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We need to start thinking about supporting healthy growth during pregnancy and from birth. You can support parents to use responsive feeding techniques to help their children grow in a healthy way that is right for them, while also helping them develop a close and loving bond with their child, by promoting responsive bottle-feeding, if [...]

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Get free specialist support with breastfeeding and early parenting in West Kent. Face to face and zoom appointments available now.

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

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See below for some local feeding support groups, for you and your little one :)

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Crowborough Breastfeeding Café

The Friends of Crowborough Hospital and the Birth Centre Staff have teamed up to provide a new breastfeeding café every Thursday morning in the Day Centre. The Friends are funding the use of the day centre and providing the equipment and refreshments, with the staffing managed by the Birth Centre. Since re-opening in April 2022, the Crowborough birth centre has supported around 165 women to give birth, as well as providing maternity care (antenatal and postnatal) for around 700 women and babies. The Birth Centre staff pride themselves on providing compassionate, woman-centred, care, which is reflected in the positive feedback the midwives receive each month. Over the past year, they have identified a need to provide an infant feeding support group as part of their service: a community based resource for new mums to meet, socialise and receive emotional support as well as expert feeding advice. The breastfeeding café is planned to open on Thursday 27 th April.

Laura Scarlett (Birth Centre Maternity Support Worker) who is championing the café explains that "infant feeding is not just about nutrition. It's also about building a relationship between mother and baby, which goes far beyond the early months, and so good, consistent, compassionate support is critical".

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Crowborough Breastfeeding Café The Friends of Crowborough Hospital and the Birth Centre Staff have teamed up to provide a new breastfeeding café every Thursday morning in the Day Centre. The Friends are funding the use of the day centre and providing the equipment and refreshments, with the staffing managed by the Birth Centre.

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Baby Umbrella | Facebook

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Breastfeeding can be challenging, especially in the early days. Some women may find breastfeeding challenging, whether its your first, second or third baby. Even if you have found it easy to breastfeed one baby, remember every breastfeeding experience is different.

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Find here a range of useful resources for parents on infant feeding and relationship building, as well as information on overcoming common breastfeeding challenges. Some resources are available individually below.

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Find below a range of useful resources for parents on infant feeding and relationship building, as well as information on overcoming common breastfeeding challenges.

There are various mother support groups which offer infant feeding support:

Find more useful organisations.

Breastfeeding is the healthiest way to feed your baby. If you decide not to breastfeed or to stop breastfeeding, it is possible to restart. Giving infant formula to a breastfed baby will reduce your milk supply. You do not need to eat any special foods while breastfeeding, but it is a good idea for you, just like everyone else, to eat a healthy diet.

Resources to support you

Below is a selection of resources to support you with feeding, caring, and building a close and loving relationship with your baby.

Overcoming breastfeeding problems

You may find whilst trying to establish breastfeeding that you run into problems. Whilst these can be debilitating and painful, thankfully the most common ones can be solved relatively quickly and easily - given the right support.

Unfortunately, support is often not available or, what is worse, mothers are told that problems such as engorgement and sore nipples are a normal part of breastfeeding. This is not true.

Below you can read about how different problems develop, how to spot them at a early stage, and how to solve them by yourself or with the support of a health professional.

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Support for parents - Baby Friendly Initiative

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Resources and information for parents to support with feeding and developing close and loving relationships with their baby.

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Find out about some common challenges with breastfeeding or expressing here, and what can help.

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The Trick to Getting a Free Breast Pump Through Insurance

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The Trick to Getting a Free Breast Pump Through Insurance

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The Trick to Getting a Free Breast Pump Through Insurance

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The Ardo Carum Hospital Grade Breastpump is delivered fully serviced and cleaned and includes two new pumpsets for single or double expressing.

Breastshells - Included with the Carum breastpump are 26mm breastshells. If you require a different size breastshell please click on the link, choose the size you require, and add it to your order. Check out the breastshell sizing guide if you are unsure.

The Carum is suitable for use from birth and is easy to operate and quiet when in use. The suction strength (vacuum) and frequency (cycle) settings can be adjusted individually and independently from one another, in stimulation and expression mode. The pump has a timer/stopwatch and a large colour display with dimmer function.

Sensitive Programme - the pump starts off with a barely detectable vacuum and cycle, which enables ultra-gentle expressing with painful, sore nipples. The settings can also be adjusted in small steps to accommodate the sensitivities of the mum. The gentle expressing programme is available as standard in every Ardo Carum.

Vacuum Seal technology - in all Ardo Pump sets provides a barrier against bacteria and ensures that no breastmilk or impurities can enter the connecting tube or pump. This provides reliable protection against contamination of the breastmilk and prevents infection. Protects Mum, Milk & Baby.

Ardo products are manufactured in Switzerland from premium-quality materials that are free from BPA, Latex and DEHP. Ardo is a trusted supplier to the NHS.

Price - £49.00 for the first 14 days (includes delivery and collection by courier and two pumpsets).

£49 for each additional month. The rental is continuous and monthly payments are taken until a collection date is booked for the return of the pump.
IMPORTANT - DO NOT THROW AWAY THE PACKAGING, IT MUST BE KEPT TO ENSURE THE SAFE RETURN OF THE BREAST PUMP - £10 CHARGEABLE COST FOR REPLACEMENT.

Carum breastpump unit

2 x Pumpsets with 150ml bottles and 26mm breastshells*

2 x lids with removable inserts

Rental agreement

Instructions
UK Mainland only orders (excludes NI & Islands)
*If you require a different size breastshell please click on the link, choose the size you require, and add it to your order. Check out the sizing guide on the breastshell pages if you are unsure.

For orders placed before 2 pm, Monday to Friday, choose from the following delivery options:

FREE delivery - 2-4 days working days - not tracked.

Next working day delivery is £7.75 - tracked, however, due to incidents that may occur beyond our control we cannot offer a guarantee.

For the Scottish Highland areas, this may be a 2/3-day delivery. AB31 - AB35, AB41 - AB54, AB36 - AB38, AB55 - AB56, FK17 - FK21, IV1 - IV63, KA27, KA28, KW0 - KW14, PA20 - PA78, PH15 - PH18, PH19 - PH29, PH32 - PH33, PH45 - PH48, PH30 - PH31, PH34-44, PH49 - PH50. 2-4 Days: KW15 - KW17HS1 - HS9ZE1 - ZE3.

Saturday delivery is £12.575 - available on orders made before 2 pm on Friday.
IMPORTANT - DO NOT THROW AWAY THE PACKAGING, IT MUST BE KEPT TO ENSURE THE SAFE RETURN OF THE BREAST PUMP - £10 CHARGEABLE COST FOR REPLACEMENT. Returning the Breastpump

Orders are only processed and despatched from Monday to Friday, excluding bank holidays. If you order after 2 pm on a Friday, over a weekend, or on a bank holiday your order will not be processed until the next working day.

It is the hirer's responsibility to arrange the collection of the pump and terminate the hire. Contact us at least 2 working days prior to the end of the hire period, the date is specified on each invoice. Collections take place Monday to Friday within the hours of 9am -5pm.

In the grey box put the pump, the electric cable, and the bottle holder. Pack the grey box in the cardboard box with protective ends you received on delivery.

Do not include any bottles or tubing that connect to the pump, these are yours to keep, we do not want them returned.

To stop the pump from being re-delivered to your address, can you please cross out your name, address, and the bar code on the label on the cardboard box before the courier collects.

If the courier is unable to collect the pump on the agreed date there will be a £12.00 re-collection charge, plus a non-refundable 30-day continuation payment will be taken if you have entered the next hire period.

Collection is available Monday to Friday 9am - 5pm from our office in Taunton, Somerset If you wish to collect a rental pump please call us to arrange.

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The Ardo Carum double electric rental breast pump is the latest in breast pump technology. This hospital grade breast pump is excellent for exclusively expressing mums.Carum 14 day Rental

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Rent Breast Pumps | Hospital Grade Breastpumps | Symphony | Medela

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Rent Breast Pumps | Hospital Grade Breastpumps | Symphony | Medela

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Hospital Grade Breast Pump Rental

The Symphony PLUS hospital grade breastpump has been developed specifically to give the necessary support to mothers throughout their breastfeeding journey of pre-term and term infants: to initiate, build and maintain an adequate milk supply. Now with a NEW PersonalFit Breast Pump Kit!

Ideal for long-term and frequent pumping

Time saving - you can pump more milk in less time

Easy to use

The NEW PersonalFit™ PLUS reusable rental pump set
Designed for pumping mothers to use easily and comfortably at home, PersonalFit™ PLUS rental pump sets for Symphony® are also proven to yield more milk in the same time, when compared to standard pump sets.

More information

Symphony PLUS - designed to mimic the natural sucking pattern of a term born infant.

The INITIATE program mimics the irregular and more rapid sucking and pausing pattern of a term born infant during the first few days of lactation.

The MAINTAIN program is based on the 2-Phase sucking pattern of a term born infant during established lactation.

Now comes with the NEW PersonalFit Plus Pumpset.

More comfortable, efficient expression for mums

Oval opening - easier fit to different breast shapes

105 degree angle - minimises breast tissue compression

The unique combination of rapid stimulation and slower expression makes pumping gentle, comfortable and efficient.

The Symphony PLUS includes the initiate and maintain pumping program 2 x Pump sets with 24 mm breast shields. The 24 mm breast shield is our standard size which is suitable for the majority of women. Other shield sizes are available to purchase from www.medela.co.uk.

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Rent Breast Pumps | Hospital Grade Breastpumps | Symphony | Medela

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Rent your hospital grade Symphony Breast Pump from Medela today! Hospitals number 1 choice for expressing breast milk. Used in 75% of UK maternity hospitals.

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Breast Pumps in Kent - Kent Baby Matters

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Breast Pumps in Kent - Kent Baby Matters

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PSBreastfeeding CIC has pumps available in West Kent to rent for any reason.
What are breast pumps?
A breast pump is a machine that is used to remove milk from the breast. Many women are able to hand express breastmilk, but may find that using a pump is quicker and easier. A double pump can remove milk from both breasts at the same time.

The majority of pumps we have available ARDO Calypso breast pumps, with Pump Genie and Ameda available in some areas. These are electric pumps with the ability to pump either one or two breasts at the same time. The collection kits provided with these pumps use a flexible membrane which prevents milk from getting to the motor, allowing these pumps to be used by multiple users.
ARDO Calypso Breast Pump Video Instructions The Cost

When a breast pump is loaned you receive a pump motor and power cord along with disposable collection kits. The pump is returned at the end of the one month loan period but the collection kits are not. The pump (motor + power cord) can be rented for £15 each month plus the cost of collection kits. You can buy as many collection kits as you need at £10 each. The kits are then yours to keep once your hire is finished. If you already have ARDO kits from your hospital stay or a previous pumping experience then you can use them with any of the pumps we have available. There are no charges for families receiving healthy start vouchers.

How can I hire a breastpump?

Visit your local Kent Baby Matters breastfeeding group and speak to the breastfeeding counsellor or lactation consultant.

Email karen@psbreastfeeding.co.uk

Call Karen at 07951600777

Message through the website on the Contact Us page.

Message through our Facebook page.

For out of hours collection or drop off in Sevenoaks 24/7 contact Karen

There are a number of videos available online which go through step by step instructions on how to assemble, use and clean the ARDO Calypso Pump. They are available for you to watch HERE.
Where else can I hire a pump?
Breast Pumps are available for hire from other organisations across Kent and the UK. You may want to start by asking the midwives at the hospital maternity ward or your community midwife. Local Breastfeeding Charities sometimes run pump loaning programmes -

ARDO agent Canterbury. Hannah Croft (Lactation Consultant) - 07732 090102

NCT Medway Pump Loans - hire@nctmedway.org.uk

ABM Deal Pump Loans - Thea at 07967 673084

NCT/Medela agent Sidcup. Alison Davis - 02083 004970 or 07929 791392

ARDO agent Sidcup. Patricia Molinari (Lactation Consultant) - 02083 002606

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Breast Pumps in Kent - Kent Baby Matters

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PSBreastfeeding CIC has pumps available in West Kent to rent for any reason. What are breast pumps? A breast pump is a machine that is used to remove milk from the breast. Many women are able to hand express breastmilk, but may find that using a pump is quicker and easier.

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Sometimes, it can be hard to convince your baby to latch on to your breast. This can be stressful but there are lots of things you can try to make it easier. If you are struggling to get your baby to latch on, first try following our guide on how to breastfeed.

You might find that it helps to hand express some drops of milk onto your nipple so your baby can smell and taste it.

If possible, try breastfeeding as soon as your baby shows any signs of hunger. A very hungry baby may become distressed and this can make latching more difficult.

If your breasts have become very full and hard, it may be hard for your baby to latch. You can try expressing just enough milk to soften your breasts, so you feel more comfortable and to make latching easier for your baby.

Reverse pressure softening may also help if your breasts are very full or engorged.

It might help to spend some time in skin-to-skin contact, with the baby close to your breast and with access to your nipple, but without pressure to latch on and feed. You could try a laid-back position with your baby laid on your tummy/chest, so they can root and seek out the breast themselves.

Sometimes it helps to take a 'Babymoon'. Sometimes families can have lots of visitors in the first few days and end up being busy making cups of tea and looking after visitors. This can impact on you as a breastfeeding parent, as you don't have the time to sit and really spend time getting to know your new baby and work together on getting breastfeeding established. This is especially true if you are worried about feeding with people around. You are also less likely to be spending time in skin-to-skin contact with baby if you have lots of visitors around!

Sometimes when you are finding feeding isn't working that well in the first weeks (or even later on) it could help to spend 24 hours or so just focusing on your little one and on feeding, especially if you have been busy. Some breastfeeding parents head to bed for lots of skin-to-skin and others just ask for no visitors (except those who are willing to look after you so that you can focus yourself and your baby!) This is sometimes called a babymoon.

If you are still having trouble with latching or breastfeeding, speak your midwife, health visitor or a breastfeeding supporter. You can visit a local support group or contact the National Breastfeeding Helpline as well.

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My baby won't latch on - The Breastfeeding Network

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Sometimes, it can be hard to convince your baby to latch on to your breast. This can be stressful but there are lots of things you can try to make it easier. If you are struggling to get your baby to latch on, first try following our guide on how to breastfeed.

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Low milk supply and helping your baby gain weight

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Low milk supply and helping your baby gain weight

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You can tell if your baby is getting enough milk by looking at how much they are weeing and pooing, and whether they are gaining weight. If they are producing the expected amount of wee and poo, and their weight is increasing and approximately following their centile line on their growth chart, then they are getting enough milk. You cannot tell how much milk you are producing from how full/empty your breasts feel, or how long your baby feeds for.

Sometimes breastfeeding mothers worry that they are not producing enough milk for their baby. However, most mothers ARE able to produce enough milk, and if your milk supply does drop, you can usually increase it again with some simple measures, including adjusting your positioning and attachment and feeding your baby frequently and responsively.

If you are concerned that your baby is not getting enough milk, speak to your breastfeeding supporter, midwife, health visitor or GP.  This article on low milk supply (and why many mothers may worry that their supply is low when it actually isn't) may also be helpful: Low milk supply 101 - Association of Breastfeeding Mothers

Some suggestions to increase the amount of milk your baby is getting:

In the first weeks we now think that babies become sleepy when the flow of milk slows, not because they are full.

The following points should help you baby get more milk at each feed:

Aim for the best attachment possible. Even good attachment can be better. You can read more on our "how to breastfeed" page.

Learn how to see milk being transferred: open mouth wide->pause->close mouth: the longer the pause the greater the amount of milk your baby is drinking

Offer both breasts at each feed. Your baby may need a pause between breasts

Ask your health visitor, midwife or a breastfeeding supporter (at a group or on the National Breastfeeding Helpline) about how to recognise early feeding cues. It is easier to attach a baby before they are really hungry. You can read more about early cues and responsive breastfeeding here.

Feeding in response to early cues may mean it is possible to fit in an extra feed within 24 hours

Ask a health professional or a breastfeeding supporter to show you how breast compression works. It can be a good way to give your baby some extra milk at a feed.

Breast compressions

Breast compression is a simple method to try and get your baby to take more milk during a feed. It is done whilst the baby is attached to the breast. You can gently squeeze the breast using a c shaped hand held away from the nipple. You should gently compress the breast and then hold, until you see your baby start to suck and swallow more rapidly and then slow again. Once the swallowing slows you can release the breast and then do another compression, maybe in a slightly different position on your breast. You can keep doing this as long as it seems to have an impact on how much milk your baby is taking (e.g. sucking/swallowing increases).

Take a look here for video explanation of breast compression.

If breast compression helps, the amount of wee or poo your baby is doing may increase. If there is no change, ask for a breastfeeding supporter or health professional to check for other factors which might make feeding more difficult.

Very occasionally, medications such as decongestants or contraceptives may affect your milk supply. You can read our factsheets to find out more or contact our Drugs in Breastmilk service to discuss this.

For more information on how to tell if feeding is going well, you can have a look at Off to the Best Start.

Common causes of low milk supply/your baby not getting enough milk:

Positioning and Attachment: How your baby attaches to your breast, including how you hold them, is often called 'positioning and attachment'. If your baby is not effectively attached at your breast, it will be harder for them to remove milk efficiently. This may mean that they are getting less milk than they need. If this continues, your milk supply may drop as milk production works on a supply and demand basis. Working on your positioning and attachment will mean your baby is able to drink more milk more efficiently, and as they take more milk from your breasts, your body will respond to the increased demand by increasing your supply.  Even if some of the other causes here are relevant for you and your baby, improving how your baby comes to the breast will improve milk transfer. Read more on our page on how to breastfeed.

Spacing out feeds or feeding to a schedule: If you attempt to space feeds out, wait for your breasts to "fill up" or to feed to a schedule, rather than feeding responsively, your breasts may become over-full in between feeds. When your breasts become full, a hormone called feedback inhibitor of lactation (FIL) tells your body to stop making milk. This in turn can cause your milk supply to drop. Breastfeeding responsively, including putting your baby to your breast any time your breasts start to feel full, is the best way to establish and maintain your milk supply, and to ensure your baby gets enough milk. Your breasts are never completely drained, they are always making more milk, so you can offer them for a feed even if they feel empty. This will help increase your milk supply.

Using a dummy or pacifier: A dummy or pacifier can mask early feeding cues, meaning you don't feed your baby as soon as they start to feel hungry, and feeds may become more spaced out. This could lead to your baby taking less milk overall, and your breasts becoming over-full in between feeds, causing your milk supply to drop. Breastfeeding parents who wish to use a dummy could consider waiting until breastfeeding is well established before introducing it.

You can find more information on using a dummy from NHS start4life and The Lullaby Trust.

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Low milk supply and helping your baby gain weight - The Breastfeeding Network

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You can tell if your baby is getting enough milk by looking at how much they are weeing and pooing, and whether they are gaining weight. If they are producing the expected amount of wee and poo, and their weight is increasing and approximately following their centile line on their growth chart, then they are [...]

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Pain in your nipples or breasts whilst breastfeeding is most often linked to how you are holding your baby and bringing them to your breast (often referred to as positioning and attachment). Before considering any alternative reasons for experiencing pain whilst breastfeeding please use our guide to positioning and attachment to rule this out as a cause of pain. Even if there is another medical basis for the pain, getting positioning and attachment as comfortable as possible will still help.

When you first start breastfeeding, it is common to experience a strong and sometimes uncomfortable sensation for the first few seconds of your baby latching on. However, this should pass quickly, and feeding should become comfortable. If this is not the case, trying some small changes to your positioning and attachment could help make feeding more comfortable for you.

Signs that attachment is not as effective as it could be include:

If the pain is worst at the start of a feed, and continues for more than a few seconds.

If your nipple changes shape after breastfeeding - either lipstick shaped or flattened

If your baby slurps onto nipple rather than attaching with open gape

If your nipple changes colour after the breastfeed - classically a white tip to the nipple, although this may not be visible on all skin tones

If your nipple is damaged, with cracks or bleeding

If the pain is not improved after trying some of the ideas in our guide on positioning and attachment, please seek support from a breastfeeding supporter. They can observe and assess a full feed. You can also find a local support group here or contact the National Breastfeeding Helpline.

If your nipple is damaged, use moist wound healing within the wound (avoid applying cream to whole nipple) to stop a scab forming, which will deepen the wound. You can continue to breastfeed on a damaged nipple as it will still be able to heal, but it is very important to get support with positioning and attachment to prevent further damage occurring.

If a breastfeeding practitioner has helped you adjust your positioning and attachment and you still have pain or nipple damage, your baby may need to be assessed for a tongue tie or other issues that might be making breastfeeding harder.

Other causes of pain in breastfeeding:

Allergy

If your nipples are itchy (which may be triggered by warmth) or changed in colour (which may show as redness on lighter skin tones) but you do not see any change in the shape of your nipples and are not experiencing pain, the problem may be an allergy to something in contact with your nipples, such as nipple cream or breast pads. Try eliminating these to identify the cause. If disposable breast pads are causing irritation, you could try washable ones instead.

The symptoms may be relieved by a non-sedating antihistamine and hydrocortisone 1% cream applied sparingly. See our factsheet on antihistamines for more information on taking these whilst breastfeeding.

Vasospasm

If your nipple turns white at tip after breastfeeds and pain or itchiness, and redness on some skin tones, occurs immediately at end of feed when blood returns, vasospasm could be the cause.

This is due to restricted circulation from compression of the nipple by the baby squashing it between their tongue and the roof of their mouth during a feed. It can be relieved by help with attachment from a specialist breastfeeding practitioner. Vasospasm can occur in one or both breasts. It does not respond to medication which is unnecessary, but can be improved by adjusting positioning and attachment.

Raynaud's Phenomenon

If the pain is worst at the end of or after a feed and your nipples change colour rapidly after breastfeeds from white to purple then red (this might not be visible on all skin tones), you may be experiencing Raynaud's Phenomenon.

If you have a history of circulation problems or migraine and pain is triggered or made worse by cold, Raynaud's Phenomenon is more likely. Pain can be immediately after a feed but may also be delayed or can be triggered by cold even when not feeding.

You may be able to improve your symptoms by avoiding breastfeeding in cold places, covering your nipple as soon as a feed is finished and applying warmth after feeds. If this is not effective, consider asking GP to prescribe nifedipine 10mg three times a day or nifedipine LA 30mg daily. Treatment for two weeks may be sufficient or may be needed long term. You can find more detail in our Raynaud's phenomenon factsheet.

A white spot, bleb or blocked nipple pore.

If pain is worst at the end of or after a feed and you can point to a discrete spot (which may be white, yellow or pale pink) on your nipple as the origin of the pain, this is likely to be due to a white spot, also called a bleb, blocked nipple pore or milk blister. Symptoms may return periodically.

A white spot is thought to be caused by a thin bit of skin growing over a milk duct opening, and milk backing up behind it.

You can continue to feed with a white spot, and feeding may cause it to clear spontaneously. If it does not clear, the skin overgrowth can sometimes be removed by soaking the nipple in warm water and rubbing gently with a clean, moist washcloth. You can also try softening the skin with an oil such as olive oil. If this doesn't work, the skin may require removal by a healthcare professional using a sterile needle. Antibiotic cream may be required if a significant wound results. If you squeeze just behind the blister some toothpaste-like thickened milk may come out through the now opened blister.

Expressing milk

If your nipple is sore or damaged and you are using a breast pump rather than feeding directly, you may need to reduce the strength of the suction on your pump or you may be using a flange that is the wrong size. Speak to your health visitor, midwife or peer supporter to get support with expressing your milk if needed.

Strong let-down

If the pain is strongest at start of feed or just before a feed and there is a sharp intense pain in your breast(s), often described as squeezing pain, this can be due to the let down or milk ejection reflex. Pain can be worse on fuller breast.

If it is associated with leaking milk, you can reduce this by applying firm hand pressure to your breast at the time of leaking.

If your baby also makes a clicking noise during feeds or pulls away choking once the feed has started, the fast flow of milk may mean your baby is struggling to attach well. Further support from a skilled breastfeeding practitioner to improve attachment may be useful.

You may find it helpful to express a small amount of milk just before a feed if your breasts are full, to get past the powerful let-down before starting the feed, or to use a laid-back breastfeeding position, so that the milk flow is less overwhelming for your baby.

Engorgement

If your breasts are painfully hard and full, and feeding or expressing milk relieves this sensation, your breasts may be engorged. This may be worst first thing in the morning, especially if you have not fed frequently through the night. You can avoid engorgement by feeding frequently and responsively, including at night time. Consider offering your baby a feed whenever your breasts start to feel full or uncomfortable. If you are unable to feed at that time, or if your baby refuses a feed, you can express just enough milk to relieve the discomfort. Avoid expressing more milk than necessary, as this could trigger an increase in your milk supply and make the engorgement worse. Allowing your breasts to remain engorged could lead to your breasts becoming inflamed (mastitis), or a reduction in your milk supply, so it is best to avoid this whenever possible.

If you find it hard to latch your baby on when your breasts become very full, you may like to try reverse pressure softening. Reverse pressure softening is a way to soften your areola. It can help make latching and removing milk easier when your areola is very swollen and engorged by temporarily relieving firmness and swelling.

It can be particularly helpful if you have some oedema or swelling due to IV fluids or drugs given during labour and birth, especially if you had a caesarean section. Breast engorgement in the early days can be caused by your milk coming in or by a combination of fluid held in the breast tissue around the milk ducts as well as by milk within the breast.

Reverse pressure softening briefly moves mild or firmer swelling away from under your areola, slightly backward into your breast for a short period of 5-10 minutes. This allows your areola to change shape and makes latching easier as your baby is able to get more of your areola and breast tissue into their mouth.

Reverse pressure softening also causes a 'let-down' reflex, making it easier for your baby to get milk or for you to remove milk by hand expressing or expressing with a breast pump.

Reverse pressure softening should not be used if you have mastitis, plugged ducts or a breast abscess.
How to do reverse pressure softening:
The key is to make your areola very soft right around the base of the nipple. This can make it easier for your baby to get a better latch.

Press gently on the edge of your areola, inward towards your chest wall, counting slowly to 50

Once the areola has softened, you can start to feed your baby or express (by hand or using a breast pump on low to medium pressure)

If you have very swollen breasts, doing reverse pressure softening lying on your back (taking advantage of gravity) will give more relief

Soften your areola right before each feeding (or expressing) until the swelling goes away. This takes two to four days or more

Blocked ducts and Mastitis

If there is a sore, lumpy area on your breast that may also feel hot and can appear red on lighter skin tones, you may have a blocked duct or mastitis. Mastitis is an inflammation of the breast. It may be accompanied by flu-like symptoms. Continue to feed responsively and seek support from a specialist breastfeeding practitioner as soon as possible. Blocked ducts or mastitis may be triggered by feeding infrequently, allowing your breasts to become overfull or other situations that increase pressure on your breast, for example, wearing a bra that is too tight or wearing your baby in a sling for longer than usual. Adjusting the way you hold your baby and bring them to your breast when feeding ( positioning and attachment) may also help.

You can take ibuprofen 400mg as anti-inflammatory if appropriate (i.e. if you have no contra-indications such as asthma or stomach ulcer), and also paracetamol for pain or fever. Antibiotics are not usually required if self-help measures are started quickly, but you should see a doctor if your symptoms persist. You can read our factsheets on pain relief medicines and breastfeeding and our mastitis page for more detailed information.

Abscess

An abscess is a rare complication of mastitis. You might want to consider whether you have an abscess if mastitis has not resolved following frequent, effective feeding and a course of antibiotics and if the skin on your breast looks like orange peel. A milk sample should be taken to ascertain the micro-organism involved in the infection to help decide which antibiotic might be most appropriate. An ultra sound investigation may be required to diagnose an abscess. Drainage of pus by needle aspiration or surgical drainage together with appropriate antibiotic might be offered. Abscess formation is a rare complication of infectious mastitis and may involve MRSA. You may benefit from emotional support from a breastfeeding supporter alongside specialist support from medical staff.

Thrush

Signs of thrush in you

Thrush (Candida albicans) infection can affect your breast while you are breastfeeding. Symptoms of thrush are a sudden start of breast and/or nipple pain in BOTH breasts after some weeks of pain free breastfeeding - pain is severe and can last for an hour after EVERY breastfeed. It should be confirmed by a swab of your nipples.

Thrush should not be diagnosed if:

You have pain in only one breast/nipple (thrush spreads quickly from one breast to the other)

You have never had pain free breastfeeding

If your nipples are shaped oddly after breastfeeds

If your nipple is white at the tip after breastfeeds

If the pain is different at different times of the day

If your baby has a tongue tie which you are waiting to have snipped.

Thrush in the first few weeks of feeding is rare unless the mother had vaginal thrush at delivery or had deep breast thrush at the end of a previous lactation. Less than perfect positioning and attachment with consequent damage are more likely to cause the pain at this stage.

Signs of thrush in your baby

Creamy white patches in your baby's mouth, on the tongue and may be far back or in the cheeks. Patches do not rub off.

Baby's tongue/lips may have a white gloss

It should be confirmed by a swab of the baby's mouth.

If you think you have thrush:

Before treating either you or your baby you should ask the person supporting you with breastfeeding to watch a full breastfeed from the moment the baby goes to the breast to the moment he/she comes away from the breast at the end of the feed. They need to look at your nipples at the end of the feed to look for change in colour and shape

If your baby has a white tongue but you are not experiencing pain, be aware of the risk of thrush but do not treat either of you immediately. Some babies have white tongues in the first few weeks after birth or this may be associated with tongue tie where the milk is not thrown to the back of the mouth.

Diagnosis should be confirmed by nipple swabs cultured for fungal and bacterial infection.

Breastfeeding should be pain free from the point of attachment (the moment the baby goes to the breast) onwards. Pain from thrush begins after a feed. There should be no change in the shape or colour of the nipple after a feed. Even good attachment can often be improved and help to relieve symptoms of pain. Be aware of the other causes of nipple and breast pain described on this page, and exclude them first.

Self-help measures

Thrush can be passed between you and your baby - and also between you, your partner and other children

Anecdotally, some mothers find acidophilus capsules can help to restore bacteria which can keep thrush under control (available from health food stores or chemists)

It is necessary to be very careful with hygiene in order to get rid of thrush completely - be sure to wash your hands well after each nappy change

Use a separate towel for each person in the family

Anecdotally, some mothers find reducing the level of sugar and yeast in their diet helps

If a thrush infection is confirmed, to make sure that you get rid of it, both you and your baby need treatment, prescribed by a doctor. Usually, once treatment begins the pain and other symptoms will begin to improve within 2 or 3 days. It may take longer for full recovery.

If there is no improvement at all after 7 days, consult your breastfeeding helper again as the cause of the pain may not be thrush.

Treatment

Ongoing attention to positioning and attachment is important because even the best latch can slip a little sometimes.

Miconazole cream applied to your nipples after every feed - sparingly and without washing off before the next feed

Miconazole oral gel applied gently to your baby's mouth 4 times a day a small amount at a time

If symptoms persist you may need fluconazole 150-400mg as a loading dose followed by 100-200mg daily for at least ten days. This is rarely necessary if your baby is less than 6 weeks old and could cause vomiting and stomach pains.

For more information, see our detailed factsheet on thrush and our factsheet on miconazole oral gel and the breastfed baby with oral thrush.

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Pain: if breastfeeding hurts - The Breastfeeding Network

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Pain in your nipples or breasts whilst breastfeeding is most often linked to how you are holding your baby and bringing them to your breast (often referred to as positioning and attachment). Before considering any alternative reasons for experiencing pain whilst breastfeeding please use our guide to positioning and attachment to rule this out as [...]

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Here at Tunbridge wells, on the NNU there are fridges and freezers to store your breastmilk.

While in hospital, it is important to clearly label any milk you express, with name of baby and the date and time it was expressed.

Your milk can then be stored in the fridge for 48 hours, there is a fridge in each of our nurseries. You are welcome to access your milk, as you are the best person to keep an eye on stock and expiry dates. If you have more milk than is needed, we can store it in our freezer until you are discharged home with your baby, or if we need it in the future.

When your baby is discharged you can follow storage recommendations as below.

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Breastfeeding a baby with Downs Syndrome

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Breastfeeding a baby with Downs Syndrome

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Breastfeeding If You Are On The Autistic Spectrum 

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Breastfeeding If You Are On The Autistic Spectrum 

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

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

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

So what has this to do with breastfeeding?

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

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

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

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

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

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

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

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

Breastfeeding mums on the Autistic Spectrum Facebook page
Breastfeeding with a disability Facebook page
The Curly Hair Project
National Autistic Society - Autistic Women & Girls
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Breastfeeding If You Are On The Autistic Spectrum - The Breastfeeding Network

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

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We stand alongside all Black mothers and families, and are willing to do anything we can to ensure mothers and babies get real change for the better.

At the heart of BfN's values is empowerment of women, and none of us can feel empowered if we are raising our children with threat from racism.

As a charity we have always believed in social justice for mothers and babies, but often we have felt limited in what to do, in part due to our own ignorance - which is our responsibility to correct.

We hear our fellow Black mothers and families and we are committed to doing more - using our core values of empowerment, empathy and actively listening.

We are committed to learning and educating ourselves.

We will share and amplify Black women's voices.

We are here for you.

Follow our social media feeds to continue the conversation: Facebook, Instagram, Twitter

Read our policy on Equality and Diversity.

Resources and further reading

For breastfeeding supporters
https://www.goldlearning.com/ce-library/all-lectures/breast-assessment-and-non-white-skin-tones-detail https://www.facebook.com/iamKSealsAllers https://www.unicef.org.uk/babyfriendly/bame-women-in-birth-and-breastfeeding/ https://www.huffpost.com/entry/why-ferguson-has-everything-to-do-with-black-breastfeeding-week_b_5736568 https://www.breastfeedingnetwork.org.uk/motherhood-experiences-of-black-women/ https://www.breastfeedingnetwork.org.uk/guest-blog-by-ruth-dennison-why-black-breastfeeding-week/
Exploring the Barriers to Exclusive Breastfeeding in Black and Minority Ethnic Groups and Young Mothers in the UK: https://pubmed.ncbi.nlm.nih.gov/18582351/

MBRRACE Report: https://www.npeu.ox.ac.uk/mbrrace-uk/reports

Talking about race with young children
https://www.prettygooddesign.org/blog/Blog%20Post%20Title%20One-5new4 https://www.bbc.co.uk/newsround/52978346 https://yoopies-cms.cdn.prismic.io/yoopies-cms/a79829ee-9d85-465c-9a08-270c4fd7e5b5_Parent%27s+guide+to+black+lives+matter.pdf
Books for children

https://drive.google.com/file/d/143-8n6D_d1bSll7IfmfFNcW9nXnxAUib/view(from @MissNewton91 on Twitter)

Black and British - A short, essential history by David Olusoga (also for adults)

Books for adults

Why I'm No Longer Talking to White People About Race by Reni Eddo-Lodge

Me & White Supremacy by Layla F Saad

How to Be an Anti-racist by Ibram X Kendi

Natives by Akala

White Fragility by Robin D'Angelo

In Search of Black History by Bonnie Greer

Rebel Ideas by Matthew Syed

Black & British: A Forgotten History, David Olusoga

I Am Not Your Baby Mother by Candice Brathwaite

Podcasts/Social Media/Online resources

Dope Black Mums https://www.dopeblackmums.co.uk/

About Race with Reni Eddo-Lodge https://www.aboutracepodcast.com/

Nova Reid https://novareid.com/free-anti-racism-guide/

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Black breastfeeding matters - The Breastfeeding Network

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We stand alongside all Black mothers and families, and are willing to do anything we can to ensure mothers and babies get real change for the better. At the heart of BfN's values is empowerment of women, and none of us can feel empowered if we are raising our children with threat from racism.

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If you have a disability you may be concerned that this will affect how you choose to feed your baby. In most cases, with the right help and support, breastfeeding with a disability is not only possible but can offer distinct advantages for both the mother and baby.

A person is considered to have a disability if they report a long-standing illness, disability or impairment which causes substantial difficulty with day-to-day activities. This is the core definition of disability in the Equality Act 2010.

Everyone's condition is unique but mothers with disabilities have told us that these are the most common problems:

Positioning and attachment issues - due to fatigue, physical difficulties, overwhelming sensory issues and use of medical equipment (e.g. wheelchairs, stoma bags) the most common positions may be impractical and unhelpful. There are many more positions out there, you can even invent your own to find the best for you and your baby.

Knowing how medication affects breastmilk - doctors and other healthcare professionals may not always have the knowledge to inform you. Always speak to your healthcare professional first but if you have other questions the The Drugs in Breastmilk information service offers up to date information on various drugs and their safety in breastfeeding mothers.

Other problems that come up are more specific to the long term condition or disability: hormone problems interfering with milk supply, digestive problems causing mother to have difficulty maintaining enough calorie intake to nourish themselves and their child, connective tissue disorders affecting joints or skin to name a few. Most of these can be helped with some creative thinking and up to date relevant knowledge. Knowing how to access help is essential to your support.

Where to look for help

Midwife/consultant - you may need to ask specific questions about the difficulties you are facing

BfN Drugs in breastmilk Facebook page

Support groups for your condition (face to face or on social media) - ask if anyone in them has breastfeed and can share tips with you

Local BfN support groups or local BfN Facebook pages

National Breastfeeding Helpline

Quotes from breastfeeding mothers with a disability:

I knew I would really struggle with fastening bottles so kept on breastfeeding. I also wanted to avoid having to go up and down stairs at night.'

That it's so handy and convenient don't have to get out of bed don't have to move boobs are always there and less to carry in bag. I think breastfeeding is one of the most accessible tools mums have!!'

Don't give up breastfeeding or think it's not possible because of your disability - tell professionals they need to help you find a way to crack it! Besides, for many of us, bottle feeding is even more difficult with holding/position of baby and washing bottles'

Many autistic women worry about sensory sensitivities and breastfeeding. But these vary from person to person. After the initial week or so when my nipples were very tender sensitivity was not a problem. On the positive side, being autistic, breastfeeding was good because the baby could be fed immediately, reducing the amount of crying. There was also no anxiety about preparing formula correctly.'

For some health conditions breastfeeding can be a protective factor in the child's future health. Breastfeeding for me staved off the postnatal crohns flare, unfortunately it did appear once my baby weaned but of course I preferred it then than in the postnatal phase!'

If you are a mother with disabilities and you want to share your experience of breastfeeding please get in touch or join our Facebook page to chat to other mums.

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Breastfeeding with a disability - The Breastfeeding Network

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If you have a disability you may be concerned that this will affect how you choose to feed your baby. In most cases, with the right help and support, breastfeeding with a disability is not only possible but can offer distinct advantages for both the mother and baby.

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The Breastfeeding Support Network and Supportline

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The Breastfeeding Support Network and Supportline

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We encourage all parents to visit at any time on the NNU and will help you to have early contact with your baby. This can be through positive touch, comfort holding and cuddles depending on what care and treatment your baby is requiring

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Premature and sick babies undergo many medical procedures that can cause them some discomfort. As your baby’s parents, you are the best people to balance this with a positive, reassuring touch.

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Positive touch is a way of communicating your love and reassurance to your baby and hearing your baby's needs in return. Babies do communicate, and by watching and listening to your baby you can learn what kind of touch to use and when it is appropriate, safe and pleasurable for your baby.

It's harder for your baby to communicate when exposed to too much noise, too much light, too much cool air, or an uncomfortable lying position. See whether the environment can be calmed down first. In time, you will get to know your baby's individual ways and you may find your baby responding more often and for longer.

Comfort holding

Comfort holding is one of many ways for you and your baby to get to know each other. Your baby may be more comfortable lying in the incubator than being held. In this case, the staff may suggest that you try comfort holding if they think your baby is well enough. Comfort holding is 'still touch'. Cradling your baby with still, resting hands can be more comforting than stroking or massage, which are more stimulating.

Comfort holding can:

soothe your baby during uncomfortable procedures.

settle a restless baby.

help your baby to get back to sleep after feeds and care.

encourage your baby to be quietly awake and responsive.

Comfort holding is a way to experience loving touch when your baby is not ready to be held.

Talk to your baby's nurse about comfort holding. Together you can watch for signs from your baby that will guide you as to when and how to do it.

Be careful to:

Remove watches and jewellery, pull your sleeves up to the elbows, and wash your hands and lower arms. This reduces the risk of infection inside the incubator.

Always make sure that your hands are warm before touching your baby.

If your baby has difficulty keeping warm, make sure there is a layer of fabric (a hat, vest or blanket) between you.

Speak to your baby before touching, so that they are aware of your presence before you start.

Cradle one or both hands around your baby's feet, head or body, and keep them still. Your baby may also like to grasp one of your fingers.

Wait and watch for signs that tell you that your baby is relaxed.

You can continue for as long as you are both comfortable. When you finish comfort holding, move your hands away from your baby very slowly.

Kangaroo Care

Kangaroo Care is skin-to-skin contact when a baby is placed against the parent's chest. Benefits include improvements with lactation and with establishing breastfeeding, and better weight gain for the baby. In the longer term, it helps parents to feel closer to their babies and more confident in caring for them. Kangaroo Care can be used with babies with high medical needs, but this will require careful planning and collaboration with the neonatal staff.

Talk to staff and plan a good time and comfortable place for you to try Kangaroo Care.

While Kangaroo Care is based on direct skin-to-skin contact, removing your baby's clothes is not vital if this is upsetting for him or her. A hat and a blanket for extra warmth might be necessary for very small babies.

Hold your baby chest-to-chest tucked inside your clothes, enclosing him/her to keep his/her temperature stable. Check that the head is well supported and if you can't see your baby easily, try using a hand mirror.

Explore what you both like to enjoy together. Some babies like to have their eyes shielded, others like to be sung to softly or while having a tube feed. Allow time for your baby to settle and get the full benefit.

If you baby is happy, you can cuddle for as long as you are both comfortable. Lie back, relax and enjoy.

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Premature and sick babies undergo many medical procedures that can cause them some discomfort. As your baby's parents, you are the best people to balance this with a positive, reassuring touch.

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We are proud to be part of the UNICEF Baby Friendly Initiative and are passionate the care and support we offer to parents as partners in care to establish close and loving relationships during their journey on the NNU.
We have currently achieved Stage 1and 2 and are working towards stage 3

The BFI accreditation  is in 3 stages.
Stage 1: Building a firm foundation
Stage 2: An educated workforce
Stage 3: Parents’ experiences

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Our Neonatal unit has a dedicated Infant Feeding Team, on hand to support you through your feeding journey on the NNU.

There is an information  board inside the NNU where you can find their contact details.

All the nurses are trained to help you with feeding your baby and to support you on a one to one basis.

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These tools are for mothers to fill in with their nurse or midwife and use several common signs to assess whether a baby is breastfeeding well and safely

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INFANT MILK INFORMATION | Types of infant milks on the UK market

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we provide information about the types of infant milks on the UK market and for infant formula, follow-on formula and infant milks marketed

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Your baby may be fed using tube feeding while on the neonatal unit. Find out why this might be and information about caring for your baby while they are being tube fed.

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What is tube feeding?

During tube feeding, breast milk or formula is given through a tube passed into your baby's nose or mouth to their stomach. Types of tube feeding include the following:

Nasogastric tube feeding (also called an NG tube) - This is when a baby is fed through a small soft tube, which is placed in the nose and runs down the back of the throat, through the food pipe (oesophagus) and into the stomach.

Orogastric tube feeding - This is when a baby is fed through a small soft tube, which is placed in the mouth and runs down the back of the throat, through the food pipe (oesophagus) and into the stomach.

Babies who are very premature or sick may need to be fed using parenteral nutrition (PN) at first.

Why does my baby need to be fed using tube feeding?

Tube feeding is often used to feed premature and sick babies as they can be too small and sick to breastfeed or bottle feed at first. Babies born premature or sick have a low supply of energy and nutrients, so it is important that they are able to have small nutritional feeds often, without lowering their energy levels.

In babies born premature, the coordination of sucking, swallowing and breathing needed for effective feeding is usually not fully established until about 32 to 34 weeks' gestation (although this is different for different babies). Babies born at term and sick may also take longer to co-ordinate feeding. Tube feeding will help your baby receive enough nutrition to grow and develop.

Can I be involved in caring for my baby if they are being tube fed?

Yes, you can. Staff on the neonatal unit will encourage you to be as involved as possible in the care of your baby on the neonatal unit. If you feel comfortable doing so, they should show you and your partner how to give tube feeds. Staff on the neonatal unit will explain how tube feeding works and will teach you how to:

Check the tube is in the correct position before feeding

Prepare the milk and fill the syringe that is connected to the feeding tube

Position your baby correctly for tube feeds

Give the milk slowly to support comfortable digestion

Know what to look for during a feed.

This can feel quite scary at first, but with practice you should gain confidence. You will have the time to give the milk very slowly which helps your baby to digest more comfortably.

If your baby is well enough to come out of the incubator, you and your partner can also practice skin-to-skin contact with your baby while they are tube feeding. Skin-to-skin contact has lots of benefits for you and your baby, and helps parents to feel closer to their baby and more confident in caring for them.

When can my baby stop tube feeding?

In time, you may notice your baby demonstrating feeding cues during a tube feed. For example, they may open and close their mouth, put out their tongue or suck their fingers during a tube feed. This shows that they might be ready to practise breastfeeding or bottle feeding.

If you are planning to breastfeed and your baby is well enough to come out of the incubator, giving them lots of opportunities to be close to the breast may help them to learn to breastfeed. During a tube feed may be a good time to do this. When they are more mature and interested enough, some babies will start licking milk and in time practice sucking. As your baby starts to take more breast and bottle feeds, they will not need as many top-ups of milk from the feeding tube. This will depend on your baby's energy levels and their ability to coordinate sucking, swallowing and breathing.

Some parents have concerns about their baby changing from tube feeding to breastfeeding, as it is more difficult to measure how much milk their baby is having. Your baby will show signs that they are receiving enough milk, such as feeding cues and wet and dirty nappies. The healthcare team supporting you will monitor your baby's feeding and will manage any top-ups that might be needed. Talk to a member of staff on your unit if you have any concerns.

What will happen if my baby needs to go home from the neonatal unit with a feeding tube?

If your baby is going home with a feeding tube, a member of unit staff will show you how to feed and care for the tube yourself. It may be you or your community neonatal nurse who will replace the tube when you go home. This will depend on your baby's needs, your preferences, and the support the unit provides.

Support will always be available if you do not feel comfortable with replacing the tube yourself. If you have any questions or concerns, talk to the unit staff.

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Your baby may be fed using tube feeding while on the neonatal unit. Find out why this might be and information about caring for your baby while they are being tube fed.

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Be prepared: what do you need?

Whether you're bottle-feeding your baby using formula milk, expressed breastmilk, or a combination of the two, it helps to be prepared. Make sure you buy any kit you'll need like bottles and teats. There are many different types of bottles and teats for sale. It may take a while to try a couple of different ones to see what works best for you and your baby.

You can also buy additional equipment if you like. For example, some mums will express milk by hand, while others will use an electric breast pump. There is also a range of sterilisation equipment available to buy (NHS Choices 2018).

Making up infant formula

Bottles and teats need to be washed thoroughly and sterilised before each use (NHS 2016). Read about how to sterilise bottles and teats.

When making up infant formula, it is very important to ensure the water is at the correct temperature as formula powder is not sterile. Measure the correct amount of water at 70°C into the bottle, before adding the correct number of scoops of powder (directions for the volume of water and number of scoops will be found on the packaging) (NHS 2016). Different brands have different sized scoops. Care must be taken to avoid accidentally using too much or too little milk powder (UNICEF UK).

It's important to follow good hygiene practices like always washing your hands before preparing your baby's feed and following any instructions on the formula packaging. This is to help prevent your baby picking up an infection (NHS 2015).

How to spot 'early hunger cues'

Keep an eye out for any early signs your baby is getting hungry. They may start to stick their tongue out, suck on their fists or perhaps turn their head to the side. Crying is the last sign of wanting to feed, so it is better to feed your baby before they do (NHS, 2019).

If you learn how to spot these early feeding cues, you may find that your little one feeds more calmly and more easily. If your baby is already upset or crying, then try to soothe them first before offering them a milk feed. You could talk to them gently or try skin-to-skin contact which can also help to calm them (Breastmilk counts, 2019).

Bond with your baby

Feeding your baby, especially in the early days, can be a good time for closeness and bonding. So, whether it's you or your partner who would like some special time with your little one, make sure you're comfortable and create a calm environment. It's better to limit the feeding to you and your partner in the early days to build a close and loving relationship with your baby and help them feel safe and secure. Some babies respond well to background music, while others prefer it to be quiet. As they get older, most babies will enjoy looking up into your eyes (First Steps Nutrition Trust, 2018; UNICEF UK, 2016).

Responsive feeding

Responsive feeding is all about trying to respond quickly to your baby's needs, not getting distracted during feeding time and not encouraging your little one to over-eat or finish bottles of milk when they're no longer hungry (UNICEF UK, 2016).

Research into responsive feeding suggests that it can help parents from over-feeding their baby and therefore help to reduce the risk of obesity (UNICEF UK, 2016; DiSantis et al, 2011; NHS 2018).

How to hold your baby for bottle feeding

Hold your baby close to you. They should be fairly upright, with their head supported - so they can breathe and swallow comfortably. Support your baby so they're slightly raised and able to look at you. Babies shouldn't be flat on their backs or left alone with a propped-up bottle when they are being fed to avoid any risk of choking (UNICEF UK).

Try talking to your baby gently and look into their eyes to reassure them during feeds. This helps them to feel safe and loved (NHS 2015; UNICEF UK, 2019; NHS, 2012; NHS Choices, 2018).

How to feed your baby using a bottle

Rub the bottle teat against your baby's upper lip gently to encourage them to open their mouth and draw the teat in, rather than forcing it into the mouth. Tip the bottle horizontal with only a slight tilt just enough to ensure there is milk in the teat. This also prevents milk from flowing too fast. Be guided by your baby's reactions while feeding. They should be able to suck and swallow, slowly and naturally, without spluttering, and without pushing the teat out with their tongue (First Steps Nutrition Trust, 2018; NHS, 2018).

If the teat becomes flattened while feeding, pull gently on the corner of their mouth to release the vacuum (First Steps Nutrition Trust, 2018; NHS 2018, UNICEF 2018).

'Pacing' feed

Babies feed in bursts of sucking with short pauses to rest. When your baby slows their sucking and swallowing, you can help 'pace' the feed by partially moving the bottle teat out and then letting them draw it in again. This mimics the stop-start motion of breastfeeding. This can also help avoid over-feeding your baby. Interrupting the feed from time to time gives your baby a chance to register how full they are and how much more they need - helping them to control their intake (UNICEF, 2018).

If your baby gets upset at having the teat removed, tip the bottle downwards while it remains in their mouth, which will stop or slow down the flow. Holding the bottle horizontal to ground with only a slight tilt will also ensure that baby doesn't get milk while they're pausing for a rest (UNICEF 2018).

Winding your baby

Your little one may need short breaks during their feed and may need to be burped. Hold them upright and rock or rub and gently pat their back to help them bring up any wind. Continue feeding your baby when they are more comfortable.

Some babies will need more winding than others. If your baby cries excessively or you are concerned about their feeding, talk to your health visitor or GP (UNICEF UK).

When you have finished feeding your baby, remember to throw away any unused formula milk as it may become contaminated and give baby an upset tummy.

Hot or cold milk?

Some babies are happy with their milk cool (room temperature) while others like it warm. Always check the temperature of the milk from your baby's bottle on the inside of your wrist before you feed them to make sure it's not too hot. This is necessary in order to avoid scalding their mouth. It should be warm or cool, not too hot. You don't need to warm it up at all if you don't want to or your baby doesn't mind.

Precious moments

Sometimes in the early days, feeding your baby can seem overwhelming and time-consuming, especially if they feed little and often and you have to get up countless times in the night.

It can be helpful to remember that as your baby grows bigger, they will get more efficient at feeding and their milk feeds usually space out more as they grow. If you are concerned about your baby's feeding talk to your health visitor or GP (UNICEF UK).

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 support line 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.

Our support line offers practical and emotional support in many areas of pregnancy, birth and early parenthood: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

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Tips for bottle-feeding your baby | Baby & toddler, Feeding articles & support | NCT

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Introducing bottle-feeding to a breastfed baby can take a bit of getting used to, so don't be discouraged if it doesn't go smoothly the first few times. Here we've put together some useful bottle-feeding tips to help you through.

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Bottle and breastfeeding advice available in other languages

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Bottle and breastfeeding advice available in other languages

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Bottle and breastfeeding advice available below in:

Arabic   -

العربية

Bengali

বাংলা

Hindi

हिन्दी भाषा

Lithuanian

lietuvių

Mandarin

普通话

Polish

Polski

Romanian

Română

Slovak

slovenský

Turkish

Türkçe

Ukranian

українська

Urdu

لتھوانیائی

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The BFI accreditation programme helps services transform their care, supporting all families with feeding and relationship building

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Supporting infant feeding and relationship building

Baby Friendly's work to support breastfeeding is based on extensive and resounding evidence that breastfeeding saves lives, improves health and cuts costs in every country worldwide, rich and poor alike. Exclusive breastfeeding is recommended by the WHO recommends for babies until six months' old and thereafter with other foods for two years and beyond.

In the UK, many mothers stop breastfeeding before they want to. We respond to the particular barriers they face by supporting health professionals to provide sensitive and effective care so that mothers can make an informed choice about feeding, get breastfeeding off to a good start and overcome any challenges. Thanks to this work, breastfeeding initiation rates have risen by 20% since the Baby Friendly Initiative was established.

We also support parents who are formula feeding by providing information on choosing milks and making up feeds, helping them to feed safely and responsively. In addition, we advocate for better regulation of marketing of breastmilk substitutes so that health professionals and families can receive scientific, unbiased and factual information about infant feeding.

Baby Friendly works to support all families to develop close and loving relationships with their newborn and to understand the importance of this for their baby's development. For example, in Baby Friendly hospitals mothers and babies now routinely stay together in the immediate post-birth period, helping to get their relationship off to a good start. In addition, our neonatal standards empower parents of sick or preterm babies to take an active part in their care on the neonatal unit. In these ways, the Baby Friendly Initiative is helping to create a "new normal" in health services, where babies, their mothers and families are put at the heart of care.

About UNICEF

UNICEF is a multilateral child-rights organisation established by the UN with 70 years of field-tested expertise, a network that spans the globe, a passion for innovation and a commitment to make every penny count. Impartial and non-political, UNICEF is never neutral when it comes to protecting children's rights and safeguarding their lives and futures. UNICEF works in some of the world's toughest places, reaching the furthest from help, the most disadvantaged and the most at risk. UNICEF saves children's lives with vaccines, clean water and therapeutic food. UNICEF protects children from violence, exploitation and abuse. And UNICEF helps children fulfil their potential, by supporting quality education and training. UNICEF works for every child, to build a better world for everyone.

The United Kingdom Committee for UNICEF (UNICEF UK) is a registered charity that raises funds for UNICEF's emergency and development work around the world and advocates for lasting change for children worldwide. This includes, for example, working to change UK Government policies and practices that are harmful to child rights in the UK and internationally. UNICEF UK is one of 33 UNICEF national charitable organisations based in industrialised countries. Find out more: unicef.org.uk

Going Baby Friendly

Whether you're at the start or already on the journey to becoming Baby Friendly, visit this page for guidance and application forms

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Learn more about the UNICEF UK Baby Friendly Initiative

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Learn more about the UNICEF UK Baby Friendly Initiative's work to improve outcomes for all babies, their mothers and families within the UK.

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Supporting Love & Nurture on The Neonatal Unit 

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Supporting Love & Nurture on The Neonatal Unit 

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Information about breastfeeding your premature or sick baby here, including how to get started and how to find support.

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Information about breastfeeding your premature or sick baby here, including how to get started and how to find support.

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Breastfeeding has lots of benefits for you and your baby. As well as the health benefits of breast milk for your baby, breastfeeding is a good way to have skin-to-skin contact with your baby, which can help you and your baby to get to know each other.

Your baby may not be ready to breastfeed as soon as they are born. They may not be well enough or strong enough to breastfeed. Some babies who are born at term and sick may find it more difficult to breastfeed because of surgery or difficulties swallowing. Some babies with breathing or heart problems may also have difficulties coordinating breathing and feeding.

If your baby is very premature or sick, they may have to be fed using parenteral nutrition (PN) and/or tube feeding before they are well enough to breastfeed. We have more information about the signs a baby being tube fed may show if they are ready for breast or bottle feeding.

You can still provide breast milk for your baby if they are unable to breastfeed by using a technique called expressing. We have more information about expressing.

Sometimes premature babies need more nutrients than you can provide in your breast milk. If this is the case, your baby's doctor may prescribe a breast milk fortifier (which is usually a powder made from cow's milk) which can be added to breast milk. This can help with growth and bone development.

Some parents may feed their baby through a combination of breastfeeding and bottle feeding. This is often known as mixed or combination feeding. It is recommended that your baby, if possible, establishes breastfeeding before introducing another type of feeding. Combination feeding may be used if there are problems with breastfeeding, such as there not being enough breastmilk, or for other reasons. If you are thinking about mixed or combination feeding, talk to your neonatal team, feeding specialist, midwife, health visitor or GP.

Staff on the neonatal unit may recommend that your baby is fed your breast milk using cup feeding. They might suggest this if your baby is looking to feed but cannot latch onto the breast or is separated from the mother for any reason. If you are unsure, speak to the staff on the neonatal unit.

If you decide not to breastfeed your baby, it is very important that you are given information about the other options that are available. Your baby can still get many benefits of breastmilk if you express. Talk to your midwife, neonatal nurse or health visitor about how you are feeling and how they can support you.

The let-down reflex

Each time you breastfeed your baby, you may notice tingling or prickling in your breasts and nipples, or a feeling as if the milk is rushing in to fill them. This is called the let-down reflex (it is sometimes called the milk ejection reflex). During the let-down reflex, a hormone called oxytocin is released, which helps with milk flow. At first, this takes a few minutes to be released, but later it will happen within a few seconds.

The let-down reflex feels different to different women. Some women describe a slight pain and some have no sensations at all. Your body may respond to certain things you do, which can trigger your let-down reflex. For example, it is normal for the let-down reflex to happen in response to having a warm bath or shower, or to breast massage. It can also happen in response to being close to your baby, hearing your baby cry or having a picture or something close by that smells of them.

Staying as relaxed as possible and having skin-to-skin contact with your baby can all help to trigger the let-down reflex. Taking some deep breaths and concentrating on your breathing can also help.

How do I start to breastfeed my baby?

You may not know where to start with breastfeeding your baby, especially if your baby has previously been tube fed. A nurse, midwife or feeding specialist (such as an infant feeding coordinator) on the neonatal unit will be able to support you.

Both parents can be involved in breastfeeding, and other people close to you can also provide encouragement and support, such as grandparents. Having as much support as possible can help ensure that you continue to breastfeed when you go home from the neonatal unit. It might be helpful to talk about how you are going to approach breastfeeding with your partner, and how they can best support you. The NHS website has more information about how dads and partners can support breastfeeding, and signposts to more support that is available.

It is important to recognise the signs that your baby is hungry (feeding cues) before breastfeeding. Early feeding cues might include putting their fingers into their mouth, making sucking motions (rooting) and becoming restless.

What breastfeeding positions should I try?

When you are on the neonatal unit, a healthcare professional such as a neonatal nurse or midwife should support you to try to breastfeed your baby. They will help you to find feeding positions that are most comfortable for you. There are positions that may be more suitable for mothers who have had surgery, or whose baby was born premature or sick. Unit staff may recommend that you use pillows to support your arms or back.

If you have twins or multiples, you may also need more support with pillows when feeding, so that you are more comfortable and your babies are supported. Some mothers benefit from a hard pillow that ties at the back or a sling. It can be daunting at first to hold multiple babies at once, but staff in the neonatal unit will help with this. Twins Trust have some more information about breastfeeding multiples that you may find useful.

I am having difficulties getting my baby to breastfeed and latch on. Why is this?

As with all newborn babies, some find breastfeeding easier than others. This can depend on factors such as your baby's age, maturity and any medical conditions they have. It is normal for babies who are born premature or sick to take slightly longer to establish breastfeeding than babies born at term. Every baby is different, and it is important to ask for help and support, especially when you start.

There are some common problems that parents experience when starting breastfeeding. Some babies born premature can be too sleepy to feed effectively, and it can be difficult to get the right position for feeding when your baby is so small. We have a page that lists common problems you may have when breastfeeding or expressing milk for your baby and what can help.

For some mothers, it can take a while to gain confidence in breastfeeding. This is normal, even if you have breastfed before. Having a baby born premature or sick is a unique experience and it is okay to find things difficult at times. Having plenty of support around you can help you build up confidence. We have more information about support you can get with breastfeeding below.

Where can I get help and support with breastfeeding?

Many parents find breastfeeding a rewarding, empowering experience. But establishing breastfeeding can be challenging at times. It can be tiring, especially when you are travelling to and from the unit, and some mothers experience discomfort when they are starting to breastfeed. There are many places where you can get help and support.

Most parents find that having lots of support helps them to get started and to continue to breastfeed. Support can come from your partner, family and friends, and from medical professionals on the unit and at home.

Support on the unit could come from your unit's feeding specialist, a neonatal nurse, or your midwife. Some neonatal units also have a lactation consultant or feeding specialist, who are trained to help parents who are having problems with breastfeeding and expressing.

If you are at home, support with breastfeeding could come from your health visitor, a community neonatal nurse, if you have one, or your GP. You can talk to your health visitor for more information about any breastfeeding support groups in your area. It is always important to speak up and ask if you need more help and support, or if you have questions.

There are also helplines and organisations that can help:

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Find more information about breastfeeding your premature or sick baby here, including how to get started and how to find support.

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How Can Dads & Partners Support Breastfeeding 

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How Can Dads & Partners Support Breastfeeding 

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When it comes to breastfeeding, you might wonder what you can do to support your partner and baby. The truth is you can make a huge difference.

Did you know that a mum is more likely to choose to breastfeed if she's sure her partner is positive about it? And if she does decide to breastfeed, she's much more likely to have a good experience and manage any difficulties if her partner supports her decision (Tohotoa, 2009; Rempel, 2011). A partner's emotional support is so important for helping mums to breastfeed for longer too (Tohatoa et al, 2009; Su, 2016).

Why is breastfeeding important?

If your partner is breastfeeding your baby - or planning to - that's fantastic because breastmilk has so many benefits for babies. For instance, breastmilk can help to reduce the risk of your baby getting infections and diseases (NHS, 2017). It also contains hormones that help your baby's development (Victora et al, 2016).

Overall, breastfeeding will have a positive impact on your baby's health. What's more, it can influence their health as an adult too (Victora et al, 2016).

Is breastfeeding hard or will my partner just know what to do?

Many parents see breastfeeding as a natural process but it can take time for mum and baby to learn this new skill together. It might take around six weeks to get the hang of it fully (NHS, 2016).

The good news is that with the right support, your partner can overcome any challenges and continue breastfeeding if she wants to. If you think your partner needs more information, support or just someone to talk to, why not give one of our trained breastfeeding counsellors a call on our support line: 0300 330 0700. The line is open every day from 8am to midnight, including bank holidays.

You might find it helpful to read up about breastfeeding and attend a breastfeeding session before your baby is born. This can help you know what to expect and perhaps give you a little more confidence. It can also help you both talk about feeding your baby and raise any questions or worries you might have.

What do I need to know about breastfeeding?

You might find it helpful to know how breastfeeding works and what normal behaviour is for breastfed babies. Here are a few quick and handy facts:

Babies are happier if they're fed as soon as they show signs of being hungry.

Babies usually feed frequently (anything from eight to 12 times or more in 24 hours) in the early weeks, especially during the evenings.

Some babies are slow feeders at first, but they get quicker as they get older.

The more a baby feeds, the more milk their mum makes because it's the removal of milk that drives the production of it.

The Department of Health recommends exclusive breastfeeding for at least your baby's first six months. Breastfeeding is also beneficial for toddlers because it gives them a health boost every time they feed. So your partner can breastfeed your baby for as long as they both want to.

Nipple soreness or pain during feeding might be a sign that a baby needs some adjustment to their attachment at the breast. If there is soreness or pain when breastfeeding, talking to a healthcare professional or breastfeeding counsellor can help.

Women enjoy feeding more when they are comfortable and relaxed.

(Department of Health, 2011; La Leche League, 2016; NHS, 2016)

What can I do to help support my partner with breastfeeding?

There are lots of things you can do to support and encourage breastfeeding.

Here are 10 tips:

1. Boost your partner's confidence by encouraging her and being positive about her progress. As with learning any new skill, reassurance and praise are a massive help.

2. Listen and talk honestly about how you each feel about finding your way with your new baby.

3. Be involved with your baby in other ways so that the caring is shared (see below).

4. Help to reduce the household chores so your partner can feed your baby for as long and as often as they need.

5. Try to help your partner to relax by giving them a massage.

6. Women don't need to eat anything special while breastfeeding, but it's a good idea to encourage your partner to eat and drink regularly.

7. Help her get specialist support if she's struggling with breastfeeding. As mentioned above, you can both talk to one of our breastfeeding counsellors on 0300 330 0700.

8. Help out by bottle feeding your baby expressed milk once your partner and baby have got the hang of breastfeeding (see below).

9. Accept your partner's decision on when to stop breastfeeding.

10. Try to remember that with your support, breastfeeding can quickly become just another part of your family life.

(Rempel et al, 2010)

What practical support can I give to my baby if my partner is breastfeeding?

You might expect to feel like a bit of a spare part with feeding but it's good to remember that each parent plays a different and vital role. The decision on how you feed your baby is certainly a joint one (deMontigny et al, 2018). It might take a while to get used to the different parts you play though.

Whatever you decide to do, you might actually find feeding is less important to you than you expected anyway. Especially if you're hands-on with your baby in different and rewarding ways.

Tips for being a hands-on partner with your baby

Changing nappies and generally caring for your baby - it's great if you can spend time with your baby and interact (see below) with them while you're looking after them.

Bathing your baby - you could bath your baby or even have a bath with your baby. You'll both enjoy the bonding benefits of skin-to-skin contact and one-to-one time together (NHS, 2018).

Talking and playing - babies enjoy hearing gentle sounds. They even recognise the muffled tones of people talking from their time in the womb and they'll be aware of familiar voices like yours (Lee and Kisilevsky, 2013). So a chat with your baby might be a little one-sided but rest assured, they know it's you. Socially interacting with your baby through their senses helps to stimulate their brain development; for example, you could pull some different expressions (Boucenna et al, 2010).

Baby carrying - this means taking your baby out and about in a sling. It can be a rewarding and comforting experience for both you and your baby (Miller, 2019).

For more ideas on being a hands-on parent, see our article about bonding with and getting to know your baby.

How can I share feeding our baby?

If you're keen to feed your baby, you could give them expressed breastmilk from a spoon, syringe, cup or a bottle. But only introduce your baby to a bottle once breastfeeding is going well. For more on expressing, see our 10 bottle feeding tips for breastfed babies article.

And once your baby's moved on to solid food, there are so many ways you can get involved with that...chopping, mashing, cleaning up all the food that ends up on the floor...

I want to support breastfeeding but will it affect our sex life?

Possibly, but tiredness - and your partner's birth experience and recovery - is more likely to affect their sex drive rather than breastfeeding (Rowland et al, 2005). See our article about breastfeeding and sex for more details.

What if I feel uncomfortable about my partner breastfeeding in public?

If you're feeling uncomfortable or nervous about your partner breastfeeding in public, have a chat with her so you can talk it through. Maybe you're worried about your partner showing her breasts in public? Yet in reality, very little breast actually shows when a baby is feeding. You might have even seen a mum breastfeeding before without realising it.

It might also help to talk to other families where the mum is breastfeeding and find out about both partners' experiences of it. The chances are, you'll change your mind as you get used to seeing breastfeeding.

It's good to know that breastfeeding in public is protected by the law under the Equality Act 2010. That means providers of any services or facilities open for the public are not allowed to discriminate against women who are breastfeeding (Maternity Action, 2019).

Many places now welcome breastfeeding and have special facilities for mums if they'd prefer to feed in private.

Some mums might feel uncertain themselves about feeding in public at first and may appreciate the reassurance of having their partner with them.

At the end of the day...

Don't underestimate the huge difference you can make if your partner is breastfeeding. With you both on board, breastfeeding can quickly become an everyday part of your lives (Rempel, 2011).
This page was last reviewed in October 2017.
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.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Visit our breastfeeding support contacts page.

NHS Choices breastfeeding information.

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

Health Talk has some interesting videos about different people's experiences of breastfeeding, click here to view them.

Boucenna S, Gaussier P, Andry P, Hafemeister L. (2010) Imitation as a communication tool for online facial expression learning and recognition. 2010 IEEE/RSJ International Conference on Intelligent Robots and Systems, Taipei: 5323-5328. Available at: https://ieeexplore.ieee.org/abstract/document/5650357 (Accessed 1st July 2018)

deMontigny F, Gervais C, Larivière-Bastien D, St-Arneault K. (2018) The role of fathers during breastfeeding. Midwifery. 58:6-12. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29272696 (Accessed 1st July 2018)

Department of Health. (2011) Breastfeeding. Available at: http://webarchive.nationalarchives.gov.uk/+/http://www.dh.gov.uk/en/Publichealth/Nutrition/Nutritionpregnancyearlyyears/DH_127625 (Accessed 1st July 2018)

La Leche League. (2016) Still nursing? Available at: https://www.laleche.org.uk/still-nursing/ (Accessed 1st July 2018)

Lee GY, Kisilevsky BS. (2013) Fetuses respond to father's voice but prefer mother's voice after birth. Dev Psychobiol. 2014 Jan;56(1):1-11. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23817883 (Accessed 1st July 2018)

Miller R. (2019). Babywearing education in the neonatal intensive care unit. The International journal of childbirth education: the official publication of the International Childbirth Education Association. 34. 43-47. Available at: https://www.researchgate.net/publication/334151320_Babywearing_Education_in_the_Neonatal_Intensive_Care_Unit (Accessed 1st July 2018)

NHS. (2016) How to combine breast and bottle feeding. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/combining-breast-and-bottle/ (Accessed 1st July 2018)

NHS. (2017) Benefits of breastfeeding. Available at: http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/benefits-breastfeeding.aspx (Accessed 1st July 2018)

NHS. (2018) Washing and bathing your baby. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/washing-your-baby/ (Accessed 1st July 2018)

Rempel LA, Rempel JK. (2010) The breastfeeding team: the role of involved fathers in the breastfeeding family. J Hum Lact. (2):115-21. Available at: http://journals.sagepub.com/doi/abs/10.1177/0890334410390045 (Accessed 1st July 2018)

Rowland M, Foxcroft L, Hopman WM, Patel R. (2005) Breastfeeding and sexuality immediately post partum. Can Fam Physician. 2005 Oct;51:1366-7. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1479788/ (Accessed 1st July 2018)

Su M, Ouyang YQ. (2016) Father's role in breastfeeding promotion: lessons from a quasi-experimental trial in China. Breastfeed Med. 11:144-9. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26836960 (Accessed 1st July 2018)

Tohotoa J, Maycock B, Hauck Y, Howat P, Burns S, Binns C. (2009) Dads make a difference: an exploratory study of paternal support for breastfeeding in Perth, Western Australia. Int Breastfeed J. 4:15. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2788531/ (Accessed 1st July 2018)

Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC; Lancet Breastfeeding Series Group. (2016) Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 387(10017):475-90. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26869575 (Accessed 1st July 2018)

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How can dads and partners support breastfeeding? | Baby & toddler, Feeding articles & support | NCT

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This article looks at how dads and partners can help support a new mum who is breastfeeding in the early days.

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Feeding twins, triplets and more is a booklet providing information and advice for mothers and health professionals.

Available for £3.50 from the Multiple Births Foundation, Queen Charlotte's & Chelsea Hospital, Du Cane Road, London W12 0HS. Cheques payable to Institute Trust (MBF).

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Feeding twins, triplets and more (MBF) booklet - Baby Friendly Initiative

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Feeding twins, triplets and more is a booklet providing information and advice for mothers and health professionals.

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Skin-to-skin contact - Baby Friendly Initiative

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Skin-to-skin contact - Baby Friendly Initiative

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Skin-to-skin contact - Baby Friendly Initiative

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

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Your nurse can complete this checklist with you to help ensure that mothers are expressing their breastmilk effectively and to address any issues or concerns you may have.

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This checklist can be used to ensure that mothers are expressing their breastmilk effectively and to address any issues or concerns mothers may have.

For sick and preterm babies the importance of breastmilk cannot be overestimated. Breastmilk supports growth and provides protection from infection, with evidence suggesting that its use decreases the incidence and severity of the life-threatening disease necrotising entercolitis.

By providing breastmilk, a mother can be assured that she is uniquely contributing to the wellbeing and development of her baby. However, expressing breastmilk over a long period of time is extremely demanding and if a mother is to succeed she needs the support from those involved with caring for her and her baby.

Assessment of breastmilk expression checklist

Assessment of breastmilk expression - staff guidance

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Assessment of breastmilk expression checklist - Baby Friendly Initiative

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This checklist ensures that mothers are expressing their breastmilk effectively and to address any issues or concerns mothers may have.

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This video looks at both the theory and practice of relationship building and responsive breastfeeding, supporting families to get their relationship with their baby off to the best start.

Hear mothers and professionals give tips and advice on what it can mean to have a close and loving relationship with your new baby.

Find more relationship building resources

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Breastfeeding and relationships in the early days video - Baby Friendly Initiative

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Baby Friendly's video on breastfeeding and relationship building covers views and tips from both mothers and health professionals.

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Meeting baby for the first time video - Baby Friendly Initiative

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Baby Friendly’s video on skin-to-skin contact and how it can help mothers and babies get their relationship off to the best start.

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The Baby Friendly standards provide services with a roadmap for transforming care for all babies, their mothers and families.

Our staged accreditation programme enables services to support families with feeding and help parents build a close and loving relationship with their baby. You can find out more about the standards in our Guide to the Standards.

Standards for universities

Our university standards for pre-registration Midwifery and Health Visiting courses help ensure that newly qualified midwives and health visitors have the strong foundation of knowledge needed to support families.

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Baby Friendly Standards - Baby Friendly Initiative

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Our staged accreditation programme enables services to support families with feeding and help parents build a close and loving relationship with their baby. You can find out more about the standards in our Guide to the Standards.

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Bliss email support service

Our email support service is here to help parents and families of premature and sick babies. Our trained staff are here to listen to your concerns and help you find the information you need.

We understand that the experience of being on a neonatal unit can be incredibly overwhelming and stressful. If you are a parent, grandparent, relative or friend please get in touch with your query or concern.

Email us at hello@bliss.org.uk any time of the day and we'll get back to you with information and support to help you through your neonatal journey.

Read our privacy statement for hello@bliss.org.uk

Where else can I find support?

You can visit the Support section of our website for information. This includes information to support you looking after your baby on the unit, your mental health and also financial information and support for families.

You can also scroll down to find out more about peer support and counselling opportunities.

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Bliss offers a wide range of services to provide support to parents and families of babies born premature or sick. Find out more about our services.

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Your baby shows you signs to let you know when they are hungry. These are called feeding cues. These cues get stronger as your baby gets hungrier until they cry as a last signal to you.

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Below is a selection of videos from the Best Beginnings 'From Bump to Breastfeeding' series. Find out more on the Best Beginnings website.

If you have any problems viewing the videos, please contact us.

Baby-led feeding

This clip shows how baby-led feeding happens in practice.

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Best Beginnings videos - Baby Friendly Initiative

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Selection of videos from Best Beginnings' 'From Bump to Breastfeeding' series. Find out more on the Best Beginnings website.

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Unicef UK Baby Friendly Initiative | Baby-led feeding

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Expressing in Neonatal Care

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Expressing milk can take time to learn. Find out how to express in neonatal care and how to look after yourself while expressing.

Expressing means collecting breast milk which you can store and feed to your baby later. You can express milk by hand or with a breast pump, which can be electric or manual.

Expressing can be helpful:

If your baby is not well enough or strong enough to feed from the breast straight away

So that both partners or others are able to share feeding

If you are too sick to feed your baby from the breast

If you cannot be near your baby and want to establish a good milk supply

If your baby has difficulty latching on to the breast, but you still want to give them your breast milk.

If your baby is not able to breastfeed straight away, the staff at the hospital will help you to express (collect) your breast milk as soon as possible after your baby is born. This means that your baby will still get the benefits of breast milk until they are ready to feed from the breast or bottle, as it can be given to them by a feeding tube.
It is important to express in the way that is most comfortable and convenient for you.
A small amount of milk is produced in the first few days after a baby is born. This milk is called colostrum, and is often thicker and more yellow in colour than breastmilk. Colostrum is really important for your baby. It helps to boost your baby's immune system, protect them from infections and helps them grow.

Some parents are worried that they are not producing enough milk in these first few days. This is normal - most parents start by expressing less than 1ml of milk at a time. This will increase gradually the more times you express. Around two to four days after giving birth, you will notice your milk becoming more white and your breasts might feel fuller. This is often referred to as your milk 'coming in'.

Later on, the amount of milk you express may change depending on the time of day and how you feel.

After expressing your milk, the milk can be kept in the fridge or be frozen and stored until your baby is ready to have feeds. We have some more information about how to store breast milk at the bottom of this page.

Your milk is best suited to your baby's needs, but sometimes premature or sick babies need more nutrients than are provided in breastmilk alone. If this is the case for your baby, your baby's doctor may prescribe a preterm fortifier (which is usually a powder made from cow's milk) to go in your milk. This will provide more nutrients that will help with your baby's growth and bone health.

Many parents tell us that expressing can feel like a big pressure. It is important not to be too hard on yourself if you are not able to express a lot of milk in the early stages. No matter how much or how little you can express, your baby will benefit.

Many parents find comfort in expressing as it is something positive and important they can do for their baby. Try not to compare the amount you are expressing with others, as they may have faced different challenges or situations to you.

Expressing breast milk can also take time to learn. The staff looking after your baby will give you support and practical help with this. Speak to your neonatal nurse, feeding specialist or midwife for more support.

In this section, we have more specific information about:

If you have any questions about expressing or are not sure what to do, you should always ask questions or seek more support. Most units will provide specific support with expressing, and your neonatal nurse will be happy to help with any questions that you have.

How often should I be expressing milk for my baby?

It is important to start expressing milk as soon as possible after your baby is born - ideally within two hours. It is recommended you express frequently to keep your milk supply up. To begin with, this is around eight to ten times in 24 hours, including at least once at night. This is because breast milk is produced on a demand and supply system, so you are likely to produce less milk overall if long periods of time are left between expressing.

In time you will find what works best for you. You may find that your milk flow responds to a fixed routine and will trigger a let-down reflex (see below), which will make it easier to express. This might include actions when you prepare to express, such as removing equipment from the steriliser, or putting the pump together.

The let-down reflex

When you express milk, you may notice tingling or prickling in your breasts and nipples, or a feeling as if the milk is rushing in to fill them. This is called the let-down reflex (it is sometimes called the milk ejection reflex). During the let-down reflex, a hormone called oxytocin is released, which helps with milk flow. This takes a few minutes to appear at first, but later it will happen in a few seconds.

The let-down reflex feels different to different women. Some mothers describe a slight pain and some mothers have no sensations at all. Your body may respond to certain things you do, which can trigger your let-down reflex. For example, it is normal for the let-down reflex to happen in response to having a warm bath or shower, or to breast massage (see below). It can also happen in response to being close to your baby, hearing your baby cry or having a picture or something close by that smells of them.

Staying as relaxed as possible and having skin-to-skin contact with your baby can all help to trigger the let-down reflex. Taking some deep breaths and concentrating on your breathing can help with this. It will also help to express at your baby's cotside if this is possible, so you can be close to your baby. Speak to the staff looking after your baby about this.

Gentle breast massage

Breast massage before expressing can help to trigger the let-down reflex and stimulate your milk flow. You can do this by gently stroking, rolling, kneading, and tapping your breasts with warm hands before hand expressing and/or using a breast pump. You should do this for at least two minutes. Breast massage during expressing can help to drain your breasts.

Looking after yourself when expressing

Expressing milk for your baby can be a great way for parents to feel more empowered and in control of their baby's care. Many mothers also tell us how difficult and exhausting it can be to express, especially at night. This can be a particularly difficult experience if their baby is not with them.

It can be a very stressful time, but it is important that you try to stay as relaxed as possible when expressing, as this helps with the let-down reflex and milk flow. Some research has shown that higher stress levels may contribute to the delay of milk production. Some parents find that having a photograph or something that smells of their baby nearby when expressing helps. It may also help to distract yourself by doing something like reading a book or watching TV when you express. Listening to soothing music, meditation or taking time to focus on your breathing may also help you to relax.

Partners can help with expressing. For example, they can offer encouragement, help you to relax, or get equipment ready.

It is not unusual to find feeding your baby a difficult experience. In our survey of over 100 parents, over 60% said that their mental health got slightly or significantly worse during the experience of feeding their premature or sick baby. It is okay to find the experience difficult, no matter your situation. Every parent will have a very different experience of neonatal care.

It is important to talk to someone if feeding your baby is having an impact on your mental health. This could come from your feeding specialist, neonatal nurse, midwife, doctor, partner, or friends and family. We have lots of information about the impact having a premature or sick baby can have on your mental health, and where you can get support.

How to store expressed milk safely

You can store milk if your baby is unable to drink it at the time it is expressed. It is very important that expressed milk is stored safely. This is something that partners can be involved with. On the neonatal unit, breast milk is stored in fridges and freezers that only store infant milk.

Many units supply sterile disposable bottles and labels for you to use. You should label each container with your baby's name, the date and time of collection.

If you will be using your breast milk within 48 hours of expressing, you should refrigerate it. If you are at home, breast milk that has recently been expressed will keep in a refrigerator for 48 hours (24 hours if it is defrosted). The breast milk should be stored at the back of the fridge and not in the fridge door. This is because the temperature in the door compartments goes up and down when the fridge is opened and closed.

If you will not be using your breast milk within 48 hours of expressing, it should be frozen. Milk can be frozen for up to 6 months in a home freezer. If you are freezing your milk, always leave at least one centimetre of free space at the top of the milk container. This is because milk will expand when frozen.

If you are on the neonatal unit, ask the unit staff about the best way to safely refrigerate and freeze milk. Different units may have different guidelines.

Once your milk is defrosted, it will need to be used within 24 hours. Try to use small containers to freeze your milk so that no milk is wasted. Defrosted milk may have a slightly soapy or sour smell, but this will not be harmful to your baby.

Fortified b reast milk that has been supplemented with addi tives should be used with the following one to two feeds. It is not suitable f or freezing and defrosting.

Talk to the hospital staff looking after your baby for more guidance on storing and defrosting breast milk.

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Expressing milk can take time to learn. Find out how to express in neonatal care and how to look after yourself while expressing.

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In this video, we explore how best to support new mothers with feeding.

Exclusive breastfeeding for the first six months ensures the best outcomes for babies, and mothers need support to get this off to the best start. Ongoing help with positioning, attachment and skin-to-skin contact help mothers to maintain their milk supply and avoids disruption to breastfeeding.

If mothers wish to bottle feed, the impact on milk supply should be discussed so that they can make informed choices. A sensitive, non-judgmental approach is key.

For more information:

Problems viewing this video? Contact us.

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Maximising breastmilk video - Baby Friendly Initiative

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In this video, we explore how best to support new mothers with feeding, including positioning, attachment and skin-to-skin contact.

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This infosheet helps health professionals to support parents to feed their babies responsively and so develop close and loving parent-infant relationships.

The Baby Friendly standards require that healthcare facilities explain a responsive feeding style to mothers, helping them to respond to their baby's needs. This infosheet explores the concept of responsive breastfeeding and bottle feeding and how this benefits both babies and their parents. It details how feeding can be a source not only of nutrition, but also of love, comfort and reassurance between baby and mother. We explain how these concepts can be introduced to health professionals and how they in turn can support parents to feed their babies responsively and develop close and loving parent-infant relationships.

Find more relationship building resources

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Responsive Feeding Infosheet - Baby Friendly Initiative

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This infosheet helps health professionals to support parents to feed their babies responsively and develop close and loving relationships.

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In this video, a breastfeeding counsellor helps a mother with her positioning and attachment whilst breastfeeding.

Key to achieving the Baby Friendly standards is a workforce able to support mothers to breastfeed effectively. This video provides some guidance on this.

You can see more of the 'From Bump to Breastfeeding' DVD on the Best Beginnings website.

Video not working? Contact us

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Positioning and attachment video - Baby Friendly Initiativ

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In this video, a breastfeeding counsellor helps a mother with her positioning and attachment whilst breastfeeding. Watch to learn more.

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This clip from Best Beginnings shows how ineffective attachment happens and how it can cause sore nipples.

You can see more of the 'From Bump to Breastfeeding' DVD on the Best Beginnings website.

Video not working? Contact us.

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Ineffective attachment video - Baby Friendly Initiative

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This clip from Best Beginnings shows how ineffective attachment happens and how it can cause sore nipples. Watch to learn more.

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Your baby may not not be ready for all feeds to given by breast or bottle and will need some tube feeds. If you would like to do the tube feeds, please talk with your nurse to help with some training

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Your baby may not not be ready for all feeds to given by breast or bottle and will need some tube feeds. If you would like to do the tube feeds, please talk with your nurse to help with some training

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Feeding and Prematurity: Our Story – Catriona Howard - Baby Friendly Initiative

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Feeding and Prematurity: Our Story – Catriona Howard - Baby Friendly Initiative

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Feeding and Prematurity: Our Story – Catriona Howard - Baby Friendly Initiative

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In this recording guest parent speaker Catriona Howard shares her family’s story with infant feeding and prematurity.

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Open 09:30am - 09:30pm
Live online support also available from online chat

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National Breastfeeding Helpline - Helpline

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

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The Breastfeeding Network | Independent Breastfeeding Support

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The Breastfeeding Network | Independent Breastfeeding Support

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The Breastfeeding Network | Independent Breastfeeding Support

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

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Many mums struggle with breastfeeding in the early weeks, but support can make all the difference. Watch this video as two mums share their experiences.

Feeding support from NCT

Our breastfeeding counsellors are here to help you on your feeding journey. They'll offer relevant information and suggestions - whether you're breastfeeding, formula feeding or mixed feeding. You can access their support in the following ways:

Call the NCT Infant Feeding Line

If you have any questions, concerns or need support - however you're feeding your baby - you can speak to our friendly breastfeeding counsellors free of charge by calling our support line on 0300 330 0700. The line is open every day from 8am to midnight, including bank holidays.

Online breastfeeding support - chat/social media

It's always helpful to talk to other women who are breastfeeding for support, tips and company. Peer support can be found on most social media platforms online, like this one.

As well as support from our breastfeeding counsellors and your health care providers, our breastfeeding commissioned services are offering virtual breastfeeding support via zoom groups, text messaging and one- to-one calls.

If you live in any of these areas and would like some support from a breastfeeding peer supporter, please get in touch:

Many of our local NCT branches are also providing online breastfeeding peer support via closed Facebook groups. Get in touch to find out more - search on your postcode and message your closest branch to see if they have any online peer support.

Visit a local NCT Baby Cafe - supporting you to feed your baby

Put your postcode in our local activity finder to see if there's an NCT Baby Cafe near you. You can expect support, encouragement and reliable information - whether getting ready to breastfeed, establishing breastfeeding, continuing breastfeeding, expressing, mixed feeding, formula feeding, introducing solids or stopping breastfeeding.

These groups are run by qualified NCT Breastfeeding Counsellors but you may also receive support from a trained peer supporter or volunteer. They are free of charge and you are welcome to drop-in - there's no need to be an NCT member or have done an NCT antenatal course in order to attend.
Free one-to-one support from a volunteer
Some NCT Breastfeeding Counsellors are able to provide one-to-one support on a voluntary basis. This could be over the phone, online or in-person. Call the Infant Feeding Line on 0300 330 0700 to find out if this support is available in your area. We can put you in touch with your friendly local breastfeeding counsellor if there is one offering voluntary support near you.

We would be interested to hear any feedback that you have following support from one of our breastfeeding counsellors. Please fill in our survey.

Our courses

All of our courses are led by specially trained and experienced practitioners who understand what matters to you. Choose from our range of classes whether you're preparing for birth or need support postnatally.

What can you expect from NCT support?

Breastfeeding Counsellor

Our Breastfeeding Counsellors are here to support you on your feeding journey. They have undertaken an extensive two-year university accredited training course in counselling, listening skills and research-based breastfeeding knowledge.

You will be offered the opportunity to be listened to without judgement and without being pushed in any one direction. Our Breastfeeding Counsellors will discuss your options and explore what would work for you, alongside offering relevant information for you to achieve your feeding goals.

They will continue to support you however you feed your baby. Breastfeeding Counsellors attend regular continuous professional development days to update knowledge and skills. They are also supported by receiving supervision to explore and reflect upon their counselling practice.

Breastfeeding Peer Supporter

Our Breastfeeding Peer Supporters are mothers who are trained to support other mothers in their feeding journeys. Their six-week training course includes listening skills and straightforward breastfeeding knowledge.

They support mothers in the community both in breastfeeding support groups and by phone or social media contact. They will also signpost mothers to information and specialist support if this exceeds the limit of their knowledge or skills.

All NCT Breastfeeding Peer Supporters receive ongoing training and support from specialist breastfeeding counsellors, helping them to reflect and learn from their experiences and maintain the boundaries of their role.

All of our Breastfeeding Counsellors and Breastfeeding Peer Supporters are mothers who have the lived experience of breastfeeding their own babies.

Practical and emotional support

Your breastfeeding counsellor will make use of person-centred counselling skills, bringing thoughtful and empathetic support to you and your family. This includes listening to you without judging or criticising and offering information and suggestions. She will provide relevant information to help you make informed decisions about feeding your baby.

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Breastfeeding support from NCT | Baby & toddler, Feeding articles & support | NCT

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Breastfeeding isn't always straightforward, but there is lots of information and help to support you - wherever you are in your feeding journey.

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Friendly breastfeeding support from pregnancy onward.

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Lactation Consultants of Great Britain - Charity

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LCGB is a registered charity working to improve the health and wellbeing of families through advocacy and expert IBCLC breastfeeding care

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ABM are a group of trained volunteers dedicated to supporting breastfeeding mums and their families. We’ve been supporting mums and nurturing families for almost 40 years. We’d love you to join us. Become a member of the ABM and help us continue our work.

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The amazing impact that love has on your newborn baby's brain

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It's important to sterilise all your baby's feeding equipment, including bottles and teats, until they're at least 12 months old.
This will protect your baby against infections, in particular diarrhoea and vomiting.

Before sterilising, you need to:

Clean bottles, teats and other feeding equipment in hot, soapy water as soon as possible after feeds.

Use a clean bottle brush to clean bottles (only use this brush for cleaning bottles), and a small teat brush to clean the inside of teats. You can also turn teats inside out then wash them in hot soapy water. Do not use salt to clean teats, as this can be dangerous for your baby.

Rinse all your equipment in clean, cold running water before sterilising.

You can put your baby's feeding equipment in the dishwasher to clean it if you prefer. Putting feeding equipment through the dishwasher will clean it but it does not sterilise it. Make sure bottles, lids and teats are facing downwards. You may prefer to wash teats separately by hand to make sure they are completely clean.

The advice about how to clean your baby's feeding equipment applies to all of the equipment, and whether you are using expressed breast milk or formula milk.

How to sterilise baby feeding equipment

There are several ways you can sterilise your baby's feeding equipment. These include:

cold water sterilising solution

steam sterilising

boiling

Cold water sterilising solution

Follow the manufacturer's instructions.

Leave feeding equipment in the sterilising solution for at least 30 minutes.

Change the sterilising solution every 24 hours.

Make sure there are no air bubbles trapped in the bottles or teats when putting them in the sterilising solution.

Your steriliser should have a floating cover or a plunger to keep all the equipment under the solution.

Steam sterilising (electric steriliser or microwave)

It's important to follow the manufacturer's instructions, as there are several different types of sterilisers.

Sterilising by boiling

Make sure the items you want to sterilise in this way are safe to boil.

Boil the feeding equipment in a large pan of water for at least 10 minutes, making sure it all stays under the surface.

Set a timer so you do not forget to turn the heat off.

Remember that teats tend to get damaged faster with this method. Regularly check that teats and bottles are not torn, cracked or damaged.

After you've finished sterilising

It's best to leave bottles and teats in the steriliser or pan until you need them.

If you do take them out, put the teats and lids on the bottles straight away.

Wash and dry your hands before handling sterilised equipment. Better still, use some sterile tongs.

Assemble the bottles on a clean, disinfected surface or the upturned lid of the steriliser.

Find out more about expressing breast milk and how to make up formula feeds.

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How to sterilise your baby's bottles and other feeding equipment safely and effectively, whether you're using boiling, steam or cold water sterilising equipment.

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Parenteral nutrition, also known as PN, is used to feed extremely premature or very sick babies.

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What is parenteral nutrition (PN)?

Parenteral nutrition (PN) is nutrition in a liquid form that is given directly into your baby's bloodstream intravenously (through a vein). The solution has nutrients such as vitamins, minerals, carbohydrates, proteins and fats. It is called total parenteral nutrition (TPN) where it is used as the only source of nutrition.

How does PN work?

PN provides food to help your baby grow. An infusion pump is used to deliver the nutrition to your baby. This allows a stream of nutrients to flow into the bloodstream over a period of time. In newborn babies it is common for the vein in the baby's umbilical cord to be used for this.

A doctor or advanced neonatal nurse practitioner will insert a tube (catheter) into your baby's umbilical cord (tummy button). The nutrition passes through this into the bloodstream. After some time, if your baby still needs PN, they will place another tube (called a long line) into one of your baby's veins (usually the arms or legs). They will then remove the tube in the tummy button.

At first, this may be their only source of nutrition.

Why does my baby need to be fed using PN?

Although very premature and sick babies can have milk feeds, these often need to be introduced gradually so their gut can learn to cope with them. Very premature babies are usually fed using PN at first, as they have an immature digestive system that needs time to develop enough so they can tolerate enough milk to meet their nutritional needs. For both very premature and sick babies, PN can be used to make sure they get enough nutrition and can start to grow while they are gradually introduced to feeds.

We understand that seeing your baby being fed using PN can be quite scary. But it will allow your baby to feed without reducing their energy. It also enables them to absorb the nutrients required to grow.

When will my baby stop needing PN?

As your baby begins to grow and becomes stronger, a method called tube feeding will be introduced. This is so your baby can start to have milk. Tube feeding is where breast milk or formula is given through a tube passed into your baby's nose or mouth to their stomach. Milk feeds will be introduced as soon as possible alongside PN.

Once tube feeding has been established, PN will stop. Some babies need PN for a week or two, but others can take longer.

We have more information about tube feeding that you may find helpful.

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Parenteral nutrition, also known as PN, is used to feed extremely premature or very sick babies.

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Feeding your premature or sick baby expressed milk or formula in a bottle

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Feeding your premature or sick baby expressed milk or formula in a bottle

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Some parents feed their premature or sick baby expressed milk or formula in a bottle. Some babies will transition to bottle feeding after being tube fed.

You may prefer to feed your baby expressed milk and/or formula in a bottle alongside breastfeeding. This is called mixed or combination feeding. If you are thinking about mixed or combination feeding, talk to your neonatal team, feeding specialist, midwife, health visitor or GP.

Like other types of feeding, it is important to recognise the signs that your baby is hungry (feeding cues) before bottle feeding. Your baby may demonstrate early feeding cues by putting their fingers into their mouth, making sucking motions (rooting) and becoming restless.

Your baby will want to be close to you while being bottle fed, so this is a great time to have skin-to-skin. When possible, it is best for you or your partner to give bottle feeds so that your baby can learn with you. Doing the following while bottle feeding your baby can help them to feed successfully and be more comfortable:

Make sure you are close to your baby and hold them in the best position suited to your baby, with their head supported. This may be upright or elevated on their side. Some units may advise you to try different positions.

Offer the bottle when your baby shows feeding cues.

Gently invite your baby to take the teat.

Avoid forcing your baby to take the teat or finish the feed.

If the milk comes too quickly, it can be difficult for your baby to coordinate their sucking, swallowing and breathing. A nurse or feeding specialist on the unit will show you teats, bottles and positions that can help your baby to do this more effectively.

Some babies have periods of low oxygen (desaturations) and/or low heart rate (bradycardia) when they are starting to bottle feed or breastfeed. This is normal in some cases and will improve with time, but can be a sign that your baby is not ready for feeding yet. If this happens, it may need to be looked at by a doctor or a speech and language therapist who specialises in swallowing.

Low oxygen and heart rate while feeding can also be a sign of reflux. Reflux happens when some of the partly digested milk or food in the stomach comes back up the tube from the mouth to the stomach (oesophagus). This is common in all babies, but is more common in babies born premature or sick. We have more information about reflux.

Staff on the neonatal unit should support you and show you how to make feeds and clean and sterilise your baby's bottles (see below). They could also encourage you to bring bottles in from home so that your baby can get used to them. For more help and support with bottle feeding, speak to your neonatal team, feeding specialist, midwife, health visitor or GP.

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Find out how to feed your premature or sick baby expressed milk or formula in a bottle.

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Unicef UK Baby Friendly Initiative | Hand expression

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Unicef UK Baby Friendly Initiative | Hand expression

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Unicef UK Baby Friendly Initiative | Hand expression

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Please refer to the Kent County website for additional information in your area

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What we offer

Each centre offers different services, including:

childcare

early education

training or finding a new job

antenatal classes

baby clinics

support with breastfeeding

support with parenting and speech and language

drop-in sessions for parents and children

services for children with special needs and disabilities

opportunities for families to get involved with volunteering and designing services

Please check with your local children's centre to find out what they offer.
Register to use children's centres

Find a children's centre

Find your nearest children's centre and discover what's on. Come along to meet other parents, have fun or get information, advice and support.
Find a children's centre

Start for Life

Start for Life aims to improve the health of babies and children under 2 by encouraging a healthy lifestyle - helping parents-to-be and mums and dads to give their children the best possible start.
Find out more about Start for Life

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childcare; child care; child-care; childcare in kent; child care in kent; pre school; preschool; pre-school; early years; children's centre; children's centres; childrens centre; childrens centres; parents; parent; drop in; antenatal; baby; baby massage; weigh in; baby clinic; baby massage; baby clinic; baby weighing; baby and toddler group; baby and you; baby bounce; baby check; baby clinics; baby group; baby register; baby rhyme; baby rhyme time; baby sensory; baby weigh in; baby weigh in clinic; baby weighing; baby weight clinic; mother and baby group; mother and baby groups; well baby clinic; well baby clinic; well baby clinics; toddler group; toddler groups; parent and toddler; parent and toddler group; parent and toddler groups; toddler; toddler activities; toddler development check; toddler group; toddler groups; toddler groups timetable; toddler time; toddlers

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Find information about children's centres in Kent.

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The Importance of relationship building video

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The Importance of relationship building video

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In this video, we look at the importance of developing close and loving relationships with babies in their early days and weeks.

Responding to babies' needs for comfort and food is hugely beneficial for brain development and makes for more confident toddlers. Parents should be supported in breastfeeding responsively and keeping their babies close to help them become happy, healthy and secure children and adults.

For more information:

Find more relationship building resources

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The Importance of relationship building video - Baby Friendly Initiative

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This video looks at the importance of developing close, loving relationships with babies in their early days and weeks.

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Infant Feeding team Board located on the right hand side as you go through the doors after reception.

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Infant Feeding team Board located on the right hand side as you go through the doors after reception.

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This bottle feeding assessment tool may help you and your nurse or midwife to recognise if bottle feeding is going well

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Chestfeeding if you're trans or non-binary

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