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Run by Whatsapp all week and Zoom on Mondays. See NCT Clapham Facebook Page

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www.tongue-tie.org.uk
Private home visits

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https://www.firststepsnutrition.org
Independent organisation with evidence based information on formula milks

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Is baby hungry?

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Cathy Sage 07720425897
cathysage@gmail.com

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http://kellymom.com/bf/got-milk/supply-worries/fast-letdown/

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Detailed info on symptoms, diagnosis and treatment for parents and health professionals

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NHS website with excellent links

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Tongue-tie (ankyloglossia) is where the strip of skin connecting the baby's tongue to the bottom of their mouth is shorter than usual.

Credit:

SCIENCE PHOTO LIBRARY

https://www.sciencephoto.com/media/266498/view

Some babies who have tongue-tie do not seem to be bothered by it. In others, it can restrict the tongue's movement, making it harder to breastfeed.

Tongue-tie is sometimes diagnosed during a baby's newborn physical examination, but it's not always easy to spot. It may not be obvious until your baby has problems feeding.

See a health visitor, midwife or GP if you're concerned about your baby's feeding and think they may have tongue-tie.

Signs of tongue-tie

To breastfeed successfully, a baby needs to latch on to both the breast tissue and nipple, and their tongue needs to cover the lower gum so the nipple is protected from damage.

Some babies with tongue-tie are not able to open their mouths wide enough to latch on to the breast properly.

If you're breastfeeding your baby and they have tongue-tie they may:

have difficulty attaching to the breast or staying attached for a full feed

feed for a long time, have a short break, then feed again

be unsettled and seem to be hungry all the time

not gain weight as quickly as they should

make a "clicking" sound as they feed - this can also be a sign you need support with the positioning and attachment of your baby at the breast

Tongue-tie can also sometimes cause problems for a breastfeeding mother. Problems can include:

Most breastfeeding problems, however, are not caused by tongue-tie and can be overcome with the right support.

If you're finding breastfeeding difficult, ask a midwife, health visitor or a breastfeeding specialist for help.

Read more about breastfeeding problems and how to overcome them.

Other signs of tongue-tie

Other signs that may indicate your baby has tongue-tie include:

difficulty lifting their tongue up or moving it from side to side

difficulty sticking their tongue out

their tongue looks heart-shaped when they stick it out

Treating tongue-tie

Treatment is not always needed, if your baby has tongue-tie but can feed without any problems. If their feeding is affected, treatment involves a simple procedure called tongue-tie division.

Tongue-tie division

Tongue-tie division involves cutting the short, tight piece of skin connecting the underside of the tongue to the bottom of the mouth.

It's a quick, simple and almost painless procedure that usually improves feeding straight away.

The procedure

Tongue-tie division is done by doctors, nurses or midwives.

In very young babies (those who are only a few months old), it is usually done without anaesthetic (painkilling medicine), or with a local anaesthetic that numbs the tongue.

The procedure does not seem to hurt babies. This is because there are very few nerve endings in the area around the bottom of the mouth. Some babies sleep through the procedure, while others may cry a bit.

A general anaesthetic is usually needed for older babies with teeth, which means they'll be unconscious throughout the procedure.

The baby's head is held securely while sharp, sterile scissors with blunt ends are used to cut the skin.

It only takes a few seconds, and you can start feeding your baby immediately afterwards.

There should not be much bleeding. Your baby may get a white patch (ulcer) under their tongue, but this should heal in 1 to 2 days. It will not bother your baby.

Research suggests most babies who have treatment for tongue-tie find breastfeeding easier afterwards.

The Association of Tongue-tie Practitioners (ATP) can help you find a tongue-tie practitioner.

Older children and adults

Untreated tongue-tie may not cause any problems as a child gets older, and any tightness may resolve naturally as the mouth develops.

However, tongue-tie can sometimes cause problems such as speech difficulties and difficulty eating certain foods.

Speak to a GP if you think you or your child are having problems caused by tongue-tie.

Tongue-tie division can be carried out in older children and adults, although it's usually done under general anaesthetic.

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Tongue-tie (ankyloglossia) is where the strip of skin connecting the baby's tongue to the bottom of their mouth is shorter than usual. Some babies who have tongue-tie do not seem to be bothered by it. In others, it can restrict the tongue's movement, making it harder to breastfeed.

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Breastfeeding after breast or nipple surgery

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Breastfeeding after breast or nipple surgery

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www.bfar.org

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Find a qualified private lactation consultant

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Find a qualified private lactation consultant

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http://www.lcgb.org/find-an-ibclc/

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Guide to breastfeeding positions and latching on

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Guide to breastfeeding positions and latching on

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Videos and photographs

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Getting your baby positioned and attached comfortably at the breast is an art-mothers often say it takes a little while for breastfeeding to feel entirely comfortable and natural, even if they've breastfed before. In the past girls grew up learning about breastfeeding by watching mothers in their families and communities. These days many of us become mothers having never seen a baby breastfeed.
But breastfeeding has worked for mothers and babies for thousands of years and it can work for you too.
Many babies can find their way to the breast by themselves, especially if they haven't been too affected by birth interventions. Other mums and babies need a little longer to work it out with maybe some help from a skilled breastfeeding supporter such as an LLL Leader.

When all is going well, specific holds and positions don't really matter because you and your baby will work out what suits you best. However if you are finding it awkward, uncomfortable or downright painful then the following information is designed to help you think about where you can make adjustments and get breastfeeding working comfortably for you.

Good positioning and attachment is important for maintaining milk production. A baby who attaches deeply at the breast is able to remove milk effectively. This is important for maintaining milk production. Well-drained breasts make milk quickly. If there is any concern about how much milk you are making, working on improving positioning and attachment is an important first step.

There's no 'right' or 'wrong'. If you are comfortable, your baby is producing plenty of dirty nappies and is gaining weight after the first few days, then breastfeeding is going well for you. There are no rules-but there are a few principles that can help you work out what to do if things aren't going well: see Latching on - getting a good attachment.

Positioning describes how you sit or lie and how you support your baby as he takes the breast. How you hold your baby can make a big difference to how well he can breastfeed. Even small adjustments can be significant. Attachment describes the way he latches onto the breast.

Tips for getting started
The laid-back approach
Latching on - getting a good attachment
Different breastfeeding positions
As time goes by

Tips for getting started

If it hurts then make changes

If it doesn't feel right to you, then it isn't fine, whatever anyone says. Pain is your body's way of letting you know something is wrong. Start by trying to improve positioning and attachment. A few quick adjustments to how you are sitting or lying or how your baby comes towards the breast may be all that are needed.

Sometimes it can take a little longer. You may need to work with one or more skilled breastfeeding supporters over a period of time to get to the point where everything falls into place and breastfeeding starts feeling natural.

Each mother and baby pair is different and what works well for one mother and baby may not work for you. This is one reason why you may hear different suggestions from different helpers. You are the best judge of what is helpful so don't be afraid to use what feels right for you and discard the rest.

Your baby needs to be calm

You can offer the breast at any time when you are both calm. You may even find it easier if your baby isn't obviously hungry. Feed your baby before he needs to cry. Early cues for wanting to eat include suckingtheir hand, smacking their lips, turning their head towards you, or fussing. They won't latch well if they are distressed. If your baby is upset take time to soothe them. Hold them upright against you, stroke them and talk to them. A little expressed colostrum or breastmilk given on a spoon can help to calm them if they are desperately hungry.

Your baby needs full body contact

When your baby is held in full body contact against you, they will feel stable and be better able to coordinate their movements. Laid back positions ensure full body contact. If you're sitting up, you'll need to hug your baby in as tightly as if you were standing up holding them against you. Babies who don't feel stable tend to wave their arms around, which can make latching more difficult. Pillows can get in the way and aren't always necessary. So wait until after your baby's latched on, and then tuck them in only if you need them for support.

Some babies need time

Some babies find it difficult to latch on, or simply nurse ineffectively at the breast. Often a difficult birth or interventions during labour or birth are the cause. Giving a baby time to recover, and using laid-back breastfeeding positions with skin-to-skin contact can maximise your baby's natural instinct to breastfeed. If your baby isn't latching or feeding well seek help from an LLL Leader and read our page My Baby Won't Breastfeed. With time and patience, most babies will breastfeed. In the meantime express your milk for your baby to maintain milk production and give you both the time to work it out.

Laid-back breastfeeding

Many people assume you have to sit up to breastfeed. Not so. In fact evidence suggests humans evolved to breastfeed in laid-back positions with our babies upright against our chests. You may have experienced this type of position when you had your first feed, soon after your baby's birth. There is more and more evidence that laid-back breastfeeding positions (also called Biological Nurturing) help babies breastfeed more effectively and are more comfortable for mothers, especially in the early days and weeks.

Laid back breastfeeding is really useful for those first few days and weeks when you want to rest and recover and your baby needs to be in close contact with you to get breastfeeding established. It can be done skin-to-skin or with you both lightly dressed. You don't have to be in bed; the sofa or a reclining chair is a comfortable alternative.

You can also use laid-back breastfeeding principles when sitting in an upright chair by shifting your weight back onto your tail bone and reclining your body back a little, to open up a space for your baby. This allows more of their weight to be supported by your body and less by your arms. It isn't safe to sleep with your baby on a chair or sofa.

Sleepy babies

If your baby is sleepy, perhaps because of birth interventions, then using laid-back positions with skin-to-skin contact can encourage your baby's interest in feeding. In laid-back positions babies often attach and feed when in light sleep so it helps to spend substantial periods of time with your sleepy baby against you. When you notice the little movements that indicate your baby is moving into a light period of sleep you can encourage them to latch.

How laid back breastfeeding works

You lay back in a comfortable, supported semi-reclining position (not flat) that opens up your body, creating space for your baby.

Your baby lies against you, their whole front against your body, vertically or at any comfortable angle.

Your baby feels stable and secure and their instinctive feeding reflexes are triggered, prompting them to bob their head and seek out the breast.

Gravity helps them latch deeply and stay latched, rather than hindering the process.

Your hands are free to support and caress your baby and help them attach.

Your body releases the hormones that stimulate milk production and make you experience loving feelings towards your baby.

There are no rules-you and your baby are free to work it out between yourselves.

Latching on - getting a good attachment

Your baby needs to tip their head back and reach forward with their lower jaw. As your baby tips their head back their jaw drops and their mouth opens wide, so they can anchor their chin and lower lip firmly against your breast. If they have to tuck their chin in to reach the nipple they won't be able to open their mouth so wide. Tipping their head back also makes a deep latch possible, swallowing easier, and frees up their nose for comfortable breathing. In laid-back positions lay your baby with their head between your breasts. If you are sitting up, keep your supporting hand away from the back of their head. Babies tend to creep forward, so try shifting them so that their eyes and nose are opposite the nipple to encourage them to reach forward and anchor their chin first. In sitting or side lying positions a little push between the shoulder blades with your supporting hand or arm as they latch brings their chest in closer and helps their head tip back.

Their lower jaw needs a clear space to anchor. Think about how you might take a mouthful from a big sandwich by placing your lower jaw first then opening your mouth to accommodate the top of the sandwich-the principle is the same. Your baby's lower jaw needs to be deeply placed on your breast well away from the nipple. Keep the fingers of your supporting hand away from the place where their chin and lower jaw need to be so their lower lip and chin can sink into your breast. Your baby's chin needs to stay firmly in contact with your breast.

Your baby needs a big mouthful. When a baby chews on a nipple, this compresses the milk ducts, prevents milk flowing and hurts. When a baby has a good big mouthful of breast beyond the nipple, breastfeeding is comfortable and milk can flow. Some women like (or need) to hold their breast when nursing. They flatten their breast as they would a big sandwich they were offering to the baby, matching it to the oval of his mouth. This can help their baby grasp more breast tissue. It doesn't matter if fingers are closer to the upper jaw but try to keep the "lower jaw fingers" out of your baby's way. Biological Nurturing™ positions make use of gravity to help a baby get a bigger mouthful.

The exaggerated latch. To get an even deeper latch you could try this optional extra. Place your thumb or finger near the base of the nipple where the middle of your baby's upper lip will be, lined up with their nose. If you press, your nipple will tilt away from your baby, presenting them with your breast rather than your nipple. Avoid pressing your nipple into their mouth. As they open wide, snuggle them in close and use your thumb or finger to tuck the breast into their mouth. Your nipple will be taken in last and unroll in their mouth. You can then slip your finger out.

Our own video below demonstrates flipple technique (aka exaggerated latch), it can be very helpful for getting an effective pain free latch:

Let your breast rest at its natural level. It can be tempting to lift your breast and move it towards your baby's mouth. If you do this, your baby probably won't get a full mouthful, and after a while your hand will get tired and the breast will drop and slip out of their mouth. Breastfeeding pillows can get in the way too because they lift a baby up too high and prevent you tucking them in against your tummy. See where your breasts naturally rest and hold your baby accordingly. If you need them, tuck pillows in after they are well attached.

Bring baby to breast, not breast to baby. Since breasts are attached to you and you baby is moveable it makes much more sense to bring your baby to the breast, not the other way round! And it works better too. With their body tucked firmly against you (or laid on top of your body), your baby will feel more stable and have better head control, and you'll feel a lot more comfortable too.

It's easier to latch onto a softer breast. It's much easier to get a deep mouthful if the breast is soft so breastfeed frequently to avoid engorgement. When your baby bobs their head and licks the nipple, it naturally makes it easier to latch on. If your breast is full and hard, you can use reverse pressure softening to move fluids away from the nipple area so your baby can latch on well. Apply gentle steady pressure with your fingertips on the areola around your nipple for about a minute. You can also press with the sides of your thumbs or fingers. Denting the breast at the edge of the areola with a finger and placing your baby's chin in the dent may also help. Gently hand express a little milk too if needed.

Your baby needs to choose his own timing. Your baby will probably do best if they pick the moment to latch on. You can help by supporting them in a position that lets them do this when they are ready. To encourage your baby to gape hold them close against you, close enough to the breast so they know the nipple is there, but where they can't quite reach it. Be prepared for your baby to lick and nuzzle for several minutes before they are ready to open wide.

The natural or laid-back breastfeeding positions shown in the following videos can be a great help in encouraging your baby to latch on well, as well as being comfortable for you. You can recline comfortably with your baby on top of you with their whole front against you and their body completely supported by yours.

Best Beginnings' video demonstrates clearly how to make sure your baby is attaching well to the breast, you can view it here.

This video demonstrates how to enable your baby to latch deeply on to your breast so that breastfeeding is comfortable for you and means your baby get enough milk:

This video shows how to attach your baby well, and shows a variety of comfortable breastfeeding positions:
http://m.raisingchildren.net.au/articles/breastfeeding_attachment_video.html

Using different breastfeeding positions

The cradle hold

Although the cradle hold is one of the most common nursing positions it can be a challenge for new mothers to learn. You need to hold your baby's body firmly against you to give them stability because their weight is supported mainly by your arms. Shifting so you are sitting on your tailbone, rather than upright can help stability and reduce the strain on your arms (see picture right). It can be difficult to control a baby's head and to keep them high enough and close enough to your breast. A small baby may tend to curl up in a ball in this position if not pulled in closely enough against your body. It may not be the best choice at first if you're experiencing any problems with latch-on, milk transfer or if you have sore nipples. Once you're more confident with breastfeeding, you may find you use a version of the cradle hold much of the time, especially when out and about.

Your baby's whole front is against your tummy, their hip resting on or near your thigh, tucked around you like a comma. Their chest will be snuggled into the breast and your nipple near their nose.

Their head is resting on your forearm and/ or wrist (not the crook of the elbow).

As your baby opens their mouth to take the breast, pull their body in firmly against you.

Once your baby is attached, settle back a little for your own comfort and so that more of their weight is taken by your body.

Laid back breastfeeding

Remember that Biological Nurturing™ positions aren't just for the first week or two. They can be really useful later on when you want to relax, and especially if you are breastfeeding more than one baby or if your baby is fussy or unwell.

The cross-cradle hold

The cross-cradle position can be useful in the early days because it gives you more control in guiding your baby to the breast. It can be uncomfortable to maintain without good support under your arms, especially with larger babies, so once your baby is attached, switch arms as shown in the picture below. After the first few weeks and as your baby grows longer and heavier, you may prefer to use other comfortable holds. Avoid touching the top or back of your baby's head because it often causes a baby to pull back from the breast. Forcing a baby onto the breast by firmly holding the back of the head usually has the opposite effect and can put a baby off breastfeeding.

Cross cradle

Tuck their whole front against your tummy, their hip near or resting on your thigh.

Your hand supports their neck (not the back of the head) with your palm between their shoulder blades.

Your other hand is free to shape or stabilise your breast if needed.

Make sure your baby isn't too far round the front-line them up so their eyes and nose are near the nipple.

As your baby opens their mouth, give a little push with the palm of your hand to bring their chest in close against you.

This will help their head tip back and let them plant their chin deeply against your breast.

Once your baby is attached you can bring your other arm round to support your baby's body and settle back a little for your own comfort and so that more of his weight is taken by your body. Hold your baby with the arm opposite to the breast he's going to latch onto.

The underarm (clutch or rugby) hold

The underarm hold is useful if you have had a caesarean birth. It helps keep the weight of your baby off your incision. It is also a good position for mothers with flat or inverted nipples and for babies with latch-on or sucking problems because it offers you a good view of baby and breast and control of your baby's head. You can also feed two babies at once in this position. For larger, longer babies you may need extra cushions behind your back to bring you further forward and allow space for your baby's length.

Your baby's front is close against your side, with your hand under their shoulders and neck.

Your elbow keeps them tucked closely against your body.

Your baby approaches your breast from below. This can work well if you have large breasts. If you have smaller breasts you may need to bring your baby into a semi-sitting position.

Make sure your baby isn't too far round the front. You may need a cushion between your back and the chair back to allow room for your baby's length and prevent them pushing themselves forward with his feet.

Side lying

This side-lying position is helpful if you are recovering from a caesarean birth or an episiotomy and invaluable for nursing in bed during the night.
It can take a while to get the knack but it's well worth persisting because it can make night feeds so much easier.
Some mothers decide to sleep with their baby alongside them. Others choose to move their baby back onto a separate sleep surface.
Safe Sleep and the Breastfed Baby will help you decide on the safest sleep arrangements for your family, based on your own individual circumstances.

* Lie on your side, with your knees bent up and a pillow under your head.
* Place your baby on their side facing you so that their body and your body form a V-shape, meeting at your hips, with your nipple level with their nose or eyes.
* You can put your arm under your baby's head as shown, or up by the pillow with your baby lying on the bed.
* As your baby latches, give a little push between their shoulder blades to bring their chest in closer and help their head to tip back and their mouth to
open wide.
* You may find it helpful to tuck a small pillow or rolled blanket behind the small of your back and/or between your knees.

Standing up

At some feeds babies just do better if you stand up. You can sway or bounce gently to help calm your baby, and the lack of a lap can be helpful. As always keep your baby nice and stable and let them lead the way. Try angling their legs down instead of holding them horizontal, and see what happens. Or try starting with them against your shoulder, supporting them as he moves down to the breast. Even when using other positions, sometimes just standing up and sitting down again straight away helps everything settle into a comfortable position.

As time goes by

Whether you choose to breastfeed sitting up, reclining or lying on your side, you will need to adjust how you support your baby as he grows in length and weight. Use the principles shown here as you experiment with different positions. Sometimes there are physical or medical causes for pain or discomfort such as tongue tie or a thrush infection. If you are still finding it difficult to get comfortable, do persist with seeking further and continued support. There is almost always a breastfeeding solution to breastfeeding problems. You can contact an LLL Leader by calling our Helpline. You can also find support and encouragement from breastfeeding mothers in your local LLL group.

Written by Sue Upstone, Karen Butler and mothers of LLLGB

Further Reading

The Womanly Art of Breastfeeding. LLLI. London: Pinter & Martin, 2010.

Mastitis
Beginning Breastfeeding
Breastfeeding Your Baby - easy read
Caesarean Birth & Breastfeeding
Comfortable Breastfeeding - easy read
Skin-to-Skin
Engorged Breasts - Avoiding & Treating
Hand Expression of Breastmilk
Inverted Nipples
My Baby Needs More Milk
My Baby Won't Breastfeed
Nipple Confusion?
Nipple Pain
Nipple Shields
Nursing Supplementers
Safe Sleep & the Breastfed Baby
Sleepy Baby - Why & What To Do
Tongue Tie
Too Much Milk & Oversupply

LLLI Resources
Position to breastfeed

Other resources
How to do Biological Nurturing: www.biologicalnurturing.com/video/bn3clip.html
Best Beginnings videos to watch online: www.bestbeginnings.org.uk/watch-fbtb

References
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, TX: Hale Publishing, 2010.
Biological Nurturing: Laid-back breastfeeding for mothers (DVD). Colson, S. et al. 2012.
An Introduction to Biological Nurturing; New angles on breastfeeding, Colson S. Amarillo, TX: Hale Publishing, 2010.
Supporting Sucking Skills, Watson Genna, C. Burlington, MA: Jones & Bartlett, 2012.

This information is available to buy in printed form form the LLLGB Shop.
It is also available in kindle edition.

Information, references and links on this page are taken from La Leche League resources, unless stated otherwise. Please note that LLLGB does not endorse information from outside sources, extra information is provided for you to consider. Information supplied is not intended as advice, and you are in the best position to make a decision as to how the information offered will affect you and your baby.

Copyright LLLGB 2016

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Positioning & Attachment - La Leche League GB

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Good positioning and attachment is important for maintaining milk production. A baby who attaches deeply at the breast is able to remove milk effectively.

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Many of you requested repeated access to our first webinar series. The Foundations of Biological Nurturing. We appreciate your comments. In this series, Advanced Biological Nurtuirng: Womb to World, for your convenience, if you miss the live sessions, you can view the live presentation from a secure website for as many times as you want for 2 weeks afterwards.

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Symptoms and treatment options

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Mastitis means 'inflammation of the breast', and includes a wide range of symptoms, from a small, tender area (often called a 'blocked duct'), through to severe infection and even abscess. If you have any signs of breast inflammation, prompt action is important to help relieve discomfort and stop it getting worse. It's also necessary to address any underlying causes.
Mastitis is not always caused by infection. However, when milk leaks into the breast tissue, your body can respond as if infection were present - with inflammation. As well as having signs of swelling in one or both breasts, you might feel ill, with a fever or flu-like symptoms.

Your commitment to breastfeeding your baby can be truly tested at times like this, especially when putting your baby to the breast may be the last thing you feel like doing. However, continuing to breastfeed (or expressing your milk) as normal is part of the solution, and stopping breastfeeding suddenly is likely to make the problem worse.

Except in very rare circumstances, your milk is safe for your baby, and medications for mastitis are safe to take while breastfeeding.

Signs of mastitis (you might have one or more)

One or more hard, sore lumps in your breast.

The skin on your breast is warmer than usual.

Feeling achy, and run down.

Feeling feverish.

You might also notice changes in colour: redness or darkening, depending on your skin tone. Colour changes on the breast are most obvious in lighter skin tones, but even if there's nothing to see, you might still have mastitis.

What you can do

Continue feeding your baby as often as they want to feed (including at night-time). It is not necessary to feed more often than usual from the affected breast, or try to remove every available drop of milk - this can increase milk production, and may make the problem worse. (See How Milk Production Works.) Try to avoid your breasts becoming overfull by encouraging your baby to nurse often enough to leave your breast feeling soft and comfortable. If they are unwilling to nurse, gently hand express or pump enough milk to get the breast comfortably soft.

Ensure your baby is well attached at the breast when they feed. It may be helpful to try some different positions from usual, to see if this helps drain different areas of the breast. If you're not confident about getting your baby deeply attached at the breast, contact an LLL Leader or your local feeding supporter. See Comfortable Breastfeeding for more information on getting a deep latch.

Use cold to reduce the swelling. You could use an ice pack or crushed ice wrapped in a cloth, a bag of peas wrapped in a towel, or a clean cloth wrung out in very cold water. Swap it every 20-30 minutes, when it's no longer cold. Older advice often suggested using heat, but we now know that this can make the inflammation worse.

It's important not to handle your breast roughly, as this can make swelling worse (and will hurt!). You can't move milk by force. Only touch the breast firmly if it helps you remove milk while feeding or expressing, or if it feels good. Use very light touch, as you would when applying cream to your skin.

Consider taking an anti-inflammatory medication such as ibuprofen, if you are able to, to reduce the inflammation. Ibuprofen is compatible with breastfeeding, but check with your pharmacy about the safety of other anti-inflammatory painkillers. If it's difficult to remove milk because the breast is so hard and tight, try taking a dose (and applying a cold compress) about half an hour beforehand, to get the swelling down first.

Rest. While you have mastitis, you need to be taken care of as if you are properly unwell (even if symptoms are mild), and rest as much as you can. Inflammation is taxing on your whole body, and you need to heal. It's common to come down with mastitis if you're feeling under the weather or doing more than usual. If it's safe to do so, go to bed with your baby, or keep your baby close to your bed - and stay there as much as you can. See our tips on Safer Sleep & the Breastfed Baby. Don't be tempted to do too much too soon. It's common to feel low and tearful when you have mastitis - as well as the discomfort, and maybe feeling unwell, inflammation can also affect your mood. Once you get the swelling under control, you will probably feel much better. If you're really not feeling like yourself, talk to supportive family or friends, your health visitor or GP - there is lots of help available.

Drink plenty of fluids.

If

You don't start to feel better after 24-48 hours of using the self-help measures above;

You have pus or blood in your milk;

You see streaks on your breast from areola to underarm or if your breast shows further changes in colour (e.g. the size of a red or darkened area is increasing)

Your breast gets hotter or more swollen;

You see signs of infection in a nipple wound, such as crustiness, yellow ooze, change in colour, size or shape of the nipple;

Your temperature increases to 38.4°C or more.

Then continue following the previous steps, and also

Contact your GP or call NHS 111. You may need antibiotics. Even if mastitis is not caused by infection, they are effective, probably because they reduce inflammation.

Take the full  course of any prescribed medication. NHS mastitis guidelines say that if antibiotics are needed for mastitis, a 10-14 day course is appropriate.

Take prompt action to reduce the swelling ...

Breastfeed your baby as normal. Continue feeding your baby on demand (including at night-time). Do not feed MORE from the affected breast as this will encourage more milk production on that side, and may make the problem worse. Encourage your baby to breastfeed enough to leave your breast feeling soft and comfortable. If he is unwilling, gently hand express or pump your milk. Try to avoid your breasts becoming overfull.

Ensure your baby is well attached at the breast when he feeds. To make sure your baby drains the breast efficiently you may need to vary your nursing position but check your baby can latch on well in any new position. It helps if you can get your baby's chin or nose pointing towards the blocked duct, even just for part of a feed. This may involve some nursing gymnastics on your part, like leaning over your baby and letting your breast hang loose! Visit our Comfortable Breastfeeding page for help with positioning and attachment.

Use cold to reduce swelling. Apply an ice pack or crushed ice wrapped in a cloth to reduce inflammation and swelling.

Massage very gently. Use a light touch, as you would when stroking a pet. Start over or behind the tender spot with your palm and fingers in a circular motion to help clear the blockage. Or massage in front of the lump. Start close to the nipple, and massage the short distance towards the nipple. Repeat, starting closer to the sore spot each time.

Consider taking an anti-inflammatory medication such as ibuprofen, if you are able to. Ibuprofen is compatible with breastfeeding, but check with your pharmacy about the safety of other anti-inflammatory painkillers.

Rest. Take your baby to bed and stay there together for as long as possible, since a blocked duct may be a sign that you are doing too much. If you have other children then ask for help and take it as easy as you can. See our tips on Safer Sleep & the Breastfed Baby.

If you:

Don't feel better or see results in 8-24 hours.

Continue to feel feverish or your temperature suddenly increases to 38.4°C or more.

See pus or blood in your milk.

See streaks on your breast from areola to underarm or if your breast shows changes in colour or is hot and swollen.

Have a cracked nipple that looks infected.

Have chills and continue to feel worse.

Continue following the previous steps and also...

See your doctor as you may need antibiotics.

Take the full 10-14 days course of any prescribed medication.

Rest and drink plenty of fluids.

Ask an LLL Leader to help you find out what is causing the mastitis so that you can help prevent it recurring.

Keep breastfeeding

It's important to keep milk flowing through the affected breast, while you're treating mastitis.

Weaning from the affected breast is sometimes suggested, but it is not necessary, and is likely to make matters worse. Antibodies in your milk will help protect your baby from any infection.

The affected breast may produce less milk for a few days, and your milk may taste slightly different. Encourage your baby to feed as normal. Occasionally, a baby will refuse a breast with mastitis - if this happens, keep the milk flowing by expressing as often as you need to, to keep the breast comfortable. Once the mastitis has resolved, milk production usually bounces quickly back to normal.

Causes of mastitis

It's important to address any underlying causes of mastitis, to help prevent future episodes. Mastitis can be caused by anything that limits or prevents milk flowing through the breast, including:

A baby who is not breastfeeding effectively.

Missed, shortened or irregular feeds or expressions. (For example, using a dummy may make early feeding cues easy to miss.)

Anything that puts pressure on the breast, such as a bra or other clothing that is too tight, a seatbelt or bag strap, a baby carrier, or even lying on your front.

Occasionally, a tiny white or yellow 'milk blister' (also known as a 'bleb') forms on the end of the nipple, and can block milk in part of the breast. See below.

Mastitis is more likely to occur if you're extra busy, or when others in the family are unwell. Changes in routine, holidays, visitors or family events - when you are busy or your baby is distracted - can also make mastitis more likely. Some mothers are more susceptible than others.

If you've had breast surgery, breast injury or have a breast abnormality, these may increase the risk too. Underlying health issues can also make mastitis more likely: if you're anaemic, for example, or have low thyroid, and are feeling exhausted.

An LLL Leader can help you identify likely causes of mastitis if you wish.

Avoiding future problems

Breastfeed your baby (or express your milk) frequently, avoiding long gaps, day and night. Sleeping close to your baby can make night feeds easier. See Safer Sleep and the breastfed baby.

Check that all areas of your breasts feel soft and comfortable after feeds. If any area of your breast is hard and uncomfortable, take action promptly: try a different position, or gently massage as you breastfeed.

Take extra care of yourself during holidays, special occasions and when family members are ill.

Milk blisters ('blebs')

Sometimes a mother gets one or more white or yellowish spots, called milk blisters or 'blebs', on the tip of her nipple. A milk blister might show up more clearly after a feed, or if you gently compress the nipple. Thickened milk may block milk flow near the opening of the nipple, or a thin layer of skin may block the milk duct.

Blebs can sometimes cause mastitis. A bleb that does not hurt or block milk may resolve on its own over several weeks - there's no need to do anything about it.

If it is painful, or is blocking milk in part of the breast:

Apply moist heat using warm compresses, and then feed your baby - nursing may open the blister.

Soak the nipple in warm water.

Wear a cotton ball soaked in olive oil in your bra to soften the skin and then attempt to peel away the thickened layer of skin.

Try using a mild steroid cream on the surface of the bleb to thin the skin. Then, compress the nipple behind the blockage to try and express the blockage. Sometimes it is possible to express a thickened string of milk, which helps open the duct and keep it open. Work back from the nipple to make sure there isn't a blockage further back. See above: Expressing Blockages.

If the ideas listed above don't help, a last resort is to open the milk blister. Some experts say that repeated opening of the skin could make the situation worse, however some mothers have found that removing the top layer of skin over the bleb enables the blockage to come out. If you decide to open the milk blister, you could try it yourself with a sterilised needle or ask a health care professional to help you. Take care to prevent infection by washing your nipple with mild soapy water.

Expressing blockages

Sometimes, when gently massaging a 'blocked duct', you may express the coagulated milk responsible for the blockage. It may look like a crystal, a grain of sand, or even a strand of spaghetti, and it may be accompanied by a little particularly thick milk or mucus. If your baby clears the blockage when feeding, this will not harm them.

Cracked nipples

Sore, cracked nipples may increase the risk of a breast infection. Good wound hygiene is important, along with addressing underlying causes of nipple damage. Always wash your hands before touching a damaged nipple. Washing your nipples gently once a day with mild soap and water may be helpful, while you have a wound.

Moist wound healing, for example using a hydrogel pad, has been shown to speed up the healing of cracked nipples. You could also ask your doctor about using a medicated ointment to promote wound healing.

Breast infections
This is the more severe end of the spectrum of mastitis.
You are more likely to develop a breast infection  if you stop removing milk from a breast that already has mastitis.

A full course of antibiotics is needed to clear a breast infection. Most antibiotics are compatible with breastfeeding. Stopping antibiotics early leaves you vulnerable to further infection.

Most, but not all, breast infections are caused by Staphylococcus Aureus bacteria. Some strains of bacteria e.g. MRSA have become resistant to certain antibiotics. Let your doctor know if you have, or have had, MRSA, as this may help with prescribing appropriate treatment.

Repeated use of ineffective antibiotics increases the risk of a breast abscess. If a breast infection recurs, and especially if you took a full course of antibiotics, discuss this with your doctor. An alternative antibiotic may be needed, and a culture of your milk and your baby's throat may be helpful. If you need treatment for MRSA you can continue to breastfeed.

Sensible hygiene precautions include hand washing (including your baby's hands), using disposable breast pads and thorough cleansing of pump parts and other items that are in contact with your nipples, e.g. nipple shields.

Breast abscess

A breast abscess is an uncommon complication of mastitis, usually because it was not adequately treated. It is a localised infection containing pus. Abscess can be diagnosed by ultrasound and needs immediate treatment by surgical drainage or aspiration of the breast. Usually, the abscess will need to be drained multiple times.

To avoid breast tissue being damaged unnecessarily, ask for the incision to be made:

As far from the nipple as possible,

From nipple to chest, rather than around the breast.

The fluid should be cultured to identify the infection, so you receive appropriate antibiotics. You can continue to breastfeed from both breasts. If the affected breast is too painful, or the incision is close to your nipple, you may need to hand express for a day or two. Keeping your milk flowing will help your breast heal.

Breast lumps

Many women worry that they may have cancer if they discover a breast lump. Studies have shown that breastfeeding reduces a mother's risk of breast cancer.

However, a lump that does not go away after a week, or recurs in the same place despite careful treatment for a blocked duct, needs checking. In many cases breast lumps are benign tumours (fibromas) or milk-filled cysts (galactoceles), which can be diagnosed and treated whilst you continue to breastfeed. It is very rare for a lump to be a sign of cancer. But do consult your doctor, especially if the lump continues to grow, does not move, or is firm and hard, and if there is dimpling of the skin.

Recovering from mastitis

It may take a little time and persistence to deal with mastitis and enjoy comfortable feeds once more. Sometimes it takes time to find the right medication for an infection. Alongside any medication, being creative about making time to rest and recuperate can make a great deal of difference and help to prevent mastitis recurring.

Written by Karen Butler and mothers of LLLGB. Thanks to Justice Reilly. Photos courtesy of Lois Rowlands.

Last updated May 2023

Further Reading

A Sudden End to Breastfeeding
Dummies & Breastfeeding
Engorged Breasts - Avoiding & Treating
Expressing Your Milk
Hand Expression of Breastmilk
How Milk Production Works
My Baby Won't Breastfeed
Comfortable Breastfeeding
Positioning & Attachment
Rhythms & Routines
Sleep Baby - Why and What To Do
Tongue-tie & Breastfeeding
Too Much Milk & Oversupply
When a Mother is Unwell

Other websites
Academy of Breastfeeding Medicine Clinical Protocol #36:The Mastitis Spectrum, 2022. https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf
Mastitis http://patient.info/health/mastitis

Books
The Womanly Art Of Breastfeeding. LLLI, London: Pinter & Martin, 2010
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, TX: Hale Publishing, 2010.

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

Copyright LLLGB 2023

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Avoiding and treating mastitis and breast infections

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How to breastfeed

Breastfeeding is a skill that you and your baby learn together, and it can take time to get used to.

There are lots of different positions you can use to breastfeed. You can try different ones to find out what works best for you. You just need to check the following points:

Are you comfortable? It's worth getting comfortable before a feed. Use pillows or cushions if necessary. Your shoulders and arms should be relaxed.

Are your baby's head and body in a straight line? It's hard for your baby to swallow if their head and neck are twisted.

Are you holding your baby close to you, facing your breast? Supporting their neck, shoulders and back should allow them to tilt their head back and swallow easily.

Always bring your baby to the breast and let them latch themselves. Avoid leaning your breast forward into your baby's mouth, as this can lead to poor attachment.

Your baby needs to get a big mouthful of breast. Placing your baby with their nose level with your nipple will encourage them to open their mouth wide and attach to the breast well.

Try not to hold the back of your baby's head, so that they can tip their head back. This way your nipple goes past the hard roof of their mouth and ends up at the back of their mouth against the soft palate.

Read Start4Life's information on 3 common positions for breastfeeding

How to latch your baby on to your breast

1. Hold your baby close to you with their nose level with the nipple.

2. Let your baby's head tip back a little so that their top lip can brush against your nipple. This should help your baby to make a wide, open mouth.

3. When your baby's mouth is open wide enough their chin should be able to touch your breast first, with their head tipped back so that their tongue can reach as much of your breast as possible.

4. With your baby's chin firmly touching your breast and their nose clear, their mouth should be wide open. When they attach you should see much more of the darker nipple skin above your baby's top lip than below their bottom lip. Your baby's cheeks will look full and rounded as they feed.

Read Start4Life's visual guide to latching your baby on

Video: how do I know if my baby is properly latched?

In this video, a midwife talks about how to check if your baby is latched on properly when breast feeding.

Help and support with breastfeeding

If you have any questions or concerns, you can:

speak to your midwife, health visitor or breastfeeding supporter

call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm, daily)

get online advice about sore nipples and other commmon breastfeeding problems

Visit healthtalk.org to see mums talking about positioning and attaching their babies at the breast.

How to tell if your baby is getting enough milk

You baby starts feeding with a few rapid sucks followed by longer sucks.

Their cheeks stay rounded out, not sucked in, and you can hear them swallowing.

Your baby seems calm during feeding and comes off your breast themselves when they have had enough.

They appear content and satisfied after most feeds.

They should be healthy and gaining weight (although it's normal for babies to lose a little weight in the first week after birth). Talk to your midwife or health visitor if you are concerned your baby is not gaining weight and is unsettled during or after breast feeds.

After the first few days, your baby should have at least 6 wet nappies a day.

After about 5 to 6 days, your baby's poo should stop looking black and thick and they should also have at least 2 soft or runny yellow poos.

See tips on building up your milk supply.

Breastfeeding premature and ill babies

If your baby is in a neonatal or special care unit after the birth, you'll probably be encouraged to try something called kangaroo care once your baby is well enough. Kangaroo care means holding your baby close to you, usually under your clothes with your baby dressed only in a nappy.

This skin-to-skin contact helps you bond with your premature baby and increase your milk supply.

Find out more about breastfeeding a premature baby.

Got a breastfeeding question?

Use the Start4Life Breastfeeding Friend chatbot for fast, friendly, trusted NHS advice anytime, day or night.

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Breastfeeding is a skill that you and your baby learn together, and it can take time to get used to. There are lots of different positions you can use to breastfeed. You can try different ones to find out what works best for you. You just need to check the following points: Are you comfortable?

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Ways to tell, and to improve milk production

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By Kelly Bonyata, BS, IBCLC

Is your milk supply really low?

First of all, is your milk supply really low? Often, mothers think that their milk supply is low when it really isn't. If your baby is gaining weight well on breastmilk alone, then you do not have a problem with milk supply.
It's important to note that the feel of the breast, the behavior of your baby, the frequency of nursing, the sensation of let-down, or the amount you pump are not valid ways to determine if you have enough milk for your baby.
What if you're not quite sure about baby's current weight gain (perhaps baby hasn't had a weight check lately)? If baby is having an adequate number of wet and dirty diapers then the following things do NOT mean that you have a low milk supply:

Now infants can get
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Your baby nurses frequently. Breastmilk is digested quickly (usually in 1.5-2 hours), so breastfed babies need to eat more often than formula-fed babies. Many babies have a strong need to suck. Also, babies often need continuous contact with mom in order to feel secure. All these things are normal, and you cannot spoil your baby by meeting these needs.

Your baby suddenly increases the frequency and/or length of nursings. This is often a growth spurt. The baby nurses more (this usually lasts a few days to a week), which increases your milk supply. Don't offer baby supplements when this happens: supplementing will inform your body that the baby doesn't need the extra milk, and your supply will drop.

Your baby nurses more often and is fussy in the evening.

Your baby doesn't nurse as long as she did previously. As babies get older and better at nursing, they become more efficient at extracting milk.

Your baby is fussy. Many babies have a fussy time of day - often in the evening. Some babies are fussy much of the time. This can have many reasons, and sometimes the fussiness goes away before you find the reason.

Your baby guzzles down a bottle of formula or expressed milk after nursing. Many babies will willingly take a bottle even after they have a full feeding at the breast. Read more here from board-certified lactation consultant Kathy Kuhn about why baby may do this and how this can affect milk supply. Of course, if you regularly supplement baby after nursing, your milk supply will drop (see below).

Your breasts don't leak milk, or only leak a little, or stop leaking. Leaking has nothing to do with your milk supply. It often stops after your milk supply has adjusted to your baby's needs.

Your breasts suddenly seem softer. Again, this normally happens after your milk supply has adjusted to your baby's needs.

You never feel a let-down sensation, or it doesn't seem as strong as before. Some women never feel a let-down. This has nothing to do with milk supply.

You get very little or no milk when you pump. The amount of milk that you can pump is not an accurate measure of your milk supply. A baby with a healthy suck milks your breast much more efficiently than any pump. Also, pumping is an acquired skill (different than nursing), and can be very dependent on the type of pump. Some women who have abundant milk supplies are unable to get any milk when they pump. In addition, it is very common and normal for pumping output to decrease over time.

See also Is my baby getting enough milk?

Who to contact if you suspect low milk supply

If you're concerned about your milk supply, it will be very helpful to get in touch with a trained breastfeeding counselor or a board certified lactation consultant. If your baby is not gaining weight or is losing weight, you need to keep in close contact with her doctor, since it's possible that a medical condition can cause this. Supplementing may be medically necessary for babies who are losing weight until your milk supply increases. If supplementing is medically necessary, the best thing to supplement your baby with is your own pumped milk.

Potential causes of low milk supply

These things can cause or contribute to a low milk supply:

Supplementing. Nursing is a supply & demand process. Milk is produced as your baby nurses, and the amount that she nurses lets your body know how much milk is required. Every bottle (of formula, juice or water) that your baby gets means that your body gets the signal to produce that much less milk.

Bottle preference. A bottle requires a different type of sucking than nursing, and it is easier for your baby to extract milk from a bottle. As a result, giving a bottle can either cause your baby to have problems sucking properly at the breast, or can result in baby preferring the constant faster flow of the bottle.

Pacifiers. Pacifiers can affect baby's latch. They can also significantly reduce the amount of time your baby spends at the breast, which may cause your milk supply to drop.

Nipple shields can be a useful tool in some cases, but they can also reduce the stimulation to your nipple or interfere with milk transfer, which can interfere with the supply-demand cycle.

Scheduled feedings interfere with the supply & demand cycle of milk production and can lead to a reduced supply, sometimes several months later rather than immediately. Nurse your baby whenever she is hungry.

Sleepy baby. For the first few weeks, some babies are very sleepy and only ask to nurse infrequently and for short periods. Until baby wakes up and begins to breastfeed well, nurse baby at least every two hours during the day and at least every 4 hours at night to establish your milk supply.

Cutting short the length of nursings. Stopping a feeding before your baby ends the feeding herself can interfere with the supply-demand cycle. Also, your milk increases in fat content later into a feeding, which helps baby gain weight and last longer between feedings.

Offering only one breast per feeding. This is fine if your milk supply is well-established and your baby is gaining weight well. If you're trying to increase your milk supply, let baby finish the first side, then offer the second side.

Health or anatomical problems with baby (including, jaundice, tongue-tie, etc.) can prevent baby from removing milk adequately from the breast, thus decreasing milk supply.

Mom's health (uncontrolled anemia or hypothyroidism, retained placenta, postpartum hemorrhage...), previous breast surgery/injury, hormonal problems (e.g. PCOS), anatomical problems, medications she is taking (hormonal birth control, sudafed...), or smoking also have the potential to affect milk supply.

Increasing your milk supply

Milk production is a demand & supply process. If you need to increase milk supply, it's important to understand how milk is made - understanding this will help you to do the right things to increase production.

To speed milk production and increase overall milk supply, the key is to remove more milk from the breast and to do this frequently, so that less milk accumulates in the breast between feedings.

OK, now on to things that can help increase your milk supply:

Make sure that baby is nursing efficiently. This is the "remove more milk" part of increasing milk production. If milk is not effectively removed from the breast, then mom's milk supply decreases. If positioning and latch are "off" then baby is probably not transferring milk efficiently. A sleepy baby, use of nipple shields or various health or anatomical problems in baby can also interfere with baby's ability to transfer milk. For a baby who is not nursing efficiently, trying to adequately empty milk from the breast is like trying to empty a swimming pool through a drinking straw - it can take forever. Inefficient milk transfer can lead to baby not getting enough milk or needing to nurse almost constantly to get enough milk. If baby is not transferring milk well, then it is important for mom to express milk after and/or between nursings to maintain milk supply while the breastfeeding problems are being addressed.

Nurse frequently, and for as long as your baby is actively nursing. Remember - you want to remove more milk from the breasts and do this frequently. If baby is having weight gain problems, aim to nurse at least every 1.5-2 hours during the day and at least every 3 hours at night.

Take a nursing vacation. Take baby to bed with you for 2-3 days, and do nothing but nurse (frequently!) and rest (well, you can eat too!).

Offer both sides at each feeding. Let baby finish the first side, then offer the second side.

Switch nurse. Switch sides 3 or more times during each feeding, every time that baby falls asleep, switches to "comfort" sucking, or loses interest. Use each side at least twice per feeding. Use breast compression to keep baby feeding longer. For good instructions on how to do this, see Dr. Jack Newman's Protocol to manage breastmilk intake. This can be particularly helpful for sleepy or distractible babies.

Avoid pacifiers and bottles when possible. All of baby's sucking needs should be met at the breast (see above). If a temporary supplement is medically required, it can be given with a nursing supplementer or by spoon, cup or dropper (see Alternative Feeding Methods).

Give baby only breastmilk. Avoid all solids, water, and formula if baby is younger than six months, and consider decreasing solids if baby is older. If you are using more than a few ounces of formula per day, wean from the supplements gradually to "challenge" your breasts to produce more milk.

Take care of mom. Rest. Sleep when baby sleeps. Relax. Drink liquids to thirst (don't force liquids - drinking extra water does not increase supply), and eat a reasonably well-balanced diet.

Consider pumping. Adding pumping sessions after or between nursing sessions can be very helpful - pumping is very important when baby is not nursing efficiently or frequently enough, and can speed things up in all situations. Your aim in pumping is to remove more milk from the breasts and/or to increase frequency of breast emptying. When pumping to increase milk supply, to ensure that the pump removes an optimum amount of milk from the breast, keep pumping for 2-5 minutes after the last drops of milk. However, adding even a short pumping session (increasing frequency but perhaps not removing milk thoroughly) is helpful.

Consider a galactagogue. A substance (herb, prescription medication, etc.) that increases milk supply is called a galactagogue. See What is a galactagogue? Do I need one? for more information.

Additional information

@

@ other websites

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Increasing Low Milk Supply * KellyMom.com

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First of all, is your milk supply really low? Often, mothers think that their milk supply is low when it really isn't. If your baby is gaining weight well on breastmilk alone, then you do not have a problem with milk supply.

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Breast and bottle feeding advice for twins and more

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Breast and bottle feeding advice for twins and more

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

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We're still here for you...We're changing how we work so we can keep supporting you and your families during the COVID-19 pandemic.

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Follow three mothers as they share their tips on the joys and challenges of feeding twins.

The rest of the DVD can be viewed by clicking through the links below. While they work very well as stand-alone films, From Bump to Breastfeeding is best viewed as a whole:

From Bump to Breastfeeding

From Bump to Breastfeeding extra films

Latest

Most read

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At Best Beginnings we believe in the power of collaboration to create and provide quality-assured and evidence based information for families. All of our content is co-created with parents and healthcare professionals and vetted by external Healthcare bodies and parents. Read more

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Follow three mothers as they share their tips on the joys and challenges of feeding twins. Vimeo Video http://www.vimeo.com/11739595 The rest of the DVD can be viewed by clicking through the links below. While they work very well as stand-alone films, From Bump to Breastfeeding is best viewed as a whole: From Bump to Breastfeeding 1.

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Support for parents of premature babies

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Watch Small Wonders videos here
Supporting you when your baby is sick or premature
More than 1 in every 10 UK babies is born prematurely or sick. As well as professional support there's so much that only you as a parent can do to make a real difference to your baby's chances of growing up fit and strong.

It can be very distressing to be told when you're pregnant that your baby is likely to be born prematurely, however there are so many ways you can make a real difference to their health and wellbeing.

Small Wonders are 12 bite-size films following families and their journey in neo-natal units.
Topics covered:

Birth

First hours

Expressing breast milk

Holding your baby

Your time in hospital

Feeding independently

Preparing for home

First months at home

Twins and triplets

Bereavement

What is Small Wonders?
Seeing how other parents have coped in a similar situation can be comforting. Seeing them become involved in their baby's care can help you feel more confident to get involved in your own baby's care.

The films, endorsed by seven Royal Colleges and many charities, aim to support families of sick and premature babies through their experiences and form the heart of a National Change Programme.

Best Beginnings has supplied Small Wonders DVDs to around 150 neonatal units in hospitals across the UK. The films address sensitive situations, some of which may not be right for you at this time. If in doubt, ask the advice of your hospital staff before watching.

We have worked closely with over 200 families, experts and endorsing organisations to produce these films and the DVD has been endorsed by over 20 organisations, including UNICEF and RCPCH.
How do I watch Small Wonders?
For a quick look at the Small Wonders, click . You can also watch online on the Baby Buddy app , on our YouTube channel, and on the desktop version of Baby Buddy. You can buy copies of the Small Wonders DVD, which comes with the supporting booklet, from our online shop. If you are a parent of a sick or premature baby you can receive a copy of the DVD for free through your hospital.
Ways parents can participate in their baby's care:

Regular skin-to-skin/kangaroo care. Skin-to-skin contact reduces susceptibility to infection and can help to stabilise a baby's temperature and reduce the length of hospital stay. It also improves awareness and helps mother to produce milk

Providing and feeding breast milk to your baby, for example through expressing. Breast milk is very important because it reduces infections and advances mental and emotional development

Providing comforting touch and comfort holding. Time spent holding or touching your sick or premature baby allows you to bond, which increases your baby's responsiveness and lets you get to know one another

Day-to-day care such as nappy changing or bathing your baby

Best Beginnings collaborates with other organisations to ensure that families receive the best possible support. For more information regarding premature and sick babies, visit the Bliss website or call their Family Support Helpline for free on 0500 618140.
What mums and dads think of Small Wonders
"I found the films useful as I am in a similar situation as some of the parents and it gives a good idea of what to expect."

"I have had a premature baby but I learnt a lot from watching these films. There are a MUST for parents who haven't had previous experience of a neonatal unit. Really good!"

"Absolutely fantastic films. Very informative and a great insight into what's to come when having a premature baby. So glad that I got a chance to watch these as it really helped myself and my partner."
Want to know more about Small Wonders?
Visit the Small Wonders Impact and Evaluation page.
To find out how Best Beginnings can work with you in your are and use our Small Wonders resources email Nilu, our Head of Evaluation and Impact at [email protected]

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Supporting you when your baby is sick or premature. Small wonders project include 12 bite-size films following families and their journey in neo-natal units. Learn more here.

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Poos and wees can show how well baby is feeding

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Poos and wees can show how well baby is feeding

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The way you hold your baby or position them will affect how easy it is for them to breastfeed effectively. You can breastfeed your baby in many different positions, so it's good to try different ones. This helps you find what's most comfortable for you and allows your baby to get just the right mouthful of breast to feed effectively and easily.

Breastfeeding positions for newborns

When you first start breastfeeding your newborn, they will not be able to hold themselves in a good position. So you'll have to maintain a comfortable position for both of you for quite long periods. It takes time for your baby to develop the muscles and skills to feed effectively.
Our video has some great tips on different ways to hold your baby.
If you're having problems breastfeeding, or with latching or attachment, do call our infant feeding support line on 0300 330 0700 to talk to a breastfeeding counsellor. Your midwife or health visitor can also signpost you to your nearest breastfeeding support group.

Getting some support with breastfeeding can help you to get comfortable in one or more of the breastfeeding positions that we describe in this article.

Here's how to get started...

Preparing to feed

Whichever nursing positions you use, your baby will feed better if they're calm and you're comfortable. Holding them against you, talking to them or perhaps wrapping them securely in a towel or shawl might help if they need to be calmed. Or they might want to have their hands free to touch and stroke your breast.

Read more about getting started with breastfeeding in our article here.

Laid-back, relaxing position

Sitting in a chair

Underarm or rugby ball

Lying down

Breastfeeding positions for a fast milk flow

If you have a fast milk flow, this could be due to a large supply of breast milk. Some mums who have a fast milk flow worry their baby might have reflux if they're having problems, but it could be that their baby needs more control when they're feeding. If this is the case, laid-back feeding could be useful as it helps your baby to attach better and pull back if they need to take a break.

Breastfeeding your baby as they get heavier

As your baby grows, they become more active in getting themselves into position, as well as being larger and heavier. You might need to adjust you and your baby's position to continue to feed comfortably and effectively.

A laid-back breastfeeding position could be useful with larger or older babies as you do not have to use your arms to hold their weight. You can always ask a breastfeeding counsellor for support with finding positions that suit you and your baby.

Breastfeeding position tips

Whichever breastfeeding position you choose, remember...

Bring your baby to your breast or let them attach themselves rather than leaning towards them.

Tuck your baby in closely to you.

Check that their ear, shoulder and hip are all in a line - not twisted round.

Make sure your baby is facing your nipple - they shouldn't have to turn their head.

Using cushions, special breastfeeding pillows and other supports might help in the early days, but you might be equally comfortable without them.

(UNICEF Baby Friendly Initiative and Public Health England, 2015)

Many women take a while to get used to holding their baby comfortably. Trying different positions can help you find the ones that work best for you and your baby.
Page last reviewed: November 2019
Further information

NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our helpline on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.

National Breastfeeding Line (government funded): 0300 100 021.

For further information on how to breastfeed, including positioning and breastfeeding attachment, and a section on expressing your breastmilk by hand, visit Unicef's Baby Friendly Initiative support area for parents.

Bump to Breastfeeding DVD: available from your midwife or library - see more at www.bestbeginnings.org.uk

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Breastfeeding positions: which are best for you?

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The way you hold your baby or position them will affect how easy it is for them to breastfeed effectively. You can breastfeed your baby in many different positions, so it's good to try different ones. This helps you find what's most comfortable for you and allows your baby to get just the right mouthful of breast to feed effectively and easily.

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How much milk does baby need?

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Breastfeeding: how much milk does a baby need?

Breastfeeding is a skill that mother and baby learn together. It is normal for it to take some practice and for it to take a while for mothers to feel confident that babies are getting the milk they need (NHS, 2018a).

In the meantime, it can be reassuring to know that a breastfed baby who is fed on demand won't overfeed (NHS, 2020). And although you can't measure how much they are drinking, they will stop drinking when they've had enough, and feed again if they want to stimulate your supply (NHS, 2020).

Watch our video about how to know if you're feeding your baby in the right way.

You'll also be able tell if they're feeding well by checking the following...

Their poo

The first type of poo your baby will produce is called meconium. It is produced from birth for the first 2-3 days, and is sticky and green/black in colour. From day four you can expect breastfed baby poo to be soft and a yellow, mustard colour. Babies who are formula feeding might have more solid poo than those who breastfeed (NHS, 2018b). Babies do an average of four poos a day for the first week.

Their wet nappies

In their first 48 hours, most babies will only have two or three wet nappies.

If you have had IV fluids during labour or if your baby was born by caesarean, this will cause extra fluids in both you and your baby, so your baby will wee more in the first 24 hours (Noel-Weiss, 2011).

But from day five, you should get at least five or six heavy, wet nappies every 24 hours. Their wee should be pale and not dark brown (UNICEF and Start4Life, 2010; UNICEF UK Baby Friendly Initiative, 2010; NHS, 2018a).

Their behaviour

If your baby has a full tummy, they should seem healthy and alert when they're awake. They will also seem calm and relaxed while they're breastfeeding (UNICEF UK Baby Friendly Initiative, 2010; NHS, 2018a).

Weight gain

It's normal for babies to lose some weight during the first few days of life: 5-7% weight loss is considered normal. If baby loses 10% or more then this is an indicator they aren't getting enough milk. This weight loss usually stops after about 3-4 days. For most babies their weight has returned to what it was at birth by the time they are three weeks old (NICE, 2017). After that, they should be growing and putting on weight steadily (NHS, 2018a).

They will be weighed regularly (approximately once a month in the first six months) and their weight recorded in their personal child health record (PCHR) or red book (NHS, 2020).

Formula feeding or expressed milk: how much milk does a baby need?

If you're offering your baby milk from a bottle, whether formula or expressed milk, it is recommended to respond to your baby's signals about when they're hungry/thirsty and when they've had enough milk, unless there is a concern and your midwife or doctor has suggested otherwise (UNICEF, 2019).

Formula packaging suggests how much milk to offer, but use this as a rough guide while you're getting to know your baby because all babies are different.

Research into responsive or 'paced' bottle feeding suggests it can help reduce the risk of obesity. When your baby has had all the milk they want, remember to throw away any milk left in the bottle. Milk left in the bottle could become a source of infection. See more suggestions about how to bottle-feed responsively. (UNICEF, 2019).

How can I tell if breastfeeding is going well?

The following are seen as signs that breastfeeding is going well:

Your baby is well-attached if:

they have a wide mouth

they have a big mouthful of breast

their chin is touching your breast

their lower lip is rolled down (although you might not see this)

their nose is not usually squashed against your breast (unless the mother has quite large breasts)

your breasts or nipples are not painful when your baby's feeding, although their first few sucks might feel strong

more of the dark skin around your nipple (areola) is visible above your baby's lips than below them.

(UNICEF UK Baby Friendly Initiative, 2010; NICE, 2015; NHS, 2018a )

Your baby is getting enough milk if:

their feeding starts with a few quick sucks and after that their sucks and swallows are longer and rhythmical, with a few pauses

you see them swallow and you may hear them swallowing by around day three to four

their cheeks are rounded when they suck, rather than hollow

they're calm and relaxed when they're feeding

they finish a feed, either by coming off the breast or falling asleep after an active feed

they've got a moist mouth after they've fed

they look content and satisfied after most feeds

your breasts become softer after feeds

your nipple looks about the same after your baby's feeds, rather than white, flattened or pinched

you may feel relaxed and sleepy after you've breastfed.

(NICE, 2015; NHS, 2016)

How do I know that my baby is thriving?

How a baby looks and their behaviour are useful guides to whether they are 'thriving'. A thriving baby:

has a good skin colour

is alert when they're awake

asks for feeds

is usually satisfied after feeds.

(UNICEF UK Baby Friendly Initiative, 2010)

What should I do if I don't think I have enough milk?

Breastmilk is made on a supply and demand basis; the more milk your baby takes from your breast, the more milk you make. But the baby must be well latched on to do this. You can increase your milk supply by: (NHS 2018a)

Feed your baby as often and as long as your baby wants

Feed from both breasts at each feed

Keep your baby close and give lots of skin-to-skin, particularly in the early weeks, to maximise opportunities to breastfeed

Avoid giving your baby infant formula

Avoid dummies until your baby has learnt how to breastfeed well

If you're worried your baby isn't getting enough milk, speak to your health visitor, midwife or a breastfeeding counsellor. They can check how the baby is latched and may suggest changes you can make to help your baby get a deeper latch. Your health visitor or midwife can also rule out any underlying health problems or may refer you for a tongue tie assessment (NICE, 2015).

If you need breastfeeding support you can visit a local breastfeeding support group (some support groups are available online). In some situations it may be possible to have a home visit.

You can also speak to an NCT breastfeeding counsellor on our helpline (0300 330 0700) which is open every day, 8am to midnight. You could take a look at our article about breastfeeding support page to find out more.

Further information

NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our helpline on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk.

Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions.

You can also find more useful articles here.

National Breastfeeding Line (government funded): 0300 100 0212.

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Is my baby getting enough milk from breastfeeding or formula? | Baby & toddler, Feeding articles & support | NCT

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It's one of the most common worries in new parents: how do you know if your baby is well fed? Here are your questions answered.

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Some women get sore, cracked or painful nipples in the early days of breastfeeding.

Sore nipples are the most common breastfeeding complication and the most common reason women give up breastfeeding (NHS, 2019a). With a little breastfeeding support this can often easily be rectified.

What causes sore nipples when breastfeeding?

Some women find their nipples get very sore a few days after they begin breastfeeding their baby.

This usually happens if your baby isn't positioned or attached well at the breast. If a baby only sucks the nipple rather than taking a good mouthful of breast, then their tongue or roof of the mouth may rub on the nipple. This causes nipples to get sore quickly and might cause nipple cracking (NHS, 2019a).

What can help sore nipples?

Breastfeeding shouldn't be painful, so it's important to get breastfeeding support right from the start (NHS, 2019a). Breastfeeding support should be offered by a midwife before you leave the hospital or birth centre. They can help you to position and attach your baby to your breast, and explain the signs that your baby is feeding well (NHS, 2019a).

If your nipples are getting sore but you're already home, it's a good idea to ask for breastfeeding support from a midwife, health visitor or breastfeeding counsellor as soon as you start to notice a problem. They can watch you while you feed your baby and check your baby is positioned well and feeding effectively.

You might also be able to feel when your baby is well attached. Your nipple should rest comfortably against the soft palate at the back of their mouth. If the nipple is nearer to the front of their mouth, your baby might be poorly attached. This can cause pinching of your nipple against the hard palate, which can cause pain.

You can check with your local NCT group what local breastfeeding support might be available. You may be able to drop in to a breastfeeding group for support or you might be able to have an NCT breastfeeding counsellor visit you at home. You can call the NCT support line for practical and emotional support on 0300 330 0700.

Your midwife, health visitor or breastfeeding counsellor might be able to help identify any other underlying issues (NHS, 2019a). Read on to find out more...

What other less common causes of sore nipples are there?

Engorgement

When breasts become full of milk, they might become sore (Breastfeeding Basics, 2015). This can happen when your breastmilk first comes in.

Feed your baby as often as they would like and for as long as they like. You can also try using a warm heat pack or having a warm shower before feeding or expressing milk, or use cold packs after feeding for pain relief (NICE, 2017).

Flat or inverted nipples

Nipples come in all sorts of sizes and shapes. While most protrude, some are flat or inverted.

These differences don't usually affect your ability to breastfeed. Yet if one or both nipples are flat or inverted, you might find it takes you a bit longer to get breastfeeding established. It can help to get extra support with positioning and attachment.

Various techniques and devices have been suggested to help 'draw out' inverted nipples but it's uncertain how effective they are. Things that can help include stimulating the nipple before feeding, holding the breast while baby is latching on, or using an exaggerated latch position (La Leche League, 2016a). Here's a video showing you how to get an exaggerated latch or 'flipple'.

Tongue tie

Tongue-tie is when the skin joining the underside of the baby's tongue to the floor of their mouth (frenulum) restricts how they can move their tongue. This causes difficulty in latching, which can result in sore nipples.

Other symptoms of tongue tie include: your baby having difficulty latching or staying latched onto the breast; nipples becoming squashed in your baby's mouth; feeding very frequently or for a long time; slow weight gain; or making a clicking sound while feeding. Some parents notice that their baby has difficulty moving their tongue from side to side or sticking out their tongue.

If you're experiencing breastfeeding difficulties and you think your baby might have tongue-tie, speak to your health visitor and you could ask to be referred to a local tongue-tie practitioner. If your baby has tongue-tie, they might suggest dividing your baby's frenulum, which involves cutting the piece of skin; it's a quick, simple, painless procedure and can immediately improve feeding (NICE, 2017). You can find an independent tongue-tie practitioner here.

Thrush (candida) infection

Breast or nipple pain can sometimes be caused by a thrush infection. Candida can infect your nipples if they become cracked or damaged.

Babies who are breastfed can also develop thrush in their mouth. This is likely to be the cause if you have severe pain in both breasts for up to an hour after breastfeeding, despite weeks of pain-free breastfeeding (NHS, 2018).

Symptoms in the mum

Feeling new pain in or behind the nipples or through the breast after feeds. Pain can be described as shooting or pins-and-needles pain. Pain can last for several hours after a feed.

It's unlikely to be thrush if it's only in one breast, accompanied by fever or a red/dark patch on the breast (NHS, 2018).

Symptoms in the baby

Unsettled during feeds, white film on lips, and white spots in their mouth, which don't come off if rubbed; persistent nappy rash (NHS, 2018).

Treatment

If you think you have thrush, see your GP. They can prescribe cream to treat you and your baby. It's important that both mum and baby are treated for thrush because it is very easily transmitted from one to the other. Other members of the family might need to be treated too (NHS, 2018).

It's recommended that you wash and sterilise several times any bottle teats, dummies or anything else that has been in baby's mouth. It's also best not to use any expressed milk from when you had thrush because it might be contaminated with thrush (NHS, 2018).

Mastitis

Mastitis is an inflammation of the breast caused by uncleared blocked ducts or an infection, that often causes the breast to become darker or red (depending on skin colour) and inflamed. See our article on mastitis for more information on symptoms and treatment. Continue to feed your baby and make sure they are attached well to the breast.

Mastitis can lead to a breast abscess (collection of pus), which might need draining, so you may want to see your GP to discuss antibiotics (NHS, 2019b).

Nipple vasospasm

Sometimes painful and sore nipples can be caused by nipple vasospasm, where blood flow is restricted to the area. This can be triggered if a baby's latch is shallow and can also be connected to Raynaud's phenomenon (a condition affecting blood supply) (Breastfeeding Support, 2018).

Some mums' nipples look white (blanched) after a feed and they may experience a deep pain or burning sensation. If this is the case, avoid exposing your nipples to the cold, wear warm clothing and breastfeed in a warm environment (NICE, 2017).

Should I limit my baby's time at the breast to avoid sore nipples?

Limiting your baby's time at the breast is likely to decrease your milk supply. Continue breastfeeding if you can and get breastfeeding support to help you solve any issues like a poor latch or attachment (NICE, 2017).

What are nipple shields or breast shells and can they help?

Nipple shields are thin, protective covers worn over the nipple while breastfeeding. Breast shells are hard, protective covers worn inside the bra.

The use of nipple shields is controversial. They can reduce milk transfer but their use can help women to continue breastfeeding (McKechnie and Eglash, 2010).

For some women and babies, nipple shields can help to establish breastfeeding and make it more comfortable. They might also compensate for immature feeding behaviour in premature babies. On the other hand, they might reduce milk supply, leading to premature weaning from the breast. Babies can also become reliant on them, not wanting to feed without (Chow et al, 2015).

Nipple shields, while effective in helping some women to continue breastfeeding, do not correct the underlying problem (a poor latch). So skilled help is recommended for sore nipples and for women using nipple shields (La Leche League, 2016b).

Breastfeeding support can help you identify and solve any breastfeeding issues (NICE, 2017; NHS, 2019).

Treatment of sore nipples

Early breastfeeding support can help make sure your baby is positioned and attached well. Some women treat nipple cracks with nipple cream, but the evidence for this is inconclusive. You might wish to consider expressing breast milk if your nipples are very sore or cracked.

Getting sore nipples from breastfeeding suggests that it could be helpful to get support with the positioning and latching of your baby from an appropriately trained person (NHS, 2019a).

For more information, read our article on self-help tips for sore nipples.

Further information

NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our helpline on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.

National Breastfeeding Line (government funded): 0300 100 021.

Best Beginnings - Bump to Breastfeeding DVD Chapter 7 'Overcoming Challenges'.

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Sore nipples when breastfeeding | Baby & toddler, Feeding articles & support | NCT

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Sore nipples can be a problem in the early days of breastfeeding and beyond. This article discusses causes of sore nipples and how to ease the pain.

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Encouraging helpful UNICEF video on hand expressing

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Encouraging helpful UNICEF video on hand expressing

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This video guides mothers on how to hand express and talks about the times when hand expression might be useful.

See the Breastfeeding Network website for FAQs and a leaflet all about expressing and storing breastmilk.

Problems viewing this video? Contact us.

Find more resources

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Hand expression video - Baby Friendly Initiative

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This video guides you through how to hand express, and talks about the times when hand expression might be useful for you.

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Information and video from NHS

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Your breast milk is important to your baby at any age. Giving your premature baby your breast milk benefits their health as well as yours.
Breast milk:

helps protect your baby from infections, particularly of their gut - premature babies are more likely to get infections

contains hormones, nutrients and growth factors that help your baby to grow and develop

is easier for your baby to digest than formula milk, because it's human milk specially designed by your body for your baby

See other benefits of breastfeeding.

If your baby is very small or sick, they may not be able to breastfeed from your breast at first. But, you can start regularly collecting your breast milk (called expressing) as soon as possible after your baby's born. This will help get your milk supply going and the milk you express can be frozen so you can give it to your baby later. Then you can start breastfeeding from the breast once you and your baby are ready.

Even if you were not planning to breastfeed, you could express your breast milk for a while to help boost your baby's immune system in the early weeks after birth.

Spending lots of time close together with your baby can help boost your breast milk supply and establish breastfeeding.

Skin-to-skin contact with your premature baby

If your baby is well enough, you'll usually be encouraged to spend time holding them against your skin as soon as possible. This is sometimes called kangaroo care.

Your baby will usually be dressed just in a nappy, hat and socks and then placed inside your top, under a blanket, or in a soft sling so they can be held securely against your skin. If it's cold outside you can also put them in a sleeveless vest with an open neck.

This skin-to-skin contact helps you feel close to your baby. Your partner can enjoy this kind of contact as well.

For your premature baby, skin-to-skin contact:

reduces stress and/or pain

promotes healthy weight gain

helps to establish breastfeeding

helps them sleep better

helps to regulate and support their heart rate and breathing

For mums, skin-to-skin contact:

helps reduce your chance of developing postnatal depression

increases your confidence as a new parent

can help make breastfeeding easier and increase the amount of milk you make

For dads and partners, holding your baby skin to skin:

helps you bond with your baby - babies can hear both parents' voices in the womb and will be calmed by the sound of your voice as well as their mum's

helps you feel more confident as a parent

Expressing milk if your baby is premature

It's recommended you express often, ideally at least 8 times a day to begin with - including at least once at night - to keep your milk supply up.

In the early days, it's often easier to express your milk by hand. Your midwife or a breastfeeding supporter can show you how.

You'll probably only express a few drops to begin with but, if you hand express often, this will increase. Even if you are only expressing a small amount it will still help your baby.

In the early days you can collect your breast milk in a small, sterile cup and store it in a syringe.

Once you are producing more milk, you could try using a breast pump. If your baby is in a neonatal unit, the hospital will usually be able to lend you an electric breast pump for expressing your milk. If they cannot lend you one, you can hire one.

Read more about breastfeeding help and support to find out about hiring a pump, or phone the National Breastfeeding Helpline on 0300 100 0212.

The staff, your midwife or a breastfeeding supporter can give you advice about how to increase your milk supply. They can also show you how to encourage your milk to flow and how to use a breast pump.

Always ask for help early if you have any worries or questions.

Tube feeding your baby

Babies do not normally learn to co-ordinate the sucking, swallowing and breathing needed for feeding until about 34 to 36 weeks of pregnancy.

If your baby is born before this time, they may need to have breast milk via a feeding tube to begin with. This goes through their nose or mouth into their stomach. The staff in the neonatal unit can show you how to feed your baby this way.

Babies who are very premature or sick may need to be fed via an intravenous (IV) line to begin with. A fluid containing nutrients is fed straight into your baby's vein.

Visit the Bliss website to read more about tube feeding.

Using donor breast milk

Some hospitals can provide donated breast milk for your baby to have until your own supply is established.

See the United Kingdom Association for Milk Banking (UKAMB) website for more about donor breast milk.

If donor breast milk is not available, your baby can have formula milk until you're producing enough breast milk.

It's recommended you do not buy donor milk over the internet. This is because the source cannot be confirmed and you cannot be sure whether the donor or the milk has been screened for infections.

Moving on to breastfeeding your premature baby

While holding your baby, you may notice them try to move towards your breast. Gradually, as they develop and get stronger, they will be able to breastfeed directly.

The first time you try it, the hospital staff may ask you to express first, then put your baby to your breast. This is so your baby is not overwhelmed when your milk lets down.

At first, your baby may only lick the breast, then next time take a few sucks until they gradually become happy and confident feeders.

You can combine tube feeding with breastfeeding until your baby is getting everything they need from the breast only.

Using a lactation aid (supplementer)

You could also consider using a lactation aid. This is a way of supplementing your baby's breastfeeds with either expressed breast milk or formula.

A tiny tube is taped next to your nipple so your baby can get milk via the tube as well as from your breast while attached to your breast. This helps to support your baby as they get used to attaching to the breast.

Visit healthtalk.org to see mums talking about feeding their sick or premature babies.

Got a breastfeeding question?

Sign into Facebook, or use an Amazon Alexa or Google Home and use the Start4Life Breastfeeding Friend chatbot for fast, friendly, trusted NHS advice anytime, day or night.

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Your breast milk is important to your baby at any age. Giving your premature baby your breast milk benefits their health as well as yours.

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Information on many issues including the use of various medicines, drugs and medical procedures, transgender parenting

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Can I Breastfeed if...? Archives * KellyMom.com

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NHS/Dept of Health information and videos

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Breastfeeding is a skill that takes time to get the hang of. Lots of mums wonder if their baby's feeding well and getting enough - especially in the first few days. But once you've mastered it, you'll probably find it's the easiest and most satisfying way to feed your baby.

Apart from the fact that breast milk is tailor-made for your baby, contains vitamins and minerals and is always available, it also offers protection from certain infections and helps improve your baby's long-term health. Breastfeeding reduces the risk of SIDS (Sudden Infant Death Syndrome), childhood diabetes and leukaemia.

We're here to provide lots of helpful information and advice on breastfeeding. If you have any breastfeeding worries or concerns, the best thing to do is speak to your midwife or health visitor, or join a local breastfeeding support group.

Any amount of breastfeeding is beneficial, but exclusively breastfeeding your baby for 6 months offers a lot more protection. There are benefits and advantages for you too - breastfeeding helps:.

your uterus get back down to size - after your baby is born, your uterus (womb) will gradually get smaller day-by-day, but breastfeeding will help speed this up

you bond with your baby - breastfeeding is a lovely way to feel close and strengthen the bond between you and your baby

release a hormone called "oxytocin" which helps you feel calm and connected to your baby

protect your health - breastfeeding lowers your risk of breast cancer, ovarian cancer, osteoporosis (weak bones), diabetes and cardiovascular disease (conditions affecting the heart or blood vessels)

burn off calories - if you are exclusively breastfeeding, this will help burn off about 300 calories a day

There are many benefits of carrying on breastfeeding after 6 months - your breast milk protects your baby from infections and there's some evidence it helps them digest solid foods.

Breastfeeding Friend from Start for Life

The Breastfeeding Friend, a digital tool from Start for Life, has lots of useful information and expert advice to share with you - and because it's a digital tool, you can access it 24 / 7.

For confidential breastfeeding information and support, call the National Breastfeeding Helpline on 0300 100 0212. Lines are open 9:30am to 9:30pm every day.

Sign up now for our pregnancy, baby and toddler guide

Get personalised emails for trusted NHS advice, videos and tips on your pregnancy week by week, birth and parenthood.
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Breastfeeding can take practice - read our guides on breastfeeding to find out what works best for you

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Skip to main content Breastfeeding is a skill that takes time to get the hang of. Lots of mums wonder if their baby's feeding well and getting enough - especially in the first few days. But once you've mastered it, you'll probably find it's the easiest and most satisfying way to feed your baby.

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Videos on many elements of breastfeeding

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This information and videos are available in verified by experts in our Editorial Board including representatives from Royal College of Midwives, Royal College of Paediatrics and Child Health and Royal College of Psychiatrists as well as other key health organisations in the UK. To download Baby Buddy, visit the relevant app store of your choice:

Meet four prospective mums, Melissa, Maria, Teresa and Angela. Melissa has never been through labour - she had a caesarian-section with her previous child. For medical reasons Maria has to have a c-section; Teresa wants to give birth at home; and Angela is expecting her third child. We follow them as they prepare for their births.

All our mums have different birth experiences. Find out why skin-to-skin contact is so important and about breastfeeding for the first time. "It's a great feeling to be able to provide for him without anything else, just me myself," Angela says. Melissa's partner Andy says breastfeeding is healthy, cheaper and much less effort than making up bottles.

Angela is back home with baby Cameron and breastfeeding is going well. "It's a great feeling to be able to sit there and watch him feeding away. It's a really special bond," she says. Teresa is making sure she has plenty of contact with Rufus, ensuring her body is supplying enough milk for him. Breastfeeding can protect you against ovarian cancer and give you stronger bones in later life.

How to make sure your baby is attaching well at the breast.

Meet four mums whose babies have been breastfeeding for a little while and hear their experiences. Linda was troubled by breastfeeding outside the home - until she tried it. "I thought, 'nobody breastfeeds in public,'" she says. "What I realised is, loads of women breastfeed in public, you just don't realise it's happening."

Find out about overcoming challenges like uncomfortably full breasts and mastitis, and how to position your baby so he or she feeds properly.

Linda and Heidi have fed their babies breast milk for six months. Now their babies are ready to try their first solids.

Join a class with specialist midwife Bella Dale, who explains how breastfeeding works and how mums' bodies start preparing to feed their babies before birth.

Three mums tell us how they overcame hurdles with breastfeeding. Thomasina overcame sore nipples, while Lowri encountered mastitis, both of which were caused because their babies weren't attaching properly at the breast.

We meet three mothers who express their milk for different reasons and learnt how to do it in different ways. Find out techniques for expressing, different pumps and ways to store breast milk. We also discover how mothers fit breastfeeding into their return to work.

In their first few weeks, pre-term babies may be fed using a nasogastric tube. But as they progress they will begin to take milk feeds, usually through a tube into the baby's mouth or nose. Breast milk is best for many reasons. Find out why and how as we follow four mothers and their premature babies.

Follow three mothers as they share their tips on the joys and challenges of feeding twins.

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The Impact Lead will focus on developing Best Beginnings' frameworks for monitoring and evaluating our national and international work ensuring that learning continues to be captured in ways that can be shared and used for effective advocacy and influencing. The successful candidate will also play a pivotal role influencing policy and its implementation within the maternity, early years, digital health and public health context.

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Your guide to breastfeeding and how to do it successfully.

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Well researched information especially on mother's medication and breastfeeding

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Department of Health guidance states breastfeeding is the healthiest way to feed your baby. Exclusive breastfeeding (giving your baby breast milk only) is recommended for around the first six months (26 weeks) of your baby's life. After that, giving your baby breast milk alongside other food will help them continue to grow and develop.

This section covers a wide range of topics which have been grouped as follows:

A mothers story

"I knew I wanted to breastfeed my baby. I knew it was natural. So I was surprised when baby James and I could not seem to get the hang of it. I phoned a Breastfeeding Supporter. She gave us some good ideas about how I was sitting and holding James. But most of all it was good to have someone to talk to."

We have several information leaflets and other publications available to view and download or you can visit our to buy them in larger numbers.

You can also look at some External Websites for more information and useful resources.

Please note that the Breastfeeding Network is not responsible for the content or reliability of any externally linked website and does not necessarily endorse the view expressed within it.

See also NHS information:
Page last updated March 2017

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Breastfeeding Information - The Breastfeeding Network

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Department of Health guidance states breastfeeding is the healthiest way to feed your baby. Exclusive breastfeeding (giving your baby breast milk only) is recommended for around the first six months (26 weeks) of your baby's life. After that, giving your baby breast milk alongside other food will help them continue to grow and develop.

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Information and support from La Leche League

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Information and support from La Leche League

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There are a range of ways LLLGB can offer you support with breastfeeding, by telephone, in writing, or using our online information and printed materials. If the blue "chat now" button is showing, then you can also use our online chat service to have an instant conversation with one of our breastfeeding counsellors.

LLLGB Breastfeeding Information

Getting breastfeeding started

Life with a new baby

Common Concerns

Milk supply issues

Milk expression and storage

Family Foods

Working and separation

Breastfeeding an older baby

Can I breastfeed if...?

Issues

Breastfeeding Today (LLLI)
Information & stories
article index
Please note: The breastfeeding information on this website has been put together by La Leche League Leaders, who are accredited by La Leche League to provide breastfeeding information. Please note that Leaders have a wide knowledge and experience of breastfeeding but are not medically trained. If you have a medical query, or are concerned about your health or the health of your child please consult your doctor.

Information, references and links on this website are taken from La Leche League resources, unless stated otherwise. Please note that La Leche League GB does not endorse information from outside sources, extra information is provided for you to consider.

Information supplied is not intended as advice. You are in the best position to make a decision as to how the information offered will affect you and your baby.

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There are a range of ways LLLGB can offer you support with breastfeeding, by telephone, in writing, or using our online information and printed materials. If the blue "chat now" button is showing, then you can also use our online chat service to have an instant conversation with one of our breastfeeding counsellors.

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How to do it - video and photos
Different positions

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Including how to position baby at the breast
Skin to skin contact
Commonly asked questions

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Breastfeeding information leaflets from nct

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Breastfeeding information leaflets from nct

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Information and photographs covering most elements of baby feeding

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Whether you're breastfeeding, formula-feeding or both, you'll find lots of useful articles about feeding here. Plus, tips on introducing solids when you're ready.