naked breast. Avoid waiting too long or your baby may drift into a deep sleep and may not latch again, with or without a shield.

If your baby wakes fully and refuses to latch, pop the shield back on, and try removing it part way through a feed (#3 ) or continue the feed as usual this time.

#5 Try different positions

Sometimes trying a different breastfeeding position to the usual one can help to break the expectation of the silicone nipple and your baby might be more open to try something new. He might think it is a game or a new toy instead of a feed. For example with an older baby:

For a slightly older baby, using new positions in a playful way may help turn breastfeeding into more of a casual fun thing, rather than an activity that creates tension and anxiety. Trying different positions and places for latching on-in the bath, the garden, kitchen, while walking about, in a dark room, even dangling a breast over him when he is on the floor (while you both giggle)-may all help make it more of a fun thing to do.

Try to keep this playful and pick a time when baby is not going to be overly hungry.

#6 Try different shapes of shield

Shields come in different shapes and sizes. Some are shaped so that your baby's nose has contact with your breast. Others are butterfly shaped allowing even more skin contact above and below the nipple. More skin contact below the breast will allow your baby to taste your skin and get used to the new sensation on his tongue. Trying a different shape may help some babies move towards weaning from a nipple shield-if the style suits you as a nipple protector.

#7 Stop trying for a while

If your baby gets frustrated with your attempts to get rid of the nipple shield, calm him back down and resume the feed with the nipple shield for that feeding. If he seems to be getting fussy at every feed because he is anticipating interruptions, it may be helpful to stop trying for a couple of days or a week and resume pleasant skin-to-skin time instead (#3).

Let your baby decide

Each day your baby gets older and more skilled and many mothers have found their babies leave the shield behind when the time is right for them. Many babies have suddenly stopped using them at two, four or six months of age or older. And some mothers have just carried on using the nipple shields. Nipple shields are not the end of the world if your baby is able to transfer milk and is gaining weight well. If your baby is not gaining weight well or your milk supply is low, an IBCLC lactation consultant can help you increase your milk supply and see How to Make More Milk.

# 8 Find support

Finding support from other mothers at a breastfeeding support group such as La Leche League meetings can be very helpful. Experienced breastfeeding mothers may have their own tips that worked for them and it will be reassuring to hear their success stories. Older babies may even benefit from watching other babies latch on without shields. It may also be useful to see an experienced breastfeeding specialist such as an IBCLC lactation consultant for one-to-one help and support.

What not to do

Don't force baby to the breast

Don't let your baby get constantly frustrated and upset at each feed or they might begin to associate feeling unsafe with breastfeeding. If your baby is getting upset at the breast even with nipple shields in place it is time to take a step back or take a break. See the section "Baby crying, arching and pulling away?" in How to Get Baby Back to the Breast.

Don't cut away the shield

Some mothers may have heard friends or family suggest gradually cutting away the shield to make it smaller and smaller so your baby gradually gets used to less shield and more breast. Nipple shield manufacturers do not recommend this at it could leave sharp edges to damage your baby's mouth or loose fragments could be a choking hazard. See #6 for information about different shaped shields that allow more skin contact.

When baby latches but breastfeeding hurts

Depending on the reason you started using nipple shields in the first place, there may still be an underlying issue with your baby's latch. If your baby starts latching to the naked breast but you find breastfeeding is painful, check out Why Does Breastfeeding Hurt? and check in with your IBCLC lactation consultant. Your lactation consultant will be able to make suggestions to improve latch, positioning and tongue function, the most common causes of painful feeding.

Summary

There are several tips to help with weaning from a nipple shield. Some babies will move on from them quicker than others. If milk transfer and weight gain are good, but weaning from a nipple shield is taking longer than expected, remember you're still breastfeeding even if you would prefer it to be without the shield. For advantages and disadvantages of nipple shields see Nipple Shields Good or Bad?

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Weaning From a Nipple Shield - Breastfeeding Support

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Nipple shields can be a useful gadget to help a baby breastfeed in some situations. But what if a mother is ready to stop using them but her baby isn't? While simply removing the nipple shields might work for some babies, other babies refuse to close their mouths properly ( latch) on a naked breast and get very upset if they can't feel the shield that they are used to.

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How to recognise when a  baby is drinking well

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Baby's behaviour and developmental changes at 4 months

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Baby's behaviour and developmental changes at 4 months

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What to do when your baby won't take a bottle | Rachel O'Brien, IBCLC

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Bottle refusal is incredibly hard for breastfeeding parents. Learn exactly what to do when your breastfed baby won't take a bottle.

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FAQ about using infant formuls

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Questions about infant milk safety Are powdered infant milks sterile? Powdered infant milks are not sterile and they may contain harmful bacteria. However, if milks are made up appropriately for infants, they should be safe. Salmonellaand Cronobacter sakazakii(previously known as Enterobacter sakazakii)are the organisms of greatest concern in infant formula and a range of Cronobacterspecies ...

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When pumping the flange fit is important for both the users comfort and effectiveness of collecting the milk.

Be aware of a few things:-

Recent research has identified that often the wrong size has been used

Each breast could require a different sized flange.

With continued pumping the size may well need to change.

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BALIME Flange Inserts 10PCS 13/15/17/19/21mm for 24mm Flange/Shields of All Breast Pump, Nipple Measurement Card, Compatible with Medela Elvie Momcozy Spectra Jheppbay Bellababy

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Free delivery and returns on eligible orders. Buy BALIME Flange Inserts 10PCS 13/15/17/19/21mm for 24mm Flange/Shields of All Breast Pump, Nipple Measurement Card, Compatible with Medela Elvie Momcozy Spectra Jheppbay Bellababy at Amazon UK.

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This blog explores the myth that lip ties impact feeding and explains how a lip tie is normal anatomy. It examines the research on the role of the upper lip in feeding and what advice to seek if you are concerned.

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Bottle-fed babies swallow millions of microplastics a day, study finds

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Exposure is far higher than previously thought and also affects plastic food containers

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Article

Published:

Dunzhu Li 1,2 na1,

Yunhong Shi 2 na1,

Luming Yang 1,2,

Liwen Xiao orcid.org/0000-0003-3621-9568 2,3,

Daniel K. Kehoe 1,

Yurii K. Gun'ko 4,5,

John J. Boland orcid.org/0000-0002-3229-8038 1,4 &

...

Jing Jing Wang orcid.org/0000-0001-5721-7989 1

Show authors
Nature Food 1, 746-754 (2020) Cite this article

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Abstract

Polypropylene-based products are commonly used for food preparation and storage, but their capacity to release microplastics is poorly understood. We investigated the potential exposure of infants to microplastics from consuming formula prepared in polypropylene (PP) infant feeding bottles (IFBs). Here, we show that PP IFBs release microplastics with values as high as 16,200,000 particles per litre. Scenario studies showed that PP IFB sterilization and exposure to high-temperature water significantly increase microplastic release. A 21-d test of PP IFBs showed periodic fluctuations in microplastic release. To estimate the potential global exposure to infants up to 12 months old, we surveyed 48 regions, finding values ranging from 14,600-4,550,000 particles per capita per day, depending on the region. We demonstrate that infant exposure to microplastics is higher than was previously recognized due to the prevalence of PP-based products used in formula preparation and highlight an urgent need to assess whether exposure to microplastics at these levels poses a risk to infant health.

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Data availability

All data analysed in this study are contained within the Supplementary Information. The raw data that support the findings of this study are available from the corresponding author upon request to J.J.W. or from the Figshare repository at https://figshare.com/account/home#/projects/88406. Source data are provided with this paper.

Code availability

The mathematical algorithm used for MP exposure assessment has been included in the Methods. The sales data mining software Jungle Scout is available at https://www.junglescout.com/.

References

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Acknowledgements

This work was supported by Enterprise Ireland (grant number CF20180870), Science Foundation Ireland (grants numbers 12/RC/2278, 16/IA/4462 and 16/RC/3889), the School of Engineering Scholarship at Trinity College Dublin, and the China Scholarship Council (201506210089 and 201608300005). We also thank Keyence for help. The presentation of the material in this publication does not imply the expression of any opinion whatsoever on the part of Trinity College Dublin about specific companies or of certain manufacturers' products and does not imply that they are endorsed, recommended, criticised or otherwise by Trinity College Dublin in preference to others of a similar nature. Errors and omissions excepted. All reasonable precautions have been taken to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall Trinity College Dublin be liable for damages arising from its use.

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Author notes

These authors contributed equally: Dunzhu Li, Yunhong Shi.

Authors and Affiliations

1. AMBER Research Centre and Centre for Research on Adaptive Nanostructures and Nanodevices (CRANN), Trinity College Dublin, Dublin, Ireland

Dunzhu Li, Luming Yang, Daniel K. Kehoe, John J. Boland & Jing Jing Wang

2. Department of Civil, Structural and Environmental Engineering, Trinity College Dublin, Dublin, Ireland

Dunzhu Li, Yunhong Shi, Luming Yang & Liwen Xiao

3. TrinityHaus, Trinity College Dublin, Dublin, Ireland

Liwen Xiao

4. School of Chemistry, Trinity College Dublin, Dublin, Ireland

Yurii K. Gun'ko & John J. Boland

5. BiOrbic Bioeconomy SFI Research Centre, University College Dublin, Dublin, Ireland

Yurii K. Gun'ko

Contributions

J.J.W. and L.X. supervised the project and led the overall effort. D.L., J.J.W., J.J.B. and L.X. wrote the manuscript. J.J.B. contributed to the experimental design and validation. Y.S. and D.L. performed online data mining and analysing. D.L., Y.S. and L.Y. carried out the sample preparation. D.L. and J.J.W. carried out the Raman measurements. D.L., D.K.K. and J.J.W. carried out the AFM and scanning electron microscopy characterization. All authors discussed the results and commented on the manuscript.

Corresponding authors

Correspondence to Liwen Xiao, John J. Boland or Jing Jing Wang.

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Li, D., Shi, Y., Yang, L. et al. Microplastic release from the degradation of polypropylene feeding bottles during infant formula preparation. Nat Food 1, 746-754 (2020). https://doi.org/10.1038/s43016-020-00171-y
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DOI: https://doi.org/10.1038/s43016-020-00171-y

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Microplastic release from the degradation of polypropylene feeding bottles during infant formula preparation - Nature Food

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Polypropylene-based products are commonly used for food preparation and storage, but their capacity to release microplastics is poorly understood. We investigated the potential exposure of infants to microplastics from consuming formula prepared in polypropylene (PP) infant feeding bottles (IFBs). Here, we show that PP IFBs release microplastics with values as high as 16,200,000 particles per litre.

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Avoid Mixing Breastmilk & Infant Formula - information shared by LLL Canada 

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Avoid Mixing Breastmilk & Infant Formula - information shared by LLL Canada 

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Mixing formula and human milk in the same bottle is not recommended, here’s why:

🧪 Different storage rules:

Formula must be discarded right after a feed, but human milk can be safely stored for 1–2 hours. Mixing the two could lead to wasting your milk if the bottle isn’t finished.

🛡️ Loss of protective properties:

Mixing formula with human milk can reduce lysozyme activity, an enzyme that helps protect against harmful bacteria like E. coli.

⚖️ Nutrient interference:

Added components in formula, like iron, may bind to the nutrients in your milk, reducing their absorbability.

💡 Best practice?

Offer human milk and formula separately to preserve the unique benefits of your milk.

La Leche League Canada, to learn more: lllc.ca/should-you-mix-human-milk-formula

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This research has found that doing skin to skin immediately after a caesarean birth has improved the breastfeeding outcomes

https://www.sciencedirect.com/science/article/pii/S0020748925000471?ref=pdf_download&fr=RR-9&rr=9408dfdf9db17068

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Thrush - Physician Guide to Breastfeeding

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Thrush Thrush (or yeast infection of the mouth) is uncommon in full term, healthy infants who are exclusively breastfed. It is more common in immunosuppressed infants (for example, very early babies in the NICU). Even if your pediatrician diagnoses or suspects thrush in your infant’s mouth, it is not contagious (the way vaginal yeast infections […]

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We are delighted to announce that PANDAS have collaborated with Neurodivergent Birth CIC to provide a new FREE online resource for neurodivergent people (including professionals and their networks) to help better understand how to access and advocate for support, including knowing your rights and what "reasonable adjustments" are and how they can help.

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Neurodivergent Resource - PANDAS Foundation UK

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We are delighted to announce that PANDAS have collaborated with Neurodivergent Birth CIC to provide a new FREE online resource for neurodivergent people (including professionals and their networks) to help better understand how to access and advocate for support, including knowing your rights and what "reasonable adjustments" are and how they can help.

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08451 202 918 Helpline Call Back Service

Leave a message anytime and a LLL Leader (breastfeeding counsellor) will contact you in daylight hours

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ABM - Association of Breastfeeding Mothers

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Available 7 Days/week - 9.30am-10.30pm

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Find an IBCLC Lactation Consultant - Private Practice IBCLCs (generally not a free service)

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Find an IBCLC Lactation Consultant - Private Practice IBCLCs (generally not a free service)

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Drip Drop Feeding to encourage baby's suckling

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Drip Drop Feeding to encourage baby's suckling

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Drip-drop feeding is as easy as 1-2-3! We are delighted to co-publish this video about the... | By La Leche League International | Facebook

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