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Breastfeeding Clinic Joint Poster October 2017

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Having problems with breastfeeding? Here's how to spot what's causing the problem and how to sort out common issues like sore nipples, breast milk supply and engorgement.

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Breastfeeding provides nutrition and immunity for your baby (WHO, 2013a). It is also a time for closeness and connection, no matter how old your baby or toddler is.

We support parents whichever way they feed their babies. If you are breastfeeding and you decide you'd like to stop, there are ways to make it easier for you and your baby.

You might find it helpful to explore your options for stopping with a breastfeeding counsellor or supporter from your local NCT branch. You could also call our support line on 0300 330 0700.

Watch our video for tips on how to stop breastfeeding.

Recommendations for when to stop

The NHS and the World Health Organization (WHO) recommend that you exclusively breastfeed your baby - give them breastmilk only - for the first six months of their life (WHO, 2013b; NHS, 2017). The WHO also recommends continuing to breastfeed your baby for up to two years and beyond (WHO, 2013c).

"The longer you breastfeed up to two years, the greater the health benefits might be for you and your child (WHO, 2013c). Yet the most important thing is to continue breastfeeding for as long as feels right for you and your baby, rather than what other people think (ABM, 2018)."

At the same time, it's worth considering your reasons for stopping breastfeeding.

When should I stop breastfeeding?

If you're having breastfeeding problems, there's support available.

"Getting the right support may mean you don't need to stop breastfeeding if you wish to continue."

It's sometimes possible to restart breastfeeding if you've had a short break and want to carry on. If you aren't sure whether to continue breastfeeding, you could call our Infant feeding support line on 0300 330 0700.

Common reasons mums consider stopping breastfeeding:

Breastfeeding difficulties. If your baby is struggling to feed efficiently or not gaining weight, there's help available. You can get support from one of our breastfeeding counsellors and peer support from other breastfeeding mums. This may help you continue breastfeeding if you wish to.

Returning to work. This doesn't mean you have to stop breastfeeding - you should be able to continue to breastfeed if you want to. Workplaces should provide a private place for you to express and store breastmilk if required. You may wish to consider changing your work hours or combination feeding your baby (offering both breastmilk and formula milk).

Going on holiday. A break away doesn't mean you need to stop breastfeeding. Many breastfeeding mums find breastfeeding on holiday is easy because they don't need to take bottles, formula or sterilising equipment.

Your baby's age. It's up to you and your baby how long you continue breastfeeding.

How to stop breastfeeding your baby

Even if your baby is eating solids, breast milk or formula still has to be their main drink until they're at least one year old. This is a must.

Whichever way you stop breastfeeding and whenever you do it, take it slowly. Stopping breastfeeding your baby gradually is important for your own comfort and wellbeing. It can also make the adjustment gentler for your baby

Approaches to stopping breastfeeding

Here are some of the different approaches to stopping breastfeeding but only you know which approach is right for you and your baby.

1. One option is to increase the gaps between breastfeeds by offering a drink of formula milk. Use a bottle if your baby is 6 months or under or a cup for older babies.

2. Another idea is to, after a year, start by dropping a breastfeed a day and replacing it with a suitable alternative milk. Carrying on breastfeeding while giving your baby some formula can work very well.

3. You may want to keep some breastfeeds. For example, keep a breastfeed to help your baby settle to sleep in the evening or during the night, or an early morning feed to give you extra time in bed. You can drop these feeds when it suits you and your baby.

4. Some mums go for breastfeeding to natural term, which is where their child chooses when to stop breastfeeding. This is likely to happen gradually over a long time - months or more. If you breastfeed to natural term, you'll notice your little one's feeding sessions eventually become shorter and more infrequent, until they finally stop completely. (La Leche League GB, 2016; NHS Choices, 2017)

It's helpful to stop breastfeeding gradually for toddlers as well as for babies. Often toddlers are very keen on breastfeeding and sometimes increase their need for it. Read our article Ten tips for stopping breastfeeding a toddler, to help smooth the transition for you and your toddler.

Other mums who have breastfed beyond babyhood may have useful experiences and tips to share. Check with your local NCT branch to see if there is a drop-in breastfeeding group. These groups give you the chance to chat with other mums or speak to one of our breastfeeding counsellors for support. You can find our breastfeeding support contacts listed here and find out what support might be available in your area here.

"It's important to stop breastfeeding when the time feels right for you. Whenever you choose to stop breastfeeding, support is available."

This page was last reviewed in October 2017

Further information

Our support line offers practical and emotional support in all areas of pregnancy and early parenthood, whether you are breastfeeding your baby, formula-feeding them or a combination: 0300 330 0700.

NHS Choices breastfeeding information.

Visit our breastfeeding support contacts page.

ABM. (2018) Questions mums ask about stopping breastfeeding. Available from: https://abm.me.uk/breastfeeding-information/questions-mums-ask-about-stopping-breastfeeding/ [Accessed 1st October 2017].

La Leche League GB. (2016) Thinking of weaning. Available from: https://www.laleche.org.uk/thinking-of-weaning/ [Accessed 1st October 2017].

La Leche League GB. (2017) When breastfeeding ends suddenly. Available from: https://www.laleche.org.uk/breastfeeding-ends-suddenly/ [Accessed 1st October 2017].

NHS Choices. (2017) How to stop breastfeeding. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/stopping-breastfeeding/ [Accessed 1st October 2017].

WHO. (2013a) Short-term effects of breastfeeding. Available from: http://apps.who.int/iris/bitstream/handle/10665/95585/9789241506120_eng.pdf?sequence=1 [Accessed 1st October 2017].

WHO. (2013b) Global strategy for infant and young child feeding. Available from: http://www.who.int/nutrition/publications/infantfeeding/9241562218/en/ [Accessed 1st October 2017].

WHO. (2013c) Beyond survival: integrated delivery care practices for long-term maternal and infant nutrition, health and development. Available from: http://www.who.int/nutrition/publications/infantfeeding/BeyondSurvival_2nd_edition_en.pdf?ua=1 [Accessed 1st October 2017].
Further reading
Ystrom E (2012) Breastfeeding cessation and symptoms of anxiety and depression: a longitudinal cohort study. BMC Pregnancy and Childbirth. 12:36. doi:10.1186/1471-2393-12-36. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22621668 [Accessed 1st October 2017].

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Breastfeeding provides nutrition and immunity for your baby (WHO, 2013a). It is also a time for closeness and connection, no matter how old your baby or toddler is. We support parents whichever way they feed their babies. If you are breastfeeding and you decide you'd like to stop, there are ways to make it easier for you and your baby.

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What does 'expressing milk' mean?

Expressing milk means the same thing as pumping milk. It's a way of taking milk from the breasts without baby needing to breastfeed directly (NHS Choices, 2014). You can do this using your hands, a manual pump or an electric breast pump.

Using expressed milk can be handy for women for many different reasons. Some people may do it because they have babies who can't feed. Some because they might want to allow a partner or other family members to get involved in feeding. Others find it helpful in the early days for comfort. For example, if their baby is not feeding effectively, or has had a longer gap between feeds leaving them feeling uncomfortably full or engorged.

Do I have to express milk if I'm breastfeeding?

Not at all. Only do it if it's something that works for you and your baby. If you do decide to express, it may help to wait until you and your baby are in the habit of breastfeeding. Some women find it helpful to try around three to six weeks in, as they've usually resolved any early day challenges by then. There is no evidence to suggest there's a 'best' time to see whether your baby takes a bottle.

How long should I express for?

Get comfortable and express your milk for as long as it is flowing well rather than letting time guide you. This will vary between women: for some five minutes on one breast will be enough while others will find it helpful to spend 15/20 minutes. It's usually more efficient to pump both breasts at the same time. Some mums also find it helpful expressing on one breast while feeding their baby from the other. Babies are very good at encouraging the release of oxytocin, the hormone associated with the milk ejection reflex.

Do I really need to sterilise everything I use to express milk?

The guidance varies a lot, which is really confusing. What everyone agrees on is that starting with clean hands really matters. The NHS says it's important that you clean and sterilise any containers or parts that your milk touches, like pump flanges, bottles, cups or spoons after every use, until the child is at least 12 months old (NHS Choices, 2016).

The Academy of Breastfeeding Medicine suggests sterilising is not necessary but that everything should be thoroughly cleaned in hot soapy water, rinsed well and dried (air or paper towels).

Does expressed breast milk need warming up?

Babies don't need their milk warm but some prefer it at body temperature. The safest way is to stand it in a jug of warm water.

Warm the milk just enough to take the chill off and shake out a few drops onto your wrist to test. Never heat milk in a microwave as it can lead to uneven heating and burn a baby's mouth (American Academy of Pediatrics, 2011; NICE, 2014).

How much milk will I need for one feed?

Babies differ so much and while young babies can only take around a few millilitres at a time, older babies will of course take more. Your baby's appetite may be bigger at different times of day, and from day to day, just like yours.

If you still want a rule of thumb, leave around 90-120ml for a feed for a baby over a month old. Less for a younger baby. Try that until you get to know your baby's habits. Some babies will take very little while they are separated and catch up when they're reunited with their mum. Remember taking milk from a bottle is a skill your baby has to learn.

How do I store expressed milk in the fridge?

Store milk in sterilised containers or in plastic bags made specifically for storing milk. Write on them the date and use up the oldest first (NICE, 2014).

You can store freshly-expressed milk for up to five days in the main part of a fridge, at 4°C or lower (NICE, 2014). If you're not sure of the temperature or if it's higher than that, use it within three days.

Go for the fridge as your first option as freezing breast milk alters some of its biologically active components (Piela et al, 2017).

If you need it on the go, you can store your refrigerated breast milk for 24 hours in a cool bag or box with ice packs in it.

What about storing expressing milk at room temperature?

The guidelines for storage of expressed milk at room temperature (between 16-25°C) vary greatly, as studies suggest different optimal times (Liebert, 2017).

Warmer temperatures can allow bacteria to grow more quickly. However, around six hours would seem to be a reasonable time for milk collected hygienically (with a sterilised pump and really clean hands).

If the breastmilk has gone off, it will smell unusual. Don't worry if it looks a little weird. Separation is very normal, with the fat rising to the top. Just give the bottle a good shake before offering it your baby.

How do I store expressed milk in the freezer?

In the freezer compartment of a fridge, you can store expressed breast milk for two weeks. If you store your breastmilk in a stand-alone freezer, it'll last up to six months at as long as it's at -18°C or lower (NICE, 2014).

It's easier to write the date on the bag before it's full of milk, and do leave some space at the top of the bag as the milk will expand as it freezes.

How do I thaw frozen breast milk?

You can thaw frozen milk by defrosting it in the fridge (NICE, 2014). You can also stand it in a container of warm water (not hot or boiling). Never use a microwave to warm or defrost your milk (NICE, 2014).

Once milk is thawed it can separate so give it a swirl or gentle shake. There are mixed opinions about how long you can keep thawed breast milk. Some say to use it straight away and throw away any that's left, others suggest a few hours at room temperature is fine (ABM 2017). If it smells sour throw it out.

Is it normal for expressing breast milk to be painful?

Expressing milk shouldn't be painful. If you're finding it difficult, call our support line on 0300 330 0700 to speak to a breastfeeding counsellor or talk to your midwife (NHS Choices, 2017). There could be many reasons like the suction being too strong, or the nipple rubbing against the flange.

Is there anything else I need to know about expressing breast milk?

Yes, the more relaxed you are the easier it will be. The hormone oxytocin is released when you're feeling happy and relaxed, and that's what causes your milk to be let down. Having your baby or a picture of your baby nearby or smelling their clothes can help.
This page was last reviewed in March 2019
Further information

We support 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.

Healthtalkonline.org has a comprehensive library of face-to-face interviews where parents share their experiences about breastfeeding, birth, parenting and many other issues.

Best Beginnings has video clips from the 'Bump to Breastfeeding' DVD.

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Expressing milk means the same thing as pumping milk. It's a way of taking milk from the breasts without baby needing to breastfeed directly (NHS Choices, 2014). You can do this using your hands, a manual pump or an electric breast pump. Using expressed milk can be handy for women for many different reasons.

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We are the UK’s leading charity for parents, for your First 1,000 Days - right through your pregnancy, birth and beyond.

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Party Cafe Family Groups Nottingham | United Kingdom | The Milk Lounge

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Party Cafe Family Groups Nottingham | United Kingdom | The Milk Lounge

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The Milk Lounge- Designed with families in mind.

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Drugs in Breastmilk factsheets - The Breastfeeding Network

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

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Welcome to the Biological Nurturing website. Whether you are a mother-to-be or have had your baby or a health professional wanting to expand your knowledge base we hope you find this website useful and informative. Please have a browse and be in touch if you have any comments or want to add your nurturing story.

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Disclaimer - PLEASE CLICK HERE Welcome to the Biological Nurturing website. Whether you are a mother-to-be or have had your baby or a health professional wanting to expand your knowledge base we hope you find this website useful and informative. Please have a browse and be in touch if you have any comments or want to add your nurturing story.

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Find out how to make sure your baby is attaching well at the breast.

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

From Bump to Breastfeeding

From Bump to Breastfeeding extra films

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Find out how to make sure your baby is attaching well at the breast. Vimeo Video http://www.vimeo.com/11692547 The rest of the DVD can be viewed by clicking through the links below. While they work very well as stand-alone films, From Bump to Breastfeeding is best viewed as a whole: From Bump to Breastfeeding 1.

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

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Recém nascidos engatinham até o seio - Newborns crawl to the breast -

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Recém nascidos engatinham até o seio ♥ Ele chega indefeso, frágil, carente e dependente

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Expressing and storing breast milk - NHS.UK

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Everything you need to know about expressing and storing your breast milk, including tips on hand expressing and electric breast pumps, and how to freeze, defrost and warm breast milk.

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You don't need to eat anything special while you're breastfeeding. But it's a good idea for you, just like everyone else, to eat a healthy diet.
A healthy diet includes:

at least 5 portions of a variety of fruit and vegetables a day, including fresh, frozen, tinned and dried fruit and vegetables, and no more than one 150ml glass of 100% unsweetened juice

starchy foods, such as wholemeal bread, pasta, rice and potatoes

plenty of fibre from wholemeal bread and pasta, breakfast cereals, rice, pulses such as beans and lentils, and fruit and vegetables - after having a baby, some women have bowel problems and constipation, and fibre helps with both of these

protein, such as lean meat and chicken, fish, eggs, nuts, seeds, soya foods and pulses - at least 2 portions of fish a week is recommended, including some oily fish

dairy foods, such as milk, cheese and yoghurt - these contain calcium and are a source of protein

non-dairy sources of calcium suitable for vegans include tofu, brown bread, pulses and dried fruit

drinking plenty of fluids - have a drink beside you when you settle down to breastfeed: water and skimmed or semi-skimmed milk are all good choices

See more detailed advice about healthy eating.

Small amounts of what you're eating and drinking can pass to your baby through your breast milk. If you think a food you're eating is affecting your baby and they're unsettled, talk to your GP or health visitor, or contact the National Breastfeeding Helpline on 0300 100 0212.

Vitamins and breastfeeding

Everyone, including pregnant and breastfeeding women, should consider taking a daily supplement containing 10mcg of vitamin D.

From late March/April to the end of September, the majority of people aged 5 years and above will probably get enough vitamin D from sunlight when they are outdoors. So you might choose not to take a vitamin D supplement during these months

You can get all the other vitamins and minerals you need by eating a varied and balanced diet.

Ask your GP or health visitor where to get vitamin D supplements. You may be able to get free vitamin supplements without a prescription if you're eligible for Healthy Start.

You're entitled to free NHS prescriptions for 12 months after your baby is born. You will need to show a valid maternity exemption certificate to prove your entitlement.

If you did not apply for a maternity exemption certificate while you were pregnant, you can still apply at any time in the 12 months after your baby is born.

Healthy snack ideas for breastfeeding mums

The following snacks are quick and simple to make, and will give you energy and strength:

fresh fruit

sandwiches filled with salad, grated cheese, mashed salmon or cold meat

yoghurts and fromage frais

hummus with bread or vegetable sticks

ready-to-eat dried apricots, figs or prunes

vegetable and bean soups

fortified unsweetened breakfast cereals, muesli and other wholegrain cereals with milk

milky drinks or a 150ml glass of 100% unsweetened fruit juice

baked beans on toast or a baked potato

Healthy Start vouchers

You can get Healthy Start vouchers if you're pregnant or have a young child under 4 and are getting certain benefits or tax credits, or you're pregnant and under 18.

These can be spent on milk and fresh or frozen fruit and vegetables, or they can be put towards formula milk if you're not breastfeeding.

You can't use vouchers to buy fruit and veg with added fat, sugar and salt or flavourings, such as oven chips and seasoned stir fries. You can also get Healthy Start vouchers for free vitamin supplements.

For more information or an application leaflet, visit the Healthy Start website, or call the helpline on 0345 607 6823.

If you're already receiving Healthy Start vouchers, ask your midwife or health visitor where you can exchange the vouchers for vitamins.

Eating fish while breastfeeding

Eating fish is good for your and your baby's health, but while you are breastfeeding you should have no more than 2 portions of oily fish a week. A portion is around 140g.

Oily fish includes fresh mackerel, sardines, trout and salmon.

All adults should also eat no more than 1 portion a week of shark, swordfish or marlin.

See more about eating fish while pregnant or breastfeeding.

Caffeine and breastfeeding

Caffeine can reach your baby through your breast milk and may keep them awake.

Caffeine occurs naturally in lots of foods and drinks, including coffee, tea and chocolate. It's also added to some soft drinks and energy drinks, as well as some cold and flu remedies.

Caffeine is a stimulant and can make your baby restless. It's a good idea for pregnant and breastfeeding women to restrict their caffeine intake to less than 200mg a day:

1 mug of filter coffee: 140mg

1 mug of instant coffee: 100mg

1 250ml can of energy drink: 80mg (larger cans may contain up to 160mg caffeine)

1 mug of tea: 75mg

1 50g plain chocolate bar: up to 50mg

1 cola drink (354mls): 40mg

Try decaffeinated tea and coffee, herbal teas, 100% fruit juice (but no more than one 150ml glass per day) or mineral water. Avoid energy drinks, which can be very high in caffeine.

Peanuts and breastfeeding

If you'd like to eat peanuts or foods containing peanuts, such as peanut butter, while breastfeeding, you can do so as part of a healthy, balanced diet (unless, of course, you are allergic to them).

There's no clear evidence that eating peanuts while breastfeeding affects your baby's chances of developing a peanut allergy. If you have any questions or concerns, you can talk to your GP, midwife or health visitor.

See more about food allergies.

Got a breastfeeding question?

Sign into Facebook and message the Start4Life Breastfeeding Friend chatbot for fast, friendly, trusted NHS advice anytime, day or night.

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You don't need to eat anything special while you're breastfeeding. But it's a good idea for you, just like everyone else, to eat a healthy diet.

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