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বাংলা — আপনার ভাষায় সম্পদ

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🇧🇬 Български

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🇧🇬 Български

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Български — Ресурси на вашия език

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اردو — آپ کی زبان میں وسائل

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ਪੰਜਾਬੀ — ਤੁਹਾਡੀ ਭਾਸ਼ਾ ਵਿੱਚ ਸਰੋਤ

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العربية — الموارد بلغتك

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Polski — Zasoby w Twoim języku

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Română — Resurse în limba ta

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Ending Your Breastfeeding Journey - Parent Led Weaning

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Ending Your Breastfeeding Journey - Parent Led Weaning

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Making the decision to end breastfeeding
Breastfeeding support is all about helping you to breastfeed for as long as you want to. We want families to reach their breastfeeding goals, and that means Breastfeeding Supporters are here for parents at the end of their breastfeeding experience, as well as at the start. Some families want to breastfeed for years. Some want to for months or weeks. If you are able to make the decision with the right information and feeling supported, we have done our job.

We want to make sure that you make the decision to end breastfeeding in a way that you will have peace with in the future. If you are struggling with breastfeeding, it may be that the right support can resolve issues and you can continue breastfeeding happily. We would want all avenues to be explored if the idea of ending breastfeeding is an unhappy one.

Are you hoping that ending breastfeeding might improve your child's sleep? It's important that parents understand what's normal when it comes to how babies sleep: "No difference in night wakings or night feeds was found between mothers who were currently breastfeeding or formula feeding ... Breastfeeding has no impact on infant sleep in the second 6 months postpartum." (Brown and Harries 2015)

You might have been told you have to end breastfeeding to take a medication and the Drugs in Breastmilk Information Service can provide evidence-based information on the compatibility of breastfeeding and medications. Sadly, parents are often misinformed.

It can be valuable for you to talk through your decision to end breastfeeding before starting the process. A breastfeeding supporter can help you reflect on your decision, as well as help you take some practical steps to get the process started. Every family's journey will be different because every child and parent's relationship to the breast is different. There is no 'one size fits all' approach to ending breastfeeding. In some families, the breast is at the heart of parenting. A mother might breastfeed throughout the night and day to meet her child's emotional needs in a host of different ways. In other families, a child might be feeding a couple of times a day, and even then, only when offered. You can see those families will have very different experiences around the weaning process. However, there are some general guidelines about starting the transition to ending breastfeeding.
Weaning under 12 months
If your baby under 12 months is ending breastfeeding, their nutritional requirements will obviously need to be the highest priority. A baby of around 7-9 months who is taking solid food reliably will still need around 600 ml (20 oz) of formula in 24 hours (NHS Better Health Start for Life 2023). From around 10-12 months, if we can assume that solids have become more established, we're expecting still around 400 ml (13 oz) of formula in 24 hours. If a young baby is feeding roughly eight times in 24 hours (it could easily be more), then we would start by looking at the formula total needed over 24 hours and dividing by eight. If day one means one bottle of 30 ml of formula at some point in the day (perhaps before a breastfeed), when everyone is in a good mood, that is a good place to start. If that volume increases gradually until one feed is entirely with the bottle, we might then pause for a couple of days to let breasts adjust and to consider next steps. Dropping one breastfeed no faster than every three days feels sensible to reduce the risk of breast health problems.

What kind of bottle is best? Parents often get pulled down a rabbit hole when it comes to this question. If a family is ending breastfeeding, we have less need to consider which bottle is protective of breastfeeding. There is not one 'best' bottle. We are looking for the bottle which is affordable, easy to buy where a family lives and with replaceable teats that are also easy to find.

What about choosing the type of formula? Any 'First' formula is appropriate and babies do not need 'follow-on' formula.

"All infant formula have to be of a similar composition to comply with UK compositional requirements and all brands are nutritionally adequate for infants. If a substance was found that was definitely beneficial for infant health that could be added to infant formula, it would be in all infant formula by law." (First Steps Nutrition Trust 2021)

After 12 months, full fat cow's milk can be given as a main drink. With a younger baby, giving milk in a bottle is likely to be a first choice. We want all bottle feeding parents to be confident with a technique known as responsive bottle feeding (sometimes referred to as paced bottle feeding) which can help the feed to be a time for connection and communication and reduce the risk of over-eating. However, the NHS recommend that families move away from bottles from around 12 months, and that means some older babies will be moving from a breast directly to a cup. We want families who use powdered formula to understand that the powder may contain bacteria and other pathogens and there are careful recommendations about how to make up a bottle safely. ( https://www.nhs.uk/start4life/baby/feeding-your-baby/bottle-feeding/how-to-make-up-a-feed/making-up-a-feed/)

When we talk about a baby under twelve months transitioning from breastfeeding, it is easy to get wrapped up on dropping breastfeeds and discussions of milk volume, but we must never lose sight of the fact that breastfeeding was about connection and an exchange of love and physical affection too. It was about oxytocin. We still want that oxytocin creation to happen. We are not just changing how a baby is fed but adding in a new method of feeding AND lots of opportunities for physical affection. Bottle feeding can happen skin-to-skin and there's lots of time for snuggles and connection.

Whatever age a baby is when breastfeeding ends, we need parents to be prepared for some possible impacts on them. Ideally, the transition from breastfeeding to exclusive bottle feeding happens gradually. If you have been producing a full milk supply, it is going to take time for your body to get the message that the order has changed. If that isn't handled carefully, at the very least we could be looking at engorgement and blocked ducts. In more serious cases, we could be increasing the risk of mastitis and abscesses. A gradual weaning process means it's more likely that the body will adapt. The grape-like lobules in the milk storage areas can feel lumpy under the skin and this can be frightening if you have spent months, or even years, associating lumpiness with blocked ducts. Milk storage areas that remain full are doing some important jobs. Fullness is part of the natural process which slows milk production. However, this is a balance, and we want the reduction to be as comfortable as possible. Breasts need to be well supported (but not squashed). Pain relief may be helpful. Cool compresses, and even cabbage leaves, may also provide relief. There are physical adaptations that are needed, but also emotional ones. You might experience 'weaning blues' even if you very much wanted to end breastfeeding. Your body is adapting to a change in hormones. Previously, with every breastfeed, there was a release of oxytocin. Your body may miss that, and you may have some other complicated feelings alongside the end of breastfeeding. It's important for you to be gentle with yourself and reach out for support if you need to.
Weaning an older toddler
Let's imagine we are talking about ending breastfeeding an older child. We start with doing some thinking about this child's relationship to the breast. Are they more likely to ask at a particular time of day? Or when you are engaged in a certain activity? Are they hungry for food or hungry for connection? Once we understand when requests for a breastfeed are more likely, we can reflect on what a child will need to replace breastfeeding. The act of weaning is not simply the act of removing breastfeeding. Many new things often need to be added in. We can think of breastfeeding as being like the 'Swiss army pen knife' of parenting. It contained so many different tools and met so many different needs. Now you are taking it out of your tool belt, and you're going to need to replace it with some new things. Some parents will learn to parent in different ways. Your child may need new ways to ask for help in emotional co-regulation. They may need a new language that helps them feel empowered and in control of their world. They may need a new language of sleep and getting to sleep. They may need help to find ways to say, "I'm feeling a bit vulnerable, and I need to check in with you."

It may be that breastfeeding is the tool a child uses to physically calm themselves. It is how they wind down when they are buzzing. It is also often used as a tool for sleep. It makes biological sense when you think that breastmilk contains hormones that aid sleep for any age - for both the nursling and the parent. Nurslings of any age can enjoy breastfeeding as a way to transition to sleep, whether it is for a nap, at bedtime or after waking in the middle of the night. Breastfeeding might also be their decompressing tool when they feel overwhelmed at other times. They may be experiencing physical pain or feeling unwell. They may feel afraid.

Weaning is not a battle of parent versus nursling. It is trying to find a new world together, with compassion, that meets the needs of everyone. A lot is going to depend on the age of the child, but if your child is verbal and is able to understand what you are saying, they can be a partner in your process. You might start with conversations in daily life that explain milkies don't last forever for everyone. These conversations can happen long before they are personalised to say, 'One day, YOU will not have mummy milk.' We want your child to understand that one day breastfeeding ends and that can be hard, but it ends for everyone eventually. In the park, you might point out an older child on a skateboard, 'I wonder how old he is. I think he's about ten. I wonder how old he was when he stopped having mummy milk and how he felt about that?' A parent might talk about people in the supermarket, characters in the background of picture books or television friends. Does Peppa Pig still have mummy milk? It is never discussed so we assume not. I wonder how old she was when she stopped? How does she get to sleep now? What does she do when she wants to feel close to mummy pig?

Reading picture books about weaning can also be an extension of this conversation. For many young children, reading a book is a time where they are most likely to focus, and the repetition is ideal to embed new concepts. You may like to go one step further and make your own weaning book. Using online photo companies, it's possible to create individualised books using family photos with familiar phrases, that give everyone a sense of ownership of the process. Young children often like to see photos of themselves, and you can include photos of their sleeping space, special toys and their favourite foods and activities.

Alongside reading picture books, eventually the time comes to put the theory into practice. You will need to explain to your child that one day milk will go away FOR THEM. You might share pictures of early breastfeeding and share memories. You might talk about how you have loved breastfeeding and how special it is and how you will find it hard to say goodbye too. This conversation doesn't just happen once but is sprinkled throughout some days at different times. It might happen at the park or during dinner. Ideally it happens at times when emotions are steady to start with, and there is time to explore feelings that arise. A child as young as 18 months or two years old may not be able to articulate, or even fully comprehend what is being said, but repetition may help and it makes sense to try and offer some explanation, rather than underestimate their level of understanding. It is important that you reflect on how you will explain to their child WHY breastfeeding is going away. Some parents struggle with doing this authentically. You will see stories online of parents rubbing their nipples in unpleasant tasting foods or even chilli oil (ouch). Breastfeeding has been such an honest and beautiful connection. If a parent has breastfed their child for several years, it seems a shame to end it with something inauthentic, and something they may later look back on with suspicion. Are we really protecting them?

Many parents fear speaking honestly. They want to say things like, 'milk is going away because you are getting older' or 'I think we will both sleep better if we don't have milk at night.' Neither of those concepts really make sense to a child. Why is milk going away? Being 'older' or 'a big boy' doesn't mean they don't need you! They may feel they sleep better at night because they have milk. They don't want a parent to do this for them! If a parent can find a starting place that is truthful, they will be able to continue with that honest communication. You might say something like, 'My body is going to stop making milkies' or 'my boobies are tired, and my body is tired and I'm going to help you say goodbye to milkies. I know it will be hard and sometimes you might feel angry and sad that boobies are going away, but mummy cuddles will always be here.'

A nursling who is weaning reluctantly has every right to be angry. Just as you have a right to wean, your nursling has the right to be angry and disappointed. It is important that they understand the feelings they express are to be validated. There is a misunderstanding by some that validation is a tool we use to calm children down. When we say, 'I understand', that we are actually hoping it is enough to stop them being upset, but in fact things might be more painful initially. A child who knows that their feelings are being listened to and recognised, is eventually going to be in a better place.

It is sometimes said that distraction is a valuable weaning tool. I have said it myself in the past. For much younger children, it can be useful as you seek to meet their needs in other ways as quickly and as effectively as possible. It is natural to not want to imagine that a child is experiencing pain. If there is a way to avoid seeing distress or anger, that sounds like an ideal scenario. However, distraction shouldn't be about pretending weaning isn't happening. We are not aiming to wean and hope they don't notice.

The psychotherapist Philippa Perry describes how distraction 'can be an insult to a child's intelligence': "What message does distraction convey? Imagine you fall over and badly graze your knee how would you feel if your partner, instead of being concerned or interested in the pain or the blood or the embarrassment, pointed out a squirrel or promised that you could play your favourite video game?" (Perry 2019)

Distraction is attractive in the short term. It might feel like a handy short cut, but this may not be the best time for short cuts. Of course, it does depend on what a child's motivations for wanting the breast are. Ideally, if distraction does happen, it should be on-topic and meeting the underlying need. If your child is requesting connection and time with you, then offering a different loving focused activity isn't distraction so much as offering a new way to meet the same need. However, a child who is asking for connection, and is instead offered a screen and a snack, is not having that need met respectfully.

If we see weaning from breastfeeding as a time to add in new parenting tools and new languages, what can that look like in practice? A new language around thirst and nutrition is about providing opportunities. Does the child have a cup they can use independently that is within easy reach? Do they have a way to request snacks or to explain when they feel hungry? All they may be skilled to do in that situation is to ask for a breastfeed.

Giving a child a new language to ask for connection and affection is often at the heart of weaning from breastfeeding. When a child continues breastfeeding beyond infancy, the dialogue of requesting a breastfeed and having that need met can feel powerful and wonderful. The most important person in their lives is pausing and meeting their request. When they have that urge for parental love and a sign of affection, they have the tools to do that. If that tool is taken away and no alternative is given, the risk is that the child feels not only rejected but also disempowered and destabilised. That was the only way that they knew how to ask for a physical sign of love. It was the only way they knew how to say, 'Hey I need you for a moment!' Can your child ask for a cuddle? Do you ask them for a cuddle? What other kinds of physical affection do you model in your home and have words for? You may want to add in more times for attachment play and power reversal play, where your child feels in control and taking the lead. Attachment play may only last for 10-15 minutes but it's a time when you give your child your focus and your energy.

A feed that is sometimes difficult to drop is the reconnection feed that happens when a child is reunited with their parent after a day of nursery and work. That feed is a powerful moment of a child decompressing at the end of a long day and celebrating seeing the parent again. Some children will arrive home full of energy, and high energy connective play and physical games may meet a need. Some are tired and are looking for a moment of peace. Activities like a hand massage or head and shoulder massage can be special, and the nursling might take the role of the facilitator and the expert. Dens are a great tool to give little people a sense of fun and excitement. You can create a cuddle nook which may be a tent or a home-made den, with cushions, bean bags and fairy lights. This isn't a place where breastfeeding happens but where reading and cuddling and other kinds of physical connection occur. It would be sensible to discuss in the morning what will happen at the reunion. Another caregiver could mention it and remind the child during the day. The parent might even be able to speak to them on the way home via a video call to prepare them for what is going to happen.

Alongside introducing a new language around connection and physical affection, other boundaries around breastfeeding are progressively being put in place. Breastfeeding might still happen in the day, but only in certain places. Perhaps no longer on a particular chair or restricted to a less interesting and stimulating room. You might agree to do a feed for a short period of time and then offer a different activity that may be more appealing. If you are saying, 'not right now', you can give them a choice about what might happen instead to help them feel they have some control over the process.

What about night weaning? What can be helpful is the concept of habit-stacking (a term used by Lyndsey Hookway). We want the child to have more than one association with safe and soothing bedtime and the process of falling asleep. Then as the breastfeeding is removed, they are left with something familiar that already helps their brain to think, 'Ahh, yes, sleep time now.' After all, being a creature of habit is a normal human state of affairs. Adults would also not be thrilled if our familiar routine was yanked out from under us overnight. Parents can introduce one or two additional habits alongside breastfeeding. It is something that involves the parent, so they are still offering co-regulation once the breastfeeding goes. It will differ for every child. Some would be irritated by stroking or patting and may prefer something auditory. A parent might choose a gentle phrase that can be repeated. They might tell a narrative along the lines of, 'You are sleeping now. Mummy is sleeping now. Granny is sleeping now. Cats are sleeping now. The birds in the trees are sleeping now.' When it later comes time for night weaning, the parent can add in, 'Boobies are sleeping now.' Some families might choose gentle singing or a white noise machine with ocean sounds.

For older nurslings, a guided meditation can also be a valuable tool at bedtime and the peaceful language repeated during the night in smaller chunks. An older child may also be able to express an opinion on what they would like to use as their additional sleep habit. At the same time, it can be useful to have conversation in the day about the process of falling asleep, to help reinforce that this is a process that involves an element of choice. How does Daddy fall asleep at night? How does a friend? What do they do when they can't fall asleep easily? A parent might role play falling asleep with cuddly toys during playtime. What is teddy going to choose? And teddy might be angry with Mummy because booby isn't happening throughout the night. A parent might 'play bedtimes', where they are the child, and the nursling becomes the parent. Or original roles might be maintained, and the parent offers alternatives to the breast. Role play can be a useful way to work through emotions.

Breastfeeding toddlers often haven't attached to a cuddly toy at bedtime. Why would they? The parent is their cuddly toy. However, it might be useful to introduce a transitional object for the first time, to provide one further means of support if night weaning is going to happen. Again, with an older nursling, this is something they may to like have agency over. A parent might explain that one day boobies will go away, and they can choose a new friend to be with them at night to help them.

In the nights prior to the onset of night weaning, daytime conversation is valuable. This is not something that comes out of the blue. However, weeks of preparation are unlikely to be helpful. Being gentle is not always the same thing as being very slow. A young child is unlikely to have a sophisticated sense of time and concepts like 'next month' or even 'next week' are fairly meaningless. Something like 'in a few days' might be more useful. You might discuss it on the bus, walking back from the park, at dinner time. You could eventually remind their child that, 'tonight is the last night that booby happens all night. Then tomorrow booby is sleeping at night.' Or you might say, 'tonight is the last night booby happens all night. Tomorrow, we can only do two boobies at night.' You remind them that it will be hard, and you will be there to help them. Then the during the day, prior to the big night, there are lots of reminders.

What is important is to emphasise that you will be there to support your child, whatever they are feeling. We are not implying that we are asking them to be a 'good boy' or to 'try hard'. Equally, the next morning, we are not praising them for not being upset. All feelings are welcome because the child is loved unconditionally. If you have a partner, they can provide important support for both of you, but it is not ideal if your approach to weaning involves you stepping away entirely and leaving your partner to take over (or for you to leave the home entirely). Your child is scared and experiencing their first major loss in their life. They need to know they are not losing you entirely. You are there to support them through this loss. And you'll also need to practise your new skills of providing comfort and co-regulation. Sometimes when parents do attempt to use separation as a weaning technique, it can leave a child feeling more vulnerable and even more desperate for breastfeeding to continue. Sometimes there is no alternative other than to face difficult feelings and to be there for your child during their time of loss.

Ending breastfeeding is hard. Even the most careful and loving parent who approaches the weaning process sensitively and gently may find it upsetting and difficult. Just as we make space for little people to feel sad, we may need to allow ourselves to have mixed feelings too. As AA Milne says (as quoted in the weaning book, 'Booby Moon' by Yvette Reid): "How lucky am I to have something that makes saying goodbye so hard." Then, when you are done, take a moment to look back and celebrate your breastfeeding achievement. Remember those early days and weeks. Remember the special times. IBCLC Glenni Lorick says that parenting is a 'series of weanings'. This has probably been your first. Well done for getting through it.
Emma's book: SUPPORTING THE TRANSITION FROM BREASTFEEDING: A GUIDE TO WEANING FOR PROFESSIONALS, SUPPORTERS AND PARENTS will be published by Jessica Kingsley Publishers soon.
References:

1. Brown, A. and Harries, V. (2015) 'Infant sleep and night feeding patterns during later infancy: association with breastfeeding frequency, daytime complementary food intake, and infant weight.' Breastfeeding medicine 10, 5, 246-252. doi: org/10.1089/bfm.2014.0153

2. Drugs in Breastmilk information service: https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk/

3. NHS Better Health Start for Life (2023) What to Feed Your Baby. UK: NHS Public Health England. https:/www.nhs.uk/start4life/weaning/what-to-feed-your-baby/7-9-months/

4. First Steps Nutrition Trust (2021b) Infant milks: A simple guide to infant formula, follow-on formula and other infant milks. London: First Steps Nutrition Trust. https://www.firststepsnutrition.org/parents-carers

5. Perry, P. (2019) The Book You Wish Your Parents Had Read (and Your Children Will Be Glad That You Did). London: Penguin. P.79

6. Hookway, L. (2021) Still Awake: responsive sleep tools for toddlers to tweens. London: Pinter & Martin.

7. Reid, Y. (2021) Booby Moon: a weaning book for toddlers. New Zealand: Yvette Reid.

8. Lorick, G. (2009) 'Life is full of weanings', Conservative Granola Mommies, 2 March. https://conservativegranolamommies.blogspot.com/2009/03/life-is-full-of-weanings.html.

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Ending your breastfeeding journey: some approaches to parent-led weaning - The Breastfeeding Network

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Emma Pickett IBCLC Making the decision to end breastfeeding Breastfeeding support is all about helping you to breastfeed for as long as you want to. We want families to reach their breastfeeding goals, and that means Breastfeeding Supporters are here for parents at the end of their breastfeeding experience, as well as at the start.

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It's up to you and your baby to decide when you want to finish breastfeeding.

How long to breastfeed

It's recommended that you breastfeed your baby exclusively (give them breast milk only) for the first 6 months of their life.

Breastfeeding still has lots of benefits for you and your baby after 6 months. It protects them from infections and there's some evidence that it helps with the digestion of your baby's first solid foods. It also continues to provide the balance of nutrients your baby needs.

The World Health Organization recommends that all babies are exclusively breastfed for the first 6 months of their life, and from 6 months babies should start eating solid foods as well as being breastfed for up to 2 years or longer.

If you're not sure whether to continue with breastfeeding, contact the National Breastfeeding Helpline on 0300 100 0212 (available every day, 9.30am to 9.30pm).

Read more about the benefits of breastfeeding

Stopping breastfeeding gradually

There's no right or wrong way to stop breastfeeding. For lots of mothers and babies, stopping breastfeeding happens gradually as the child grows and eats more solid foods.

It's important that solid food should not simply replace breast milk. There's evidence that breast milk may play a part in helping a baby's digestive system to deal with their first solids.

Once they're eating solids, your baby will still need to have breast milk or formula as their main drink up to at least their 1st birthday.

Cows' milk is not suitable as a main drink for babies under 1 year old, although it can be added to foods, such as mashed potatoes.

Carrying on breastfeeding while giving your baby some formula can work very well.

Babies breastfeed for comfort as well as food. Phasing out breastfeeding gently will give you both time to get used to the idea. Stopping gradually will also help prevent problems like overfull, hard (engorged) breasts and mastitis.

You'll probably find it easiest to drop 1 feed at a time. It does not matter which feed you drop first, so it will usually be a case of how it fits in with your life. For example, some mothers may prefer to continue night feeds so their baby can still have the comfort at night.

If your baby is younger than 1 year, you'll need to replace the dropped breastfeed with a formula feed from a bottle or (if they're over 6 months) a cup or beaker, instead.

If your child is over 1 year and having a variety of foods and drinks, they will not need a replacement feed.

Once you and your baby are settled into a pattern of having 1 less breastfeed, you can then think about dropping another feed. Completely stopping breastfeeding can take anything from a few weeks to several months.

If you're trying to stop breastfeeding and having problems, you can get help and ideas from a health visitor or a breastfeeding specialist.

Read more about drinks and cups for babies

Combining breast milk and formula

Some women decide to combine breastfeeding and bottle feeding with formula milk rather than stopping breastfeeding completely.

If you want to do this, it's best to wait until your milk supply is fully established. This can take around 6 to 8 weeks.

You can start by replacing 1 of your baby's regular daily breastfeeds with a bottle (or, if your baby is over 6 months, a cup or beaker) of formula, instead.

Common reasons for stopping breastfeeding

Sore or painful breasts

Some women find breastfeeding uncomfortable, especially in the early days and weeks. Common problems include sore or cracked nipples and painful breasts.

These problems can often happen when your baby is not positioned or attached well at the breast. A midwife, health visitor or a breastfeeding specialist can help you with positioning your baby and getting them properly attached.

Not enough breast milk

Lots of women worry that their baby is not getting enough milk when in fact they have plenty to meet their baby's needs.

A midwife, health visitor or breastfeeding specialist can suggest ways to increase your milk supply if necessary. This could just mean making sure your baby is well attached to the breast and that you're feeding often enough.

Going back to work

Some women worry about breastfeeding and returning to work. Going back to work does not necessarily mean you have to stop breastfeeding.

If your breast milk supply is well established, going back to work does not have to affect your milk supply for your baby. You can either express at work, give your breast milk to your child's carer, or provide formula milk while you're away.

If your employer is not familiar with the rules around breastfeeding and expressing in the workplace, it's worth sharing the ACAS guidance on pregnancy and maternity with them, or contacting your union if you have one.

Going on holiday

As with work, going on holiday does not mean that you have to give up breastfeeding. In fact, breastfeeding can be more convenient while you're away.

If you breastfeed, you do not need to worry about boiling water and sterilising feeding equipment. Plus, if you're flying, there's no need to worry about restrictions on carrying bottles or cups of formula through airport security checks.

Breastfeeding also helps to equalise the pressure in your baby's ears on take-off or landing.

Getting pregnant again

If you get pregnant again while you're breastfeeding, it should not affect your baby or the pregnancy. However, you may feel tired, and changes in your appetite and emotions can make breastfeeding more challenging.

Do not be put off feeding an older baby and a newborn (tandem nursing). The more milk your babies take, the more your breasts produce, so it's possible to feed more than 1 baby.

Taking some medicines

Most medicines can be taken while you're breastfeeding without harming your baby.

But it's always best to tell a doctor, dentist or pharmacist if you're breastfeeding.

Read more about breastfeeding and medicines

Restarting breastfeeding after stopping

Stopping breastfeeding does not always have to be permanent, but starting again may take a lot of time and not everyone will produce enough to meet their baby's needs. It partly depends on how well-established your milk supply was already.

Stimulating your breasts by expressing breast milk and offering the breast to your baby regularly can encourage your body to start making milk again.

Skin-to-skin contact with your baby can promote lactation (milk production) too.

You can ask a midwife, health visitor or a breastfeeding specialist for help if you would like to restart breastfeeding.

Breastfeeding older children

There's no reason why you should not continue breastfeeding your child into their 2nd year and beyond. You and your toddler can continue to enjoy the benefits of breastfeeding for as long as you want to.

Your toddler may also find breastfeeding comforting when they're ill or upset.

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Thinking of stopping breastfeeding? Find out how to wean your baby off the breast once you're both ready to stop.

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Diversity in Breastfeeding - The Breastfeeding Network

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Copyright © 2025 The Breastfeeding Network. Registered Charity No SC027007Accessibility | Privacy Notice | Members area

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

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Chestfeeding if you're trans or non-binary

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Chestfeeding if you're trans or non-binary

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Chestfeeding if you're trans or non-binary

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

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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
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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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ADHD Awareness Month 2024: ADHD and Breastfeeding - The Breastfeeding Network

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I’m Emily, mum of two and an IBCLC and a Peer Supporter with the Breastfeeding Network. For ADHD awareness month I’m writing about ADHD and how it affects parenting and breastfeeding.

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

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

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

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

Personal stories

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

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

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

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Learning you are pregnant with twins, triplets or more changes your expectations and plans. But your decision to breastfeed doesn't have to change.

Breastmilk is especially important for multiples, who are often small at birth and need all the health benefits it provides. Breastfeeding also helps you create a special bond with each of your babies. Many mothers have nursed their multiples; you can enjoy nurturing your babies this way, too.

Planning ahead

Attend La Leche League meetings or our Antenatal Breastfeeding classes in pregnancy to learn about breastfeeding and meet breastfeeding mothers. Do read The Womanly Art of Breastfeeding, Mothering Multiples by Karen Gromada and our page on Birth and Breastfeeding.

A healthy diet with plenty of protein, complex carbohydrates and good fats will get you all off to a good start. Gaining healthy amounts of weight during pregnancy is good for your babies' birth weights and may also help prevent premature birth.

Even with good care, you might experience complications during pregnancy so it helps to be prepared. Ask your midwife for information on warning signs for premature labour. Seek medical attention quickly if any occur, or you have any of these symptoms: a severe headache or stomach ache, see spots in front of your eyes, or feel extremely irritable or tense.

Limit visitors

Limit visitors while in hospital and in the early days to those you feel comfortable breastfeeding in front of. When nursing two babies at once, you may feel exposed, at least until you can manage both babies and keeping your breasts covered (if you feel you want to). Tell friends and family you need time to recover and suggest they visit later, or drop round a meal!

Separation

Any separation after birth may make breastfeeding harder, but it's still possible. Hold, or at least touch, your babies immediately after the birth or as soon as you can. You can still touch and stroke a baby in special care and may be able to hold him against you in 'kangaroo mother care'. If he can't breastfeed, express your milk for him. This is the most important thing you can do whilst you are waiting to start breastfeeding. When you are back together, spend as much time as possible snuggling together skin-to-skin or lightly dressed to establish breastfeeding.

If you need to express your milk because one or both babies can't nurse, hand expression is useful in the first few days. Plan to express from both breasts at least eight times in 24 hours, about every two to three hours during the day and at least once during the night. As your milk increases, you can switch to a hospital grade automatic electric pump.

Once breastfeeding is established, mothers of multiples often find nursing two at once is easiest and it saves time to co-ordinate feeds. Biological Nurturing ™ positions can leave your hands free.

Breastfeeding at night lying down gives you more rest. It gets easier as your babies grow. In the meantime, use enough pillows to recline in bed and feed two babies at once. Keep a drink and snack handy plus books or music to pass the time. See Safer Sleep and the Breastfed Baby.

Making enough milk

The more milk your babies take, the more your breasts will make. This is especially important in the first few weeks. Since mothers of multiples usually experience more breast development during pregnancy, mothers of twins can almost always produce enough milk for both babies, and triplets can also be totally breastfed.

See Is My Baby Getting Enough Milk?

Encourage each baby to feed at least 8-10 times in 24 hours. If one of your babies is too sleepy or groggy to rouse himself every few hours, you will need to wake him to feed to ensure he gets enough milk. See our page Sleepy Baby-why and what to do.

At first you may feel you are doing nothing but feeding, but things will settle down as your babies grow and your milk production adjusts. Practical help with everything else will allow you to sit or lie down and concentrate on the important job of establishing breastfeeding.

Looking after yourself

You'll be busy looking after your babies but don't forget to look after yourself too. Try to eat a balanced diet and drink enough. Get as much rest as possible, and sleep whenever your babies sleep.

Looking after your babies will be a full-time job for quite a while so expect to do only the absolute minimum of housework.

Others will offer help with housework or entertaining older children-do accept if you feel you want to and make an effort to ask for help when you need it. Have a list of simple tasks ready to make it easier when people do offer help and you could share information from our pageSupporting a Breastfeeding Mother.

Your partner or support person will have a crucial role both practically and emotionally. Because they are needed so much, non-gestational parents of multiples have the opportunity to quickly develop close relationships with their babies. Other family members may also enjoy the chance to be practically involved. Take moments to appreciate this special time and be proud that you can nourish and nurture two or more little human beings at once!

Other sources of practical help

Midwives, health visitors, clinics and surgeries.

Homestart - a charity which offers support and friendship to families who are struggling to cope for a variety of reasons.

Local college students studying child development or members of local community groups.

Mixed feelings

Parents of twins or more often have mixed emotions about their multiple babies. It's normal to feel overwhelmed by the prospect of caring for two or more babies at once.

It can really help to talk to another family in the same situation. Your local LLL Leader can put you in touch with other mothers who have breastfed multiples, some LLL groups have Facebook support groups specifically for mothers of multiples. There may also be a local twins support group near you (see Further Information section). Adjusting to Motherhood has practical tips on dealing with feelings too.

Practicalities of getting out

It's daunting leaving the house with more than one baby. Start by going out briefly with someone else to help.

Keep a changing bag packed and ready. A backpack leaves your hands free.

Keep valuables and keys safe to hand in a waist pack or small bag across your chest.

Consider using a sling or carrier for one baby even when out with a pushchair. A double pushchair can be useful for carrying shopping too.

Alternate which baby gets carried: it's easy to overlook a quieter baby's need for closeness if one fusses more when out and about.

Think about suitable places for feeding ahead of time. Look out for your babies' early feeding cues so you can offer a feed before they start to fuss and attract attention from others.

Get to know your babies: with time, you will come to know your babies as individuals. Take opportunities to give them a little undivided attention: feeding, nappy changes etc. A few minutes here and there all add up. Their personalities will soon show through.

Finding support

It's OK to ask for help-it can take a while for breastfeeding to become easy, or for your babies to learn to breastfeed effectively. It will get easier as time goes on. You can get skilled help from an LLL Leader by calling our Helpline. Seek support and encouragement from the mothers in your local LLL group.

Written by Sue Upstone and mothers of LLLGB, photos courtesy of Sarah W.

Further Reading

Adjusting to Motherhood
Antenatal Expression of Colostrum
Birth and Breastfeeding
Caesarean Birth and Breastfeeding
Hand Expression of Breastmilk
My Baby Needs More Milk
Sleepy Baby - Why and What to Do
Supporting A Breastfeeding Mother
Mothering through special care

LLLI Resources
Breastfeeding Premature Babies

Other websites
Information on nursing multiples by the author of Mothering Multiples.
Website and blog of Krista Gray, IBCLC and mother of twins.
Breastfeeding Twins and Triplets by Kathryn Stagg, IBCLC

Books

The Womanly Art Of Breastfeeding. LLLI, London: Pinter & Martin, 2010.
Hold your Prem. Jill Bergman and Dr Nils Bergman. Cape Town: New Voices Publishing, 2010.
Mothering Multiples. Karen Kerkhoff Gromada. Schaumburg, IL: LLLI, 2007.
Breastfeeding Your Premature Baby. Gwen Gotsch. LLLI, 2002.

Further Information

Twins Trust provides information and support networks for families of twins or more. Tel: 0800 138 0509 (10 am-1 pm and 7pm-10pm, daily).

Breastfeeding Twins and Triplets UK is a charity providing breastfeeding information and support run by breastfeeding counsellors

This information is available to buy in printed form from our Shop.

Copyright LLLGB 2016

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Learning you are pregnant with twins, triplets or more changes your expectations and plans. But your decision to breastfeed doesn't have to change. Breastmilk is especially important for multiples, who are often small at birth and need all the health benefits it provides. Breastfeeding also helps you create a special bond with each of your [...]

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Strategies for managing mastitis have recently been reviewed, and information on how to treat it has changed. This infographic is a helpful guidance.

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Every day mothers panic and end breastfeeding or start using formula and there is not an underlying problem with their milk supply.

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Common Questions about Breastfeeding video

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Common Questions about Breastfeeding video

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Breastfeeding Network Shropshire, Telford & Wrekin

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BaSiS- Dummies, Swaddling & Baby Sleep Bags

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BaSiS- Dummies, Swaddling & Baby Sleep Bags

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Healthy Start | Healthy Start | Stoke-on-Trent

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Healthy Start is a government funded, NHS initiative that provides support if you are pregnant or have a child under the age of 4 to obtain payment to contribute towards Cow’s Milk, Fresh, frozen or tinned fruit and vegetables, infant formula milk and fresh, dried and tinned pulses. The scheme also provides entitlement to free Healthy Start Vitamins.

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Unicef UK Baby Friendly Initiative | Hand expression

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How partners can support and bond with your baby

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How partners can support and bond with your baby

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Breastfeeding Network Shropshire, Telford & Wrekin

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Breastfeeding and the Support Partners role

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Breastfeeding in the First Few Days Video

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Breastfeeding in the First Few Days Video

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Breastfeeding Network Shropshire, Telford & Wrekin

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Skin-to-skin contact - Baby Friendly Initiative

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

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Bentilee Family Hub (creche downstairs, Buzz for access) - Mondays 12pm - 1.30pm

Dawlish Drive, Stoke-on-Trent ST2 0HW

Chell Heath Family Hub (creche room to the right of the entrance) - Wednesdays 11am - 12.30pm

Bishop Road, Stoke-On-Trent ST6 6QW

Shelton Family Hub (ground floor) - Thursdays 10am - 11.30am

College Road, Shelton ST4 2DQ

Normacot Family Hub (Diamond Room behind reception) - Fridays 10am - 11.30am

Buccleuch Road, Stoke-on-Trent ST3 4RF

For full details on accessing our groups, and updates, please check out our Facebook page.

If you need additional support accessing a group, please reach out to stoke@breastfeedingnetwork.org.uk or use the self-refer form on our linktree https://linktr.ee/breastfeedingnetworkstoke

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Breastfeeding Network Stoke, Stoke-on-Trent. 726 likes · 11 talking about this. Join our breastfeeding support group in Stoke on Trent. We offer non-judgmental information, support and friendship to...

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stoke@breastfeedingnetwork.org.uk

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BfN Stoke Linktree - Self Refer For Support

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BfN Stoke Linktree - Self Refer For Support

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Book your place on our Free antenatal workshops or self-refer for support.

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breastfeedingnetworkstoke | Instagram, Facebook | Linktree

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Accredited breastfeeding/infant feeding & antenatal peer support Stoke-on-trent

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

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

nipple pain and trauma for mum

poor breast milk intake leading to poor weight gain

a possible decrease in milk supply over time.

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

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

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

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

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

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

NHS Tongue tie page

NCT Tongue tie page

GP infant feeding network

La Leche League tongue tie page

UNICEF tongue tie page

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

Links checked April 2023

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

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Thrush & Breastfeeding - Podcast with Emma Pickett & Dr Dow

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Thrush & Breastfeeding - Podcast with Emma Pickett & Dr Dow

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Thrush and breastfeeding with Dr Naomi Dow

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Podcast Episode · Makes Milk with Emma Pickett · 28/01/2025 · 1h 9m

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Steps to position and attachment of your baby to the breast

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Steps to position and attachment of your baby to the breast

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How do I know that breastfeeding is going well?

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How do I know that breastfeeding is going well?

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Stoke Thrive at Five, Stoke-on-Trent. 679 likes · 129 talking about this. The Stoke-on-Trent division of Thrive at Five. Operating in Abbey Hulton and Bentilee.

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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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Drugs in Breastmilk factsheets - The Breastfeeding Network

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

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Unicef UK Baby Friendly Initiative | Positioning and attachment

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Updated in 2022 with important new messaging on sleep safety, this leaflet offers helpful, practical advice to parents on looking after their sleeping baby both during the day and at night.

Caring for Your Baby at Night and When Sleeping covers a range of topics, including getting some rest, night feeding, safe sleeping environments and helping baby to settle. It is endorsed by the Lullaby Trust, the Baby Sleep Info Source (BASIS), the Royal College of Midwives (RCM) and the Institute of Health Visiting (iHV).

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

Caring for your Baby at Night and when Sleeping

A Guide for Parents

Download now

Caring For Your Baby at Night and When Sleeping: A guide for health professionals

Our accompanying guide supports health professionals who will be using Caring for Your Baby at Night and When Sleeping with new parents. It looks at the evidence underpinning the recommendations in the leaflet and offers guidance on discussing these issues.
An updated version of the health professional's guide will be made available soon.

Further resources

The Baby Sleep Information Source (Basis) is an informational source for parents who wish to make informed choices about their infant's sleep and night time care, and is the result of a collaboration between the Durham University Parent-Infant Sleep Lab, La Leche League, NCT, and the UNICEF UK Baby Friendly Initiative.

We have also collaborated with The Lullaby Trust, Public Health England, and Basis to create a range of resources for parents and health professionals, with accessible guidance on safer sleep practices. The following are available to download and buy on The Lullaby Trust website.

Safer Sleep for Babies: A Guide for Parents

Safer Sleep for Babies: Saving Babies' Lives - A Guide for Professionals

Safer Sleep for Babies: Quick Reference Card

Public Health Wales have produced a version of the Caring for your baby at night leaflet in Welsh, which is free to download.

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Caring for your baby at night leaflet - Baby Friendly Initiative

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This leaflet, endorsed by BASIS, the RCM and The Lullaby Trust, offers practical advice for parents on caring for their sleeping baby.

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Getting Started
Breastfeeding should be COMFORTABLE
How you sit (or lie down) and how close you hold your baby as you feed can make a difference to how well things go. Sometimes a little difference in how your baby is feeding can make a big difference to how comfortable it is for you and how easily your baby gets your milk.
Breastfeeding should NOT HURT
Changing how you hold your baby and how they start to feed can sometimes make a difference to how they settle after feeds.

How you hold your baby is frequently called positioning.

How your baby takes the breast is sometimes called attaching, latching or fixing.
Positioning can help make ATTACHMENT more effective and comfortable, here's how:
Your baby needs to be able to take a large mouthful of breast and feed effectively without causing you any discomfort.

Especially in the early days, you may find it more comfortable to feed lying in a semi reclined position, with your body and head completely supported. In this position your baby feeds while lying on your stomach, with their body and legs downwards. This way your baby can move towards your nipple and breast itself, with some gentle guidance if needed. You may prefer to breastfeed sitting up with your baby lying across your body or in a rugby hold.

Sit comfortably with your back well supported

Sit comfortably with your feet flat on the floor or raised on a stool or a pile of magazines or similar so that your lap is flat.

Keep your baby's body in a straight line with their whole body facing the food (nipple and breast).

Support their neck, shoulders and back so that your baby can tilt their head back easily.

Move your baby from your cleavage towards the nipple.

Make sure your baby's lower lip and chin is in contact with your breast first.

The following issues are possible signs that your attachment could benefit from being altered. They are not always caused by attachment, but it is worth trying to adjust the way you are holding your baby and bringing them to the breast before considering any other explanations:

Baby starts to feed then pulls away

Nipples cracked or sore

Baby is unsettled or 'colicky'

Breasts leak

Baby fights or refuses the breast

Baby wakes up frequently in the night

Baby has sore bottom or watery stools or green poo

Slow weight gain

Blocked ducts or mastitis

Baby's nose is blocked by mother's breast

Very frequent and/or lengthy feeds

There are some illustrations and more information in Off to the Best Start.

If you want to talk through positioning and attaching in more detail, you could contact the National Breastfeeding Helpline to speak to a registered Breastfeeding Supporter. The National Breastfeeding Helpline is available from 9:30 am to 9:30 pm, 365 days a year, on 0300 100 0212, or via social media and webchat.

Here are some links to external breastfeeding websites with line drawings and images that give tips on how to get your baby to the breast correctly:

Speak to a registered Breastfeeding Supporter

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How to breastfeed - The Breastfeeding Network

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

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Diane Wiessinger, Diana West, Linda J. Smith, Teresa Pitman

Photo: Weaver by Lisa on Location Photography
Excerpted fromSweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family, Chapter 2: The Safe Sleep Seven, by Diane Wiessinger, Diana West, Linda J. Smith, Teresa Pitman, a La Leche League International book, Ballantine Books, 2014.
Wah! Wah! Wah! Drag yourself out of your nice cozy bed, pick up your screaming baby, sit down to nurse, try to stay awake, put him back in the crib, stagger back to bed, and hope, hope, hope he stays asleep for at least two hours. I had no idea I could feel that exhausted. I could not understand how other mothers survived this, because I didn't think I was going to.
My friend who's a La Leche League Leader came over and saw how worn down and bleary-eyed my husband and I looked. She asked if we'd thought about bedsharing to get more sleep. No. Not for us. Never. But she laid out seven things that make it safer. That night, out of pure desperation and sleep deprivation, I brought my son into my bed for part of the night . . . and I started the next day a bit brighter. He spent more and more time in my bed at night, and lo and behold, we both got more and more sleep. -Monica

Today's culture says you should keep the baby in your room... but not in your bed. Feed him in bed and get really drowsy...but then get out of bed again. Two trips out of bed for every feeding. By about six weeks, something has to give. (1) Weaning? Leads to short-term and long-term problems. (2) Night weaning? Not healthy for you, your baby, or your milk supply at this age. (3) Supplementing? Ditto. (4) Break out the sleep-training book from the baby shower? Not as harmless as it seems (see Chapter 18).

A mother's first step is usually to find a place where she can relax for night feedings. The American Academy of Pediatrics (AAP) says, "Infants may be brought into the bed for feeding or comforting but should be returned to their own crib or bassinet when the parent is ready to return to sleep." (5) Easy to say. When most of us are "ready to return to sleep," steeped in hormones that make us sleepy, the last thing we want is to get up again. If a mother's afraid to nurse in her own bed, her most likely options are a sofa, recliner, or upholstered chair-all riskier places to sleep with a baby. One study found that 44 percent of mothers who nurse in those places at night fell asleep there at least once. (6) Eventually, many mothers find that bedsharing is a low-risk, long-term solution for sleep deprivation and an unhappy baby. (7) But they often go through several high-risk arrangements along the way.

The Safe Sleep Seven Bedsharing Song

(to the tune of "Row, Row, Row Your Boat")
No smoke, sober mom
Baby at your breast
Healthy baby on his back
Keep him lightly dressed.
Not too soft a bed
Watch the cords and gaps
Keep the covers off his head
For your nights and naps.

Even though most new breastfeeding mothers today don't plan to bedshare, studies show that eventually 60 to 75 percent of them will, at least some of the time. (8) Why? Probably because most breastfeeding mothers get more sleep when they bedshare. (9) In fact, a lot of mothers who say they don't bedshare actually do. If the baby starts the night in the crib, if the baby started the night in the crib last night, if the baby usually comes into his mother's bed at the first waking, even if a family simply owns a crib . . . any of those can lead a mother to say-and believe-that she doesn't bedshare when she actually does. (10)

One of the big reasons that bedsharing is safer when you're breastfeeding is the way you position your body next to your baby. During sleep, you'll automatically go into the same position as breastfeeding mothers all over the world and throughout time. It's called a cuddle curl, and it's nature's way of protecting a baby during sleep. Your knees come up and your arm tucks under your head or pillow, or curls around your baby, creating a protected space. There's no way for you to roll toward your baby because your bent legs won't let you. And no one else can roll into the space because your knees and elbows are in the way. (11) Very cool! (If you're worried about your partner, just sleep between your partner and the baby.)

Even during sleep a breastfed baby will instinctively stay with his face near the breast, because that's the center of his universe (and his kitchen). (12) If your baby homes in on your breast, he's not going to wander up into the pillows or down under the covers (and your arm and legs won't let him).

There's another layer of protection too: normally, we're aware of the edges of our bed and the bodies of our pets, even when we're sound asleep. We don't roll over on a baby any more than we roll off the side of the bed or roll over on the cat. And of course both the cat and the baby would react if you tried.

A mother who has never breastfed loses some of these protections. She tends to move her baby closer to her own face, where those puffy, smothery pillows are. (13) And a baby who doesn't breastfeed is more likely to wander up there himself, even if the bottles are filled with his mother's milk.

What if you're still working out the kinks, maybe pumping for a baby who isn't nursing yet? A newborn will automatically seek his mother's breast. If you've been focused on helping him breastfeed, you'll probably find yourself doing a cuddle curl, at least at first.

If you breastfeed most of the time but give occasional bottles of pumped milk, you'll probably still sleep in a breastfeeding cuddle curl, and your baby will most likely stay at chest level. (14) But if either of you sees a bottle as the more important food source, you and your baby may not automatically "think breast," and your bedsharing risk may increase. (15) If you're just not sure, think carefully about how you cradle your baby when you lie down, and maybe have your partner watch how you interact before you decide for or against bedsharing.

What if your baby gets formula sometimes? Exclusive formula-feeding increases the risk of SIDS (see Chapter 19); partial formula-feeding is a smaller SIDS risk.

By about four months, any responsible adult can bedshare as safely as a responsible breastfeeding mother. (16)

For those who say they don't need to prepare their bed for bedsharing because they'll never, ever do it, think about car accidents. No one ever expects them to happen either. But they do. That's why we wear seat belts. It's not that we're planning to have an accident; it's that accidents are never planned. So we plan ahead, and we don't give it another thought. Simple and safe-or as safe as being in a car can get.

A planned-ahead bed is just a seat belt. Then at 3:00 a.m. when your baby just can't sleep alone even though you've tried everything up, down, and sideways, you can collapse in bed with your baby and stay there snugly until morning. Tomorrow morning you can decide what you want to do tomorrow night. Life is risky, no matter how you live it. A safe bed, like a seat belt, can greatly reduce that risk.

The Key Points for Safe Sleep for All Babies
Stay smoke-free. Stay sober. Stay off sofas, upholstered chairs, and recliners for sleep. Keep your healthy baby lightly dressed, on his back, and near you for sleep. And, of course, keep breastfeeding.

But what about all the warnings against bedsharing? If you meet the criteria outlined in the Safe Sleep Seven, then you're not the mother the warnings are for! Only a small subset of babies with certain preexisting vulnerabilities is at risk for SIDS. The risk for SIDS or suffocation is far, far, far greater in a household where the mother smokes, where alcohol or drugs are involved, where the baby is formula-fed, or in truly chaotic settings where the baby sleeps who knows where or with who knows whom (see Chapter 19). In an attempt to reach certain mothers and protect certain babies, the warnings have be en made very clear, very strong, and very simple. The answers for you are just as simple.

The Key Points for Applying the Key Points
Every situation is different. Life is never 100 percent safe. And everyone balances risk and benefits differently. Take the information we present and use your mother-wisdom to decide what's best for you, your baby, and your family.

All those scary warnings are about only the first four months. Beyond that? Even the researchers behind the bedsharing cautions agree that by about four months bedsharing by any responsible, nonsmoking adult is as safe as having your baby sleep separately in a bassinet or crib. (11)

If you and your baby fit the Safe Sleep Seven criteria, your baby's risk of SIDS is what one sleep researcher calls vanishingly small. And you'll virtually eliminate overlying and other suffocation risks.

If you are:
1. A nonsmoker
2. Sober and unimpaired
3. A breastfeeding mother and your baby is:
4. Healthy and full-term
5. On his back
6. Lightly dressed
and you both are:
7. On a safe surface

Then your baby in bed with you is at no greater risk for SIDS than if he's nearby in a crib. The Safe Surface checklist explains number 7 and practically eliminates breathing risks no matter where he sleeps. Rolling over on your baby is virtually impossible because you have the cuddle curl (see above) and responsiveness of a breastfeeding mother. By the time the baby is about four months old, research indicates that bedsharing with a healthy baby by any responsible nonsmoking adult on a safe surface is as safe as any other sleep arrangement.

The Safe Surface Checklist

Avoid these possible smothering risks:

Sofas and recliners

Softness or sagging that rolls your baby against you or keeps him from lifting his head free

Spaces between mattress and headboard, side rails, or wall where a baby could get stuck

Pets that could interfere

Clear your bed of:

Unused pillows

Stuffed toys

Heavy covers and comforters

Anything nearby that dangles or tangles (such as cords, strings, scarves, ribbons, elastics)

Check your bed for possible hazards:

Distance to floor

Landing surface

Sharp, poking, or pinching place

The remainder of Chapter 2 explores the details of each Safe Sleep Seven criteria, including the research and common sense behind them.

Something to Sleep On

Research on infant sleep risks, which we go over in depth in Chapter 19, shows again and again that the big risks of shared sleep are a mix of SIDS risks that affect vulnerable babies and breathing hazards that affect all babies: smoking, alcohol or drugs, risky surfaces like sofas, baby on his front (unless he's on an adult's chest), and formula-feeding. Combine two or more of those, and the risk can skyrocket.

If you and your baby meet the requirements in the Safe Sleep Seven checklist, you've already eliminated all the biggest SIDS risks. And if you prepare your bed, then your baby's overall nighttime risk becomes vanishingly small. It's like putting your seat belt on and then driving slowly on a deserted (and lovely!) country road. Enjoy having your baby beside you for the journey.

Sleep: Bedshare
Sleep: Safe Sleep
Sleep: Safe Surface
Sleep: Talking With Your Doctor About Bedsharing
Infant Sleep
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References

1 Ball, H. L. Breastfeeding, bed-sharing, and infant sleep. Birth 30, no. 3 (2003): 181-188. Ball, H. L., Hooker, E., Kelly, P. J. Where will the baby sleep? Attitudes and practices of new and experienced parents regarding cosleeping with their newborn infants. American Anthropologist 101, no. 1 (1999): 143-151.

2 U.S. Department of Health and Human Services. Executive summary: the surgeon general's call
to action to support breastfeeding. Breastfeeding Medicine 6, no. 1 (2011): 3-5.

3 Imong, S. M., Jackson, D. A., Wongsawasdii, L., et al. Predictors of breast milk intake in rural northern Thailand. Journal of Pediatric Gastroenterology and Nutrition 8, no. 3 (1989): 359-370. Kent, J. C. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics 117, no. 3 (2006): e387-e395.

4 Howel, D., Ball, H. Association between length of exclusive breastfeeding and subsequent breastfeeding continuation. Journal of Human Lactation 29, no. 4 (2013): 579-585.

5 Moon, R. Y., et al. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics 128, no. 5 (2011): e1341-e1367.

6 Kendall-Tackett, K., Cong, Z., Hale, T. W. Mother- infant sleep locations and nighttime feeding behavior. Clinical Lactation 1, no. 1 (2010): 27-30.

7 Colson, E. R., Willinger, M., Rybin, D., et al. Trends and factors associated with infant bed sharing, 1993-2010. The National Infant Sleep Position Study. JAMA Pediatrics 167, no. 11 (2013): 1032-1037.

8 Ball, H. L. Breastfeeding, bed-sharing, and infant sleep. Birth 30, no. 3 (2003): 181-188. Ball,
H. L. Bed-sharing practices of initially breastfed infants in the first 6 months of life. Infant and Child Development 16, no. 4 (2007): 387-401.

Ball, H. L. Reasons to bed-share: why parents sleep with their infants. Journal of Reproductive and Infant Psychology 20, no. 4 (2002): 207-221.

Kendall-Tackett, K., Cong, Z., Hale, T. W. Mother- infant sleep locations and nighttime feeding behavior. Clinical Lactation 1, no. 1 (2010): 27-30.

Lahr, M. B., Rosenberg, K. D., Lapidus, J. A. Maternal-infant bedsharing: risk factors for bedsharing in a population-based survey of new mothers and implications for SIDS risk reduction. Maternal and Child Health Journal 11, no. 3 (2007): 277-286.

Blair, P. S. The prevalence and characteristics associated with parent-infant bed-sharing in England. Archives of Disease in Childhood 89, no. 12 (2004): 1106-1110.

9 Quillin, S. I. M. Interaction between feeding method and co-sleeping on maternal-newborn sleep. Journal of Obstetric, Gynecologic, and Neonatal Nursing 33, no. 5 (2004): 580-588.

10 Ball, H. L., Hooker, E., Kelly, P. J. Where will the baby sleep? Attitudes and practices of new and experienced parents regarding cosleeping with their newborn infants. American Anthropologist 101, no. 1 (1999): 143-151.

11 Ball, H. Parent-infant bed-sharing behavior. Human Nature 17, no. 3 (2006): 301-318.

Ball, H. L., Klingaman, K. Breastfeeding and mother- infant sleep proximity. In Trevathan, W. R., Smith, E. O., McKenna, J. J. (eds.), Evolutionary Medicine. New York: Oxford University Press, 1999.

12 Richard, C., Mosko, S., McKenna, J., et al. Sleeping position, orientation, and proximity in bedsharing infants and mothers. Sleep 19, no. 9 (1996): 685-690.

Baddock, S. A., Galland, B. C., Bolton, D. P. G., et al. Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting. Pediatrics 117, no. 5 (2006): 1599-1607.

13 Ball, H. Parent-infant bed-sharing behavior. Human Nature 17, no. 3 (2006): 301-318. Ball, H. L., Klingaman, K. Breastfeeding and mother-infant sleep proximity. In Trevathan, W., Smith, E. O., McKenna, J. J. (eds.), Evolutionary Medicine and Health: New Perspectives. Oxford: Oxford University Press, 2008.

14 Ball, H. Parent-infant bed-sharing behavior. Human Nature 17, no. 3 (2006): 301-318. McKenna, J. J., Ball, H. L., Gettler, L. T. Mother-infant cosleeping, breastfeeding and sudden infant death syndrome: what biological anthropology has discovered about normal infant sleep and pediatric sleep medicine. American Journal of Physical Anthropology 134, suppl. 45 (2007): 133-161.

15 Volpe, L. E., Ball, H. L., McKenna, J. J. Nighttime parenting strategies and sleep-related risks to infants. Social Science and Medicine no. 79 (2013): 92-100.

16 Blair, P. S., Fleming, P. J., Smith, I. J., et al. Babies sleeping with parents: case-control study
of factors influencing the risk of the sudden infant death syndrome. CESDI SUDI Research Group.
BMJ 319, no. 7223 (1999): 1457-1461. Carpenter, R. G., Irgens, L. M., Blair, P. S., et al. Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet 363, no. 9404 (2004): 185-191. Tappin, D., Ecob, R., Brooke, H. Bedsharing, roomsharing, and sudden infant
death syndrome in Scotland: a case-control study. Journal of Pediatrics 147, no. 1 (2005): 32-37. Vennemann, M. M., Bajanowski, T., Brinkmann, B., et al. Sleep environment risk factors for sudden infant death syndrome: the German Sudden Infant Death Syndrome Study. Pediatrics123, no. 4 (2009): 1162-1170. Ruys, J. H., De Jonge, G. A., Brand, R., et al. Bed sharing in the first four months of life: a risk factor for sudden infant death. Acta Paediatrica 96, no. 10 (2007): 1399-1403. Moon, R. Y., et al. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics 128, no. 5 (2011): e1341-e1367.

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The Safe Sleep Seven - La Leche League International

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Diane Wiessinger, Diana West, Linda J. Smith, Teresa Pitman Photo: Weaver by Lisa on Location Photography Excerpted from Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family, Chapter 2: The Safe Sleep Seven, by Diane Wiessinger, Diana West, Linda J. Smith, Teresa Pitman, a La Leche League International book, Ballantine Books, 2014.

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

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Give Feedback About your maternity Experience Through Maternity Voices Stoke-on-Trent

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Give Feedback About your maternity Experience Through Maternity Voices Stoke-on-Trent

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My name is Helen Carr and I am the Maternity and Neonatal Voices Partnership Lead for Staffordshire and Stoke-on-Trent.

I work within the Maternity Transformation Programme and my main aim is to recruit maternity champions who are all volunteers and between us, we engage with women and their families to gather feedback on their experiences to help to shape the future of local maternity services.
What is the Maternity and Neonatal Voices Partnership? (MVP)
In 2015 a national review was carried out into maternity services. The review report, Better Births was published in 2016. In response to the report and its recommendations, NHS England advised that Local Maternity and Neonatal Systems (LMNS's) should be established.

The MVP is one of 5 projects sitting within the Staffordshire and Stoke-on-Trent Maternity Transformation Programme.

This MVP's focus is to gather feedback from women and families around their experiences of using maternity services and help shape the future of the service. Contributions will allow the opportunity for services to be co-designed and co-produced by women and their families and healthcare professionals.
What is a Maternity Champion and what do they need to do?
Maternity Champions are volunteers who are asked to collect information from various sources at various forums. This could be parent and toddler groups, children's centres, libraries, leisure centres, antenatal clinics out in the community and in the hospital and postnatal wards. It would also be useful to know if local families are choosing services outside of the Staffordshire and Stoke area and their reasons for this. During the pandemic whilst we have not been able to access face to face groups, we have relied heavily on social media to gather feedback.

Feedback will include experiences (positive and negative) from the beginning of pregnancy and beyond birth. There will be some particular subjects that will require feedback. For example, the use of digital notes.

The way a Maternity Champion provides feedback can be in a variety of ways. Feedback can be presented at the Maternity Champion Meetings or can be sent in via email for the team to feedback. The aim is to gather as much feedback from those people using the services and informing those who provide the services. The MVP Lead will then present quarterly feedback reports to the Local Maternity and Neonatal Partnership Board and the MVP meetings alongside a "you said, we did report"

There are 23 localities across the Staffordshire and Stoke-on-Trent area so we are hoping to recruit 23 Maternity Champions to work in their own area. This will cut down on travelling time and means the champion will know their own area and the best places to visit to get the feedback. Travel expenses will be paid and will need to be recorded and submitted in a timely manner.

We are keen to hear from everyone, dads and partners included and we gather feedback on experiences that service users have had whilst using maternity services. National guidance not only refers to COVID in maternity services, it is more about reducing inequities.

I am really keen to hear from seldom heard groups and those that may not have access to social media platforms and although I am still home working in the next month or so I am hoping that we will be able to travel to groups that may make things a little easier to communicate, engage and promote the MVP.

Contact the Project Support Officer/MVP Lead - Helen Carr: 07928 525377

Email: sasot.mvp@nhs.net

Join our Maternity Voices Partnership closed Facebook group (you will be asked to answer three simple membership questions).
Useful information:
Categorised in: News

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Maternity Champions | Maternity and Neonatal Voices Partnership - Community Health Champions

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A message from Helen Carr, Maternity and Neonatal Voices Partnership Lead: My name is Helen Carr and I am the Maternity and Neonatal Voices Partnership Lead for Staffordshire and Stoke-on-Trent.

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Stoke-on-Trent City Council Learning Services

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PEGiS - Parent Engagement Group in Stoke - Organisations – SEND Local Offer

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National Breastfeeding Helpline - Helpline

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

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Drop the Drugs in Breastmilk team a Facebook DM, if you have any questions around drugs/medications in Breastmilk.

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Log into Facebook to start sharing and connecting with your friends, family, and people you know.

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North Community Midwives Team

01782 231 152

Central Community Midwives Team

01782 233 582

South Community Midwives Team

01782 231 822

Newcastle-under-Lyme Midwives Team

Base Number - 01782 679 822

Health Visiting and School Nurse Service

0300 404 2993

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Stoke-on-Trent City Council

General Enquiries

01782 234 234

Citywide Midwife Hub

01782 672 181

Safeguarding and Referral Team

01782 235 100

Health Visiting and School Nurse Service

0300 404 2993

Stoke-on-Trent Libraries

01782 238 455

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Apply online for our volunteer training opportunities

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At the heart of our organisation are our volunteers who give their time to support other families in their communities and over the helplines. We currently have over 900 volunteers across the UK of all ages and from all backgrounds. You can give a few hours every week, or each month or offer to help with a specific task or event for a short period of time, it is completely up to you.

Some people volunteer to give something back as a thank you for the support they received, others do it to meet new people or gain experience that might help them find a job. Whatever your reasons we would love to hear from you. Our volunteers make us who we are and enable us to support thousands of families each year, why not join us!

If you would like to volunteer your time to support other mums with breastfeeding you will first need to complete our Training. This helps us make sure that the support and information our volunteers offer is safe, up to date and consistent across the UK.

We would love to be able to offer training to everyone who asked, but unfortunately, this is not possible due to funding. This means we may not have training available in your area or you may need to wait for several months before you can get a place on a course.

We provide two levels of training designed for mums who have breastfed to become registered BfN volunteers. This can be provided as part of a Peer Support projector as a stand-alone activity, to increase breastfeeding awareness and support in a specific area.

All our peer support training has been granted Assured Status by OCN London and is delivered by trained BfN tutors. You will work through the training as part of a group. This enables you to share experiences and develop relationships with other women training to volunteer in your local area or across the UK.

BfN training is open to all women who have personal experience of breastfeeding their own babies. It is open to mothers of all ages and background; to enable them to widen their knowledge, skills and experience to support breastfeeding within their communities or remotely.

BfN is committed to promoting equality and diversity and to eliminating discrimination in our training and coordination of volunteers. All applications to our training courses are anonymised before they are reviewed by recruitment managers. This practice aims to reduce the impact of unconscious bias. We will always seek to make reasonable adjustments and provide additional support to ensure that our training is accessible to everyone.

What do you get when you train with us?

All workbooks, manuals, course materials and other resources to help you support mums and families

The opportunity to complete training as part of a group of mums who have breastfed

Support from a trained BfN Tutor

Assessment and internal moderation of completed coursework

Peer support from other trainees on the course and the opportunity to develop a supportive network

Registration and accreditation with Open College Network (London)

BfN ID badge and OCNL certificate upon completion

Full complimentary membership of BfN for two years (see here for full details) - including DBS and PVG checks, low-cost or free entry to our annual conference and subscription to our quarterly BfN News

Insurance to volunteer on behalf of BfN

Regular supervision (usually monthly) and ongoing support

Ongoing training and opportunities for further development (Helpers can train to become Supporters and Supporters can go on to train as Supervisors and Tutors)

The opportunity to work as a registered volunteer which can be useful work experience when applying for paid employment, also with a reference from a national charity

BfN Helper Course (Peer Supporter)

This is our first level of training for volunteers. By completing the course you can hope to achieve:

The knowledge to support other mums with breastfeeding

A nationally recognised, Open College Network (London) accredited qualification (two units at Level 2, equivalent level to GCSEs in England and National 5s in Scotland)

The opportunity to continue training to become a BfN Registered Breastfeeding Supporter

Training to become a BfN Helper volunteer is free and may include a crèche facility.

BfN Registered Helpers (peer supporters) can volunteer in a variety of different ways: in BfN breastfeeding drop-in groups, in hospitals, schools and in antenatal classes.

The course itself usually consists of twelve 2 hour sessions which are traditionally delivered face to face at a local community venue. We are currently developing a more blended approach. This combines the same excellent support from an experienced BfN tutor and access to an accredited course using an online format. The online course includes around seven group tutorials delivered via video call.

There is also a version of the BfN Helper Course aimed specifically at training peer supporters to be able to volunteer in the neonatal unit.

BfN Supporter Course

BfN Registered Helpers may go on to do a second stage of training if they wish. On completion of this second level of training you would become a BfN Registered Supporter. You would develop the skills to work more independently and to offer phone support on the National Breastfeeding Helpline (NBH).

The BfN Supporters course consists of at least two units at OCNL level 3, with the opportunity to complete a further unit (equivalent level to GCE A levels in England and Highers in Scotland and worth up to 12 credits). There are 13 group sessions delivered face to face or as online video calls over around 6 months. Trainees are expected to complete 13 assignments which are then assessed and moderated. This course may be delivered entirely face to face or using a mix of online training and group video call tutorials.

Availability of Training

Courses accepting applications just now are listed below.If there is no course listed for your area at present, please to go to our Peer Support Projects page where you can view individual project pages and contact details.

Please refer to our Volunteer Recruitment Policy for more information about how the process works.

If your area is not listed it is unlikely that we are currently offering training near you. We are developing new courses, including online training, and information will be made available here on the website and on social media so please keep checking back.

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Train to be a registered BfN volunteer - The Breastfeeding Network

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At the heart of our organisation are our volunteers who give their time to support other families in their communities and over the helplines. We currently have over 900 volunteers across the UK of all ages and from all backgrounds.

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

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

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Getting off to the best possible start can play a key part in your breastfeeding journey.

Four key factors have been identified by WHO and UNICEF as being important in establishing and sustaining breastfeeding:

1. A breastfeed within the first hour of life - skin to skin contact after delivery can help to get this started.

2. Exclusive breastfeeding - breastfeeding babies do not need any other food or drinks, including water for at least the first six months.

3. Breastfeeding when your baby displays signs of being hungry, such as sucking fingers and licking lips, and for as long as the baby wants i.e. until the baby comes off the breast by themselves and has completed the feed.

4. Avoiding the use of bottles, teats or dummies, including nipple shields.

Some ideas to help you find more information include:

Read and download the Department of Health leaflet Off to the Best Start or the NHS Health Scotland leaflet Off to A Good Start for good general information including skin to skin and the first feed.

Have a look at Baby Tom: A New Mums Diary to see what to expect in the first week.

Think about going along to a local drop-in group where you can talk to other breastfeeding mums about their experiences. Find out here if there is a group near you.

Bookmark or favourite the BfN website on your phone, laptop or tablet so you can always find our numbers or you can access or online chat facility. You could even give them a call if you would like to speak to someone while you are pregnant.

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How Can I Get Off to a Good Start? - The Breastfeeding Network

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Getting off to the best possible start can play a key part in your breastfeeding journey. Four key factors have been identified by WHO and UNICEF as being important in establishing and sustaining breastfeeding: A breastfeed within the first hour of life - skin to skin contact after delivery can help to get this started.

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As new parents, we suddenly find ourselves examining our babies' poo more closely than we could ever have imagined. We pay attention to the colour, quantity, texture and smell, and notice the slightest changes. We then go to the internet looking for answers and fear the worst. There are many versions of normal, and we will share some of these below.

When your baby is born, your colostrum (first milk) has laxative and diuretic compounds in it to make your baby wee and poo. In the first few days your midwife and health visitor will ask how many wet and dirty nappies your baby has had, so you may find it helpful to take note of how many nappies you change.

Your baby may not poo much at first but this will increase as your milk comes in. For an idea of how many poos to expect, see https://www.laleche.org.uk/is-my-baby-getting-enough-milk/#dirtynappies

It can be tricky to tell if disposable nappies are wet - after five full days, when copious milk comes in, they should be heavy.
Many disposable nappies have a faint line down the middle of the nappy which changes colour when wet.
You can feel what a properly wet nappy should feel like by putting three tablespoons (45ml) of water onto a clean, dry one. Urine should be pale and mild smelling.
This post on signs of effective feeding has more information.

Pictures 1-9 below show the contents of one baby's nappy in the first few days of his life, to give you an idea of what to expect from a healthy, full-term baby. If you have any concerns about your baby's poo, or if you see blood in the nappy (beyond the first few days, when baby girls can have a mini period caused by birth hormones), don't hesitate to contact your midwife, health visitor or GP.

Picture 1
Baby's first bowel movement, called meconium, is tar-like, sticky and hard to remove.

Picture 2
Baby's second bowel movement.

Picture 3
Poo from the first day of baby's life. Reddish pink urate crystals are visible in this nappy; see picture 10 for more about urates.

Picture 4
Bowel movement on day two. Your baby's poo will gradually change colour, from black to green to brown. It becomes a lot easier to wipe off as your baby begins to drink more milk.

Picture 5
Day three bowel movement. Looking a lot paler, heading towards a yellowish colour, and much less sticky.

Picture 6
Day four bowel movement.

Picture 7
Day five bowel movement.

Picture 8
Day six bowel movement.

Picture 9
Day ten bowel movement. By this age most fully breastfed babies' poo will be this pale yellow colour. It is common for babies to have what are described as "explosive" poos, which may take you by surprise if your baby poos while you are changing her nappy!
The following pictures show some ways in which your baby's poo may look different from the typical pattern shown above.
Picture 10
In the first few days, you may see reddish pink crystals called urates in your baby's nappy. They are often described as looking like brick dust. As your baby begins to take more milk, the urates should stop appearing in her nappy.

Picture 11
Sometimes your baby's poo may be light green rather than yellow, and have small lumps in it like cottage cheese. This is common and not significant by itself, unless your baby has other symptoms that you are worried about.

Picture 12
This poo came from a three-week-old baby who was given Gaviscon because of reflux. When the medication was stopped, the baby went back to having runny yellow stools.

Picture 13
After the 12-week injections this baby had green poo, which went back to being yellow after a few days.

Picture 14
This dark green poo came from a baby who was later diagnosed with cow's milk protein intolerance.

Picture 15
This poo, containing mucus, came from a baby diagnosed with allergies. Mucus in the poo is also common when a baby has a heavy cold, but this should be temporary and should stop when the baby is well again. If your baby's nappy has persistent or unexplained mucus in it, seek medical advice.

Picture 16
As your baby starts to eat solid foods, you will see the results in his nappy. It is common for your baby's very first foods to come out looking almost exactly as they did when they went in, as his digestive system is not used to dealing with these other foods yet. This is much easier to spot if your baby is eating finger foods rather than mashed food; the mashed foods are passing through semi-digested in the same way, but are less obvious in the nappy.

With time, your baby's poo will gradually change from yellow liquid to soft brown lumps, and you won't generally see pieces of food. However, some foods are hard to digest and tend to pass through the body unchanged (even for older children or adults). This picture shows an 11-month-old's nappy with partially digested grapes visible in it. Strongly coloured foods (like blackberries or beetroot) can also affect the appearance of your baby's wee and poo.

Written by Amanda Dunbar and Emma Taylor for LLLGB, 2017

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As new parents, we suddenly find ourselves examining our babies' poo more closely than we could ever have imagined. We pay attention to the colour, quantity, texture and smell, and notice the slightest changes. We then go to the internet looking for answers and fear the worst.

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With special thanks to Kathryn Stagg IBCLC

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

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

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

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

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

Your breastmilk

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

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

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

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

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

Expressing breastmilk

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

When might I need to express?

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

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

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

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

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

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

Hand Expressing

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

Remember to wash your hands first.

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

Relax with a warm drink, music or TV.

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

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

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

Take care not to drag your skin:

Stroke with your fingertips

Roll using your knuckles.

Try using circular movements.

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

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

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

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

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

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

Good hygiene is very important:

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

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

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

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

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

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

Storing expressed breastmilk

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

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

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

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

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

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

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

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

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

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

Safe Storage of breastmilk in the home

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

Why are there variations in recommendations for storing expressed breastmilk?

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

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

Feeding baby expressed breastmilk

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

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

Defrosting frozen breastmilk

How do I defrost my milk?

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

How long can I keep defrosted breastmilk?

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

Why can't I defrost breastmilk in a microwave?

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

Travelling with expressed breastmilk

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

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

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

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

Re-heating expressed breastmilk

How do I re-heat expressed breastmilk?

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

If the milk smells sour DO NOT USE.

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

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

Finding a breast pump

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

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

References

(links checked May 2023)

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

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

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

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

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

Page reviewed and updated November 2019

Variations in Recommendations for Storing Expressed Breast Milk

Written by Anabel Hands

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

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

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

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

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

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

References

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

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

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

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

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

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

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Expressing and storing breastmilk - The Breastfeeding Network

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

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What bottles and teats do you need for babies? | NCT

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There are so many different brands of bottles and teats, that choosing one can feel confusing. Here’s a round-up so you can decide what’s best for you and your baby.