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At this link you can find the Flying Start guide on our website. This information can then be translated into your preferred language.

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University Hospitals Sussex NHS Foundation Trust

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Flying Start: A guide to feeding and caring for your baby to help them get off to a flying start in life. - University Hospitals Sussex NHS Foundation Trust

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This guide provides information to help you prepare for feeding and caring for your baby/babies.

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This leaflet helps you to understand if your baby is feeding well or if you need to ask for support.

This leaflet can be translated at the link into your preferred language.

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University Hospitals Sussex NHS Foundation Trust

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How to know breastfeeding is going well - University Hospitals Sussex NHS Foundation Trust

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How to know breastfeeding is going well.

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This leaflet contains information, practical guidance, and space to record your baby's feeds, helping you build confidence and understand your baby's feeding patterns.

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University Hospitals Sussex NHS Foundation Trust

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My Feeding Journal - University Hospitals Sussex NHS Foundation Trust

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This leaflet contains information, practical guidance, and space to record your baby’s feeds, helping you build confidence and understand your baby’s feeding patterns.

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This guide shares simple tips to help your baby feed effectively and build your milk supply.

This leaflet can be translated at the link into your preferred language.

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University Hospitals Sussex NHS Foundation Trust

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Helping your breastfed baby to get all the milk they need - University Hospitals Sussex NHS Foundation Trust

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This guide shares simple tips to help your baby feed effectively and build your milk supply.

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The possible effects of giving formula top-ups to a breastfed baby

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The possible effects of giving formula top-ups to a breastfed baby

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This information explains the effects of giving a breastmilk substitute (formula) to a breastfed baby. It will help you make an informed decision about feeding choices.

This leaflet can be translated at the link into your preferred language.

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University Hospitals Sussex NHS Foundation Trust

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Download and print as a PDF (507kB pdf)

On this page

1. What is this information about?

2. Why have I been given this information?

3. What is Colostrum and why is it important?

4. Why does my baby seem unsettled after birth?

5. Why do some parents choose to give formula?

6. Is formula the same as breastmilk?

7. What are the possible effects of giving formula to breastfed baby?

8. Should I continue breastfeeding if I decide to use formula?

9. Things you can do to protect breastfeeding if you give formula to your baby:

10. How do I store my colostrum or breastmilk?

11. Where can I find more information or support?

What is this information about?

This information explains the effects of giving a breastmilk substitute (formula) to a breastfed baby. It will help you make an informed decision about feeding choices.

It includes advice on:

Recognising normal newborn behaviour

The role of colostrum in the first days after birth

Why parents may consider using formula

The potential effects of formula on breastfeeding

Things you can do to protect breastfeeding if you give formula top-up to your baby

Why have I been given this information?

You have received this information because you may be considering supplementing breastfeeding with formula. It is important to understand how this choice may affect your baby and your breastfeeding journey.

What is Colostrum and why is it important?

Colostrum is the 1st milk you produce. It comes in small amounts, but is perfectly designed to support your baby and provide protection. Frequent small amounts are usually enough in the first 24-48 hours.

Why does my baby seem unsettled after birth?

Newborns may appear unsettled due to:

seeking closeness and comfort

wanting to cluster feed, especially at night

being fussy as they recover from birth

An unsettled baby does not always mean they are hungry or need formula.

Why do some parents choose to give formula?

Some parents give formula for medical reasons if breastfeeding is not possible. Others may choose to supplement due to concerns about milk supply, baby's weight gain, or personal preference.

Is formula the same as breastmilk?

No. Formula companies have not been able to replicate the unique benefits of breastmilk. While formula may be necessary in some situations, it does not provide the same protective properties as breastmilk.

What are the possible effects of giving formula to breastfed baby?

Using formula alongside breastfeeding may:

Increase the risk of allergy to cow's milk protein (CMPA)

Reduce milk supply by lowering breastfeeding frequency

Lower confidence in milk supply and breastfeeding ability

Make breastfeeding more difficult for the baby

Alter the baby's gut bacteria, increasing the risk of infections

Should I continue breastfeeding if I decide to use formula?

Yes. You can continue breastfeeding alongside formula feeding. A single teaspoon of breast milk can contain as many as 3 million germ-killing and immune-building cells, so any breastmilk you can give your baby is beneficial.

Things you can do to protect breastfeeding if you give formula to your baby:

Make sure you express before or after giving a supplement. We can support you with this.

Breastfeed or express at least 8 times in a 24-hour period, with at least one feed or session at night. Stimulating your milk supply frequently and consistently in the first two weeks is crucial for long-term milk supply.

Have lots of skin-to-skin contact with your baby and try a laid-back feeding position. This can be good if you are tired or uncomfortable.

Consider using a cup or tube or syringe - ask a midwife or maternity support worker for assistance with this.

If using a bottle, make sure you are paced bottle feeding and following baby's cues during the feed.

How do I store my colostrum or breastmilk?

Breastmilk can remain at room temperature for 6 hours.

We can also store it in our postnatal ward milk fridge or freezer. Please ask a maternity staff member to help you with this.

All expressed breastmilk will need to be labelled with the mother's name and the date and time the milk was expressed.

Where can I find more information or support?

Speak to your midwife, health visitor, or lactation consultant for tailored advice.

Visit the NHS Website for general guidance on infant feeding.

Contact local breastfeeding support groups for help and reassurance.

Visit our Padlet for more resources and scan the QR code below to access it

Information:

The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

Today's research is tomorrow's treatments. That's why UHSx is proud to be a research-active Trust. Find out how you can get involved.

Visit our website www.uhsussex.nhs.uk/research-and-innovation/information-for-patients-and-public or scan the QR code:

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The possible effects of giving formula top-ups to a breastfed baby - University Hospitals Sussex NHS Foundation Trust

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This information explains the effects of giving a breastmilk substitute (formula) to a breastfed baby. It will help you make an informed decision about feeding choices.

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Breastfeeding Workshops (all hospital sites)

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Breastfeeding Workshops (all hospital sites)

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Face-to-face and virtual antenatal breastfeeding workshops.

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Face-to-face and virtual breastfeeding workshops for expectant families booked at University Hospital Sussex.

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Breastfeeding is more than food, it is also great for calming and soothing your baby

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Hand expressing breastmilk during pregnancy

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Hand expressing breastmilk during pregnancy

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Breastfeeding in the first few days in Pashto, Russian and Ukranian

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Breastfeeding in the first few days in Pashto, Russian and Ukranian

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Maternity information translations

*** Now updated with Ukrainian and Russian translations ***

We know that women from minority ethnic groups, refugees, asylum seekers and those whose first language is not English are at greater risk of poorer maternity and neonatal outcomes. We are working hard across the region to reduce these health inequalities, making birth safer and more personalised.

In collaboration with Papillon Translations and Surrey Heartlands' Local Maternity and Neonatal System, these maternity information resources aim to support our Afghan and Ukrainian families through pregnancy, labour, birth and the early days with their new baby. Using current information on the NHS website, the leaflets and the app provide written and audio information in Dari and Pashto, Ukrainian and Russian as well as English.

These resources are designed to support discussions between women and their healthcare professionals, facilitated by a suitable interpreter, to help them make informed choices about their maternity care.
To read or listen to information on the topics below in different languages, download the Papillon Translations app from Google Play or Apple Store, and scan each of the QR codes in the documents below:

The resources can also be downloaded as PDF documents here:

You are welcome to share this campaign content widely throughout your networks, please ensure the South East Maternity Team is credited wherever possible. We welcome any feedback to england.sematernity@nhs.net

This website uses cookies to improve your experience. If you continue to use this site, you agree with it.

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Maternity information translations - Welcome

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Maternity information translations *** Now updated with Ukrainian and Russian translations *** We know that women from minority ethnic groups, refugees, asylum seekers and those whose first language is not English are at greater risk of poorer maternity and neonatal outcomes. We are working hard across the region to reduce these health inequalities, making birth safer and more personalised.

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Sometimes a baby may need supplemental breast milk, donor milk or formula in addition to direct breastfeeding. There are many possible reasons for low milk supply and if a baby isn't gaining weight or not gaining enough weight more milk may be needed either temporarily or longer term.

Traditionally supplemental milk has been fed by spoon, syringe, cup-feeding or bottle. But there is another option; supplementing at the breast using a fine feeding tube or supply line. This article looks at how at-breast supplementers work, when to use one, and the pros and cons of supplementing at the breast.

How supplementing at the breast works

Supplementing at the breast requires a container of milk connected to a length of flexible feeding tube. The tube and container may be referred to as an at-breast supplementer, nursing supplementer, lactation aid or a supply line. The free end of the feeding tube is held or taped to run alongside mother's nipple so that the baby takes the tube and nipple together in his mouth when he latches. Alternatively the tube can be inserted in the corner of baby's mouth part way through a breastfeed after the breast has been drained. While the baby feeds at the breast, he also receives supplemental milk via the small tube. As long as baby breastfeeds with a good attachment (latch) and suction, with his lips sealed around the breast, milk will flow up the tube with much the same principle as sucking up a straw.

It is a good idea to stay in contact with your IBCLC lactation consultant or health professionals while supplementing at the breast.

Types of supplemental feeding system

There are currently only a few commercial systems, each using different designs and each with their own advantages and disadvantages. It is also possible to make a homemade version, see Homemade Supplemental Nursing System or use a supply line as a finger-feeder. The commercial systems include:

The Medela Supplemental Nursing System (SNS) uses a hard sided container for the supplement which hangs from your neck. Two tubes deliver the supplement from the container one to each breast. The feeding tubes can be taped to the breast with surgical tape or a sticking plaster. Slits in the cap make it possible to pinch shut one or both tubes to prevent milk flowing.

The Lact-Aid uses a soft disposable bag to hold the supplement which also has a neck strap to hang around the neck like the SNS and a clamp to stop milk flow if needed. This system only has one feeding tube which can be moved between breasts. There are ongoing costs to buy new sterile bags to hold the supplement.

Haakaa's Supplemental Feeding Combo is a new supplementer on the market currently available in New Zealand. Squeezing the container of milk controls the flow of supplement.

Controlling the rate of flow of milk

It is important to get the flow of supplement at the right speed-too fast and your baby may get too much milk to cope with. If the flow is too slow, an underweight baby may not have the stamina to keep feeding long enough or at all. Ideally with the supplementer in place, your baby will be having one swallow of milk after every suck or after every two to three sucks for most of the feed. The rate of flow of milk from the supplementer varies with:

The diameter of the tube-the wider the tube, the faster the flow of milk. The Medela SNS provides several sizes of tube to help you find the right flow rate for your baby.

The position of the container in relation to the baby-the flow is slower if the bottle is positioned below the baby and faster if the container is positioned above baby's head.

Lactation consultants Diana West and Diane Wiessinger discuss how to adjust flow rate in the Medela SNS in the following excerpt:

A baby who is seriously underweight or who has a weak suck might be fed with the larger tube, while a baby who is gaining well might use the smaller tube. Most mothers start with the medium size tubing. If milk flow is not sufficient with any one tube size, even when the bottle is as high as it can go, another option is to tape both tubes of a given size together on one breast, or to tape one tube to the side of the bottle, facing upwards and unclamp it, allowing air to enter the reservoir more quickly. Milk exits only when air enters, so the faster air flows into the reservoir, the faster milk can be removed from it.

Cleaning a supplemental nursing system

The small feeding tubes are very difficult to clean and will need replacing regularly. Follow manufacturer's cleaning recommendations very carefully for commercial feeding systems and for information about cleaning homemade versions see Homemade Supplemental Nursing System on this website.

When to use an at-breast supplementer

Supplementing at the breast can be used short term or long term and helps avoid a baby losing interest in breastfeeding prematurely in favour of a bottle. Potential uses include:

Supplementing a baby if there is a reason for low milk supply including insufficient glandular tissue.

Keeping an adopted baby fed at the breast to give mother and baby the experience of breastfeeding.

Keeping a baby interested in latching when encouraging a baby back to the breast after a period of bottle feeding or while a mother is relactating.

The tube can be used as part of a finger feeding exercise for suck training.

Pros and cons of supplementing at the breast

Advantages

Baby can get the additional milk he needs at the breast without introducing other feeding methods or techniques.

Baby gets more practice at breastfeeding well. If baby doesn't feed correctly, milk won't come up the tube.

Mother is able to enjoy the full experience of breastfeeding.

Helps avoid bottle preference or nipple confusion. There is less chance that a baby will start to prefer a bottle instead of the breast or stop breastfeeding correctly due to nipple confusion with a bottle teat.

Increases the flow of milk. Supplementing at the breast eliminates a baby's frustration with slow flow when milk supply is very low.

The breasts are stimulated to make more breast milk by additional suckling.

Baby associates feeling full with the breast and this reinforces his desire to breastfeed.

Disadvantages

It can be difficult and fiddly to use until you get the hang of it, particularly when away from home. An IBCLC lactation consultant can help you get started.

It is difficult to clean the little tubes thoroughly.

The system can leak, particularly homemade versions.

Doesn't work for all babies. Some babies can't seem to suck milk up the tube or are not able to get very much. A very underweight baby may still fall asleep at the breast without having fed well. Older babies may be aware of the tube and keep pulling it out.

Only works with good positioning. It isn't a suitable method if a baby isn't latching or is latching so badly as to make his mother's nipples painfully sore.

May affect baby's attachment at breast (latch). Some babies are aware of the tube and it can disturb their latch, tweaking it into different positions may help. Some babies try to suck on the tube like a straw rather than breastfeed correctly.

The tube could cause gagging if it reaches too far into the baby's mouth. Taping the tube to the breast with medical tape so that it aligns with the end of the nipple or behind the nipple can avoid this (see "Taping the tube" below)

Reconstituted powdered formula may clog the tubing.

What supplements can be used with a supply line?

This will depend on your individual circumstances. Supplements could be a mother's own expressed breast milk, donor milk or formula supplements if needed. Some mothers prefer to use ready made formula as powdered formula may clog the small tubes if it is not well blended. If using powdered formula, use the World Health Organization (WHO) guidelines for safe preparation or the UK's National Health Service guidelines Making up Infant Formula, NHS, 2019. And when using expressed breast milk see our storage guidelines. If your baby is underweight, your health professional or IBCLC lactation consultant can guide you with suggested volumes of milk to use in the supplementer. Generally a baby will take as much as they need at any given feeding and this could vary widely depending how much breast milk he is also getting direct from the breast. Staying in contact with your health care team for regular weights will ensure baby is getting enough and growing appropriately.

Taping the tube

The manufacturer's instructions for one of the commercial systems discuss taping the tube beyond the end of the nipple. However, this might cause a baby to gag or use the tube as a straw instead of breastfeeding correctly. The tube need not extend beyond the mother's nipple to work. Surgical sticky tape can be used horizontally across the tube or vertically along its length to prevent the tube from slipping. Some mothers use sticking plasters to guide and hold the tubes by slipping the tube under the non sticky portion of the plaster at each feed.

Video of inserting a lactation aid with Dr. Jack Newman

This clip from Dr Jack Newman's website shows a homemade supplementer being inserted during a breastfeed. Note the baby in this clip looks like he is having to turn his head slightly to reach the breast as he is on his back. Rotating a baby's body towards his mother to ensure his head and neck are all in a straight line is usually preferable to make swallowing easier for baby. See Homemade Supplemental Nursing System for further information on how to make your own at-breast supplementer.

Video using a commercial supplementation system by Natasha Batsford

Get help with breastfeeding

There are lots of ideas to increase your baby's intake of breast milk even if you can't produce a full supply. See How to Make More Breast Milk and contact your IBCLC lactation consultant for more support. Your lactation consultant can help you find the best latch and position for you and your baby, check your baby's tongue function, and help with breastfeeding management.

Summary

An at-breast supplementer or supply line allows a baby to take top ups of supplemental milk directly at the breast while breastfeeding. Supplementing this way has various pros and cons but is another option to consider alongside bottles or cup feeding. A very underweight baby who has not been gaining weight can still tend to fall asleep at the breast without having swallowed plenty of milk, even with a supplemental tube in place. It is important to monitor weight gains and dirty nappies to establish whether your baby is getting enough milk. Stay in contact with your IBCLC lactation consultant or health professionals while supplementing at the breast using a lactation aid.

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This article looks at how at-breast supplementers work, when to use one, and the pros and cons of supplementing at the breast.

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Alyssa Schnell, St. Louis, Missouri, USA
Alyssa Schnell is an International Board Certified Lactation Consultant (IBCLC) based in the United States. She speaks internationally about inducing lactation and relactation and specializes in helping parents who have not given birth (non-gestational parents) to breastfeed their babies. In this article Alyssa discusses how parents who have not given birth can breastfeed by inducing lactation and how La Leche League Leaders can support them.
Breastfeeding is a special gift a baby receives from their gestational parent. However, many non-gestational parents-adoptive parents, intended parents (through surrogacy), parents whose partner is birthing, and transwomen-are finding out that this wonderful experience is also available to them. Because parents who haven't given birth do not have the hormones of pregnancy to get their bodies started with making milk, they need more information and support to make breastfeeding a reality.

Why Would a Non-Gestational Parent Choose to Breastfeed or Chestfeed?

Attachment. Breastfeeding helps the parent and baby form a secure attachment, a particular concern when babies are separated from their gestational parent or gestational carrier (in surrogacy).

Nutrition. Human milk provides the optimal nutrition and necessary immunities for human babies.
Healing. Breastfeeding can help heal the heartache of infertility, and provides a biological connection between mother/parent and baby. Breastfeeding is much more than breast milk. Breastfeeding is a close, intimate, physical and emotional relationship between two or more people who love each other.

Sharing. When both parents are breastfeeding, they share the caregiving role.

Facts about breastfeeding without birthing

Women have breastfed babies they did not birth throughout history. With the easy availability and common use of bottles and infant formula in modern developed countries, culture has largely lost track of how breastfeeding can also be an option for non-gestational parents.

Non-gestational parents can start preparing for breastfeeding as soon as they decide to grow their family, after an adoption match has occurred or once their partner or gestational carrier is pregnant. They can even wait until the baby is in their arms.

The amount of milk produced when inducing lactation can vary widely. While some parents make no milk and others make all the milk their babies need, most will make a partial milk supply. Fortunately, breastfeeding is possible no matter how much or little milk is produced-even if it is none at all! Human milk feeding can be simulated with a nursing supplementer: a bag or bottle that holds human milk or formula carried to the nipple via a tiny feeding tube. Parents who are not making any milk may also choose to feed with a bottle while their baby comforts and connects with them by suckling at the (dry) breast.

Newborn babies are wired to initiate breastfeeding, but with gentle and patient encouragement, along with a few handy tools and techniques, even older babies can learn to breastfeed.

Some mothers will take medications or herbs to help them make more milk, but this is not essential. The only necessary component to induce lactation-the official term for making milk without pregnancy and birth-is to stimulate and drain the breasts. That stimulation or emptying can happen with baby breastfeeding, with an electric breast pump, or using a variety of manual techniques.

The composition of milk produced by inducing lactation is comparable to that produced following birth., The milk does not contain dangerous levels of artificial hormones-in fact, it very rarely contains any artificial hormones at all. In most cases, the only artificial hormones that are taken are estrogen and/or progesterone before there is milk production (Step 1 below.) Progesterone and estrogen levels are high during pregnancy and taking these hormones artificially may help to make the body think it is pregnant. Estrogen and progesterone play a role in breast development in pregnancy.

It is not necessary to be fertile-or even to have ovaries or a uterus-to breastfeed. The hormones responsible for milk production (prolactin) and milk ejection (oxytocin) are released from the pituitary gland located at the base of the brain.

Both parents, whether or not one has given birth, can share the breastfeeding role. This is called co-nursing.

Step 1: Preparing the Breasts for Lactation
How to induce lactation
Step 2: Starting to Make Milk Before Baby Arrives
As stated above, the primary way to induce lactation is through breast emptying: breastfeeding, pumping, or hand expression. The effectiveness of these physical techniques can be enhanced with the use of galactogogues: medications, herbs and homeopathic remedies that support the production of milk. These tools can be put together in a variety of ways to be effective and applicable to each individual parent. While the use of medications, herbs or homeopathic preparations is an individual choice, parents should always discuss their individual situation with their health care providers.
Step 3: Feeding Baby and Continuing to Grow Milk Production
Generic protocols are available (such as Dr Jack Newman's protocol) or an experienced International Board Certified Lactation Consultant (IBCLC) can work with parents to develop a personalized protocol customized to meet their specific health history, circumstances, and values. The process can be broken down into three steps:

This step mimics the hormonal and breast changes that occur during pregnancy. This step is not about making milk; it is about growing and developing the glandular breast tissue in preparation for making milk. Many parents will take hormone therapy for a period of time to achieve this. However, this step is optional.

Milk is often produced very, very slowly when lactation is induced compared with the sudden increase in milk supply between days 3-5 following birth. In order to have a milk supply by the time baby arrives, parents will often start the process of growing their milk production several weeks or months before. The main component of Step 2 for many parents is frequent pumping. Ideally, parents will express their milk as frequently as a baby nurses-just like for birthing parents, frequent breast drainage "places the order" for healthy milk production. Parents can store any milk they produce for use when baby arrives.

This is the big payoff! Baby is here and the parent can begin feeding baby their milk. This step generally involves putting baby to breast.

Not every parent's protocol will use all three steps. Each parent's needs and circumstances determine which steps will be appropriate for them. For most parents with adequate information and support, milk production begins within 6-8 weeks of beginning the process of inducing lactation.

What is the role of a La Leche League Leader?

Although extremely rewarding, inducing lactation can be a challenging breastfeeding situation. Mothers/parents need and deserve all of the support they can get. While working with an International Board Certified Lactation Consultant (IBCLC) is highly recommended, La Leche League Leaders can also play a very valuable role. As always, Leaders provide essential information and encouragement. More specifically, La Leche League Leaders may:
Alyssa Schnell has been helping parents and babies with breastfeeding for the past 17 years, first as a La Leche League Leader and now as an International Board Certified Lactation Consultant (IBCLC). Her private practice, Sweet Pea Breastfeeding Support, provides individual lactation consultations either in person or by phone or video-conference for parents throughout the United States and beyond. Alyssa is also the co-host of the Breastfeeding Outside the Box podcast, which is devoted to families breastfeeding or chestfeeding in extraordinary situations. Alyssa enjoys working with all parents and babies, but she has a special place in her heart for helping non-gestational parents to breastfeed/chestfeed their babies. She is the author of Breastfeeding Without Birthing: A Breastfeeding Guide for Mothers Through Adoption, Surrogacy, and Other Special Circumstances and is an international speaker on the topics of inducing lactation, relactation, and other related topics. Alyssa lives in St. Louis, Missouri, USA and is the proud mother of three breastfed children-two by birth and one by adoption.

Refer parents to resources on inducing lactation (see below).

Provide support for inducing lactation.

Facilitate La Leche League Group meetings where older babies who are bottle-feeding can observe breastfeeding babies, and parents can participate in a breastfeeding culture. Group meetings are also opportunities for parents to connect with other mothers who are nursing in a variety of situations.

Facilitate healthy social media information and interaction.

Share information about donor milk.

Breastfeeding without birthing may not be easy, but it is possible and it is powerful. La Leche League Leaders can be part of the team supporting these parents and their babies.

Resources for La Leche League Leaders and parents

Some notes about language: The term "gestational" is used throughout this article instead of "biological." In surrogacy, the intended mother is often the biological mother (baby is often conceived with her egg) even though she is not gestating (pregnant with) the baby. And oftentimes same-sex female couples will conceive baby via in vitro fertilization (IVF) using the egg of one parent (biological parent) implanted in the uterus of the other parent (gestational parent). This article also attempts to use gender-inclusive language such as parent versus mother and breastfeeding/chestfeeding versus breastfeeding. Some of the parents referred to in this article may be cis male, trans male, or non-binary.

Note: inducing lactation with medication should not be started unless the parent has an approximate timeline for their baby's arrival. Taking medication without a definite end could be hazardous.

Other manual approaches might include breast massage, nipple manipulation (gently pulling out and twisting of the nipple), and a partner suckling.

Kulski, J. K., Hartmann, P. E., Saint, W. J., Giles, P. F., & Gutteridge, D. H. (1981). Changes in the milk composition of nonpuerperal women. American journal of obstetrics and gynecology, 139(5), 597-604.

Perrin, M. T., Wilson, E., Chetwynd, E., & Fogleman, A. (2015). A pilot study on the protein composition of induced nonpuerperal human milk. Journal of Human Lactation, 31(1), 166-171.

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Inducing Lactation & Breastfeeding Without Giving Birth

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Breastfeeding or chestfeeding can be an option for non-gestational parents. Learn more about inducing lactation, including facts, the 3 steps, and resources.

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Increasing your milk supply and using breast compressions

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Increasing your milk supply and using breast compressions

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Most mothers are able to provide their babies with all the milk they need. However, if a baby is not thriving as she should, this video shows a mother steps to improve her milk supply and the baby's feeding.

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Increasing Your Milk Supply - Video - Global Health Media Project

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Most mothers are able to provide their babies with all the milk they need. However, if a baby is not thriving as she should, this video shows a mother steps

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Brestfeeding videos in lots of languages

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Brestfeeding videos in lots of languages

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Breastfeeding Videos - Global Health Media Project

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© 2023 Global Health Media Project | a 501(c)(3) nonprofit

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https://www.breastfeedingnetwork.org.uk/wp-content/pdfs/BFN%20Expressing%20Leaflet%202019.pdf

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Expressing and storing breastmilk - The Breastfeeding Network

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

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Please ensure any expressed colostrum/breastmilk is brought in to hospital labelled, dated and frozen. It must be then put straight into our freezer on arrival, as once thawed needs to be used within 24 hours but kept chilled at all times.

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Expressing breastmilk can relieve breast fullness, soften the breasts, and make it easier for the milk to flow. It is also important to maintain a mother’s milk supply during separation and make milk available for someone else to feed the baby. This video shows how to hand express breastmilk.

Join the Conversation

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How to Express Breastmilk - Video - Global Health Media Project

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Expressing breastmilk can relieve breast fullness, soften the breasts, and make it easier for the milk to flow. It is also important to maintain a mother’s

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Expressing milk means squeezing milk out of your breast so you can store it and feed it to your baby later.

You might want to express milk if:

How to express breast milk

You can express milk by hand or with a breast pump. How often you express your milk, and how much you express, will depend on why you're doing it.

Sometimes it takes a little while for your milk to start flowing. Try to choose a time when you feel relaxed. Having your baby (or a photo of them) nearby may help your milk to flow.

You may find it easier to express if you cover your breasts with a warm towel first, or after you have a shower or bath.

Expressing breast milk by hand

Some find it easier to express milk by hand, especially in the first few days or weeks. It also means you can express without needing a pump, or an electricity supply.

Hand expressing allows you to encourage milk to flow from a particular part of the breast. This may be useful, for example, if one of the milk ducts in your breast becomes blocked.

Hold a sterilised feeding bottle or container below your breast to catch the milk as it flows.

These tips may help:

Before you start, wash your hands with soap and warm water.

Have something clean ready to collect the milk in.

Some find gently massaging their breasts before expressing helps their milk to let down.

Cup your breast with one hand then, with your other hand, form a "C" shape with your forefinger and thumb.

Squeeze gently, keeping your finger and thumb a few centimetres away from your nipple, just outside the darker area around it (areola). Do not squeeze the nipple itself as you could make it sore. This should not hurt.

Release the pressure, then repeat, building up a rhythm. Try not to slide your fingers over the skin.

Drops should start to appear, and then your milk usually starts to flow.

If no drops appear, try moving your finger and thumb slightly, but still avoid squeezing the darker area near your nipple.

When the flow slows down, move your fingers round to a different section of your breast, and repeat.

When the flow from one breast has slowed, swap to the other breast. Keep changing breasts until your milk drips very slowly or stops altogether.

Watch a video about expressing milk by hand on the UNICEF website

Expressing milk with a breast pump

There are 2 different types of breast pump: manual (hand-operated) and electric.

Manual pumps are cheaper but may not be as quick as an electric pump.

You may be able to hire an electric pump. Your midwife, health visitor or a local breastfeeding supporter can give you details of pump hire services near you.

The suction strength can be altered on some electric pumps. Build up slowly. Setting the strength to high straight away may be painful or damage your nipple.

You may also be able to get different funnel (the part that goes over your nipple) sizes to fit your nipples. The pump should never cause bruising or catch your nipple as it's sucked into the funnel.

Always make sure that the pump and container are clean and sterilised before you use them.

Find out how to sterilise baby bottles

Storing breast milk

You can store breast milk in a sterilised container or in special breast milk storage bags:

in the fridge for up to 8 days at 4C or lower (you can buy fridge thermometers online) - if you're not sure of the temperature of your fridge, or it is higher than 4C, use it within 3 days

for 2 weeks in the ice compartment of a fridge

for up to 6 months in a freezer, if it's -18C or lower

Breast milk that's been cooled in the fridge can be carried in a cool bag with ice packs for up to 24 hours.

Storing breast milk in small quantities will help avoid waste. If you're freezing it, make sure you label and date it first.

Defrosting frozen breast milk

It's best to defrost frozen breast milk slowly in the fridge before giving it to your baby. If you need to use it straight away, you can defrost it by putting it in a jug of warm water or holding it under running warm water.

Once it's defrosted, give it a gentle shake if it has separated. Use it straight away. Do not re-freeze milk that's been defrosted.

Once your baby has drunk from a bottle of breast milk it should be used within 1 hour and anything left over should be thrown away.

Warming breast milk

You can feed expressed milk straight from the fridge if your baby is happy to drink it cold. Or you can warm the milk to body temperature by putting the bottle in a jug of warm water or holding it under running warm water.

Do not use a microwave to heat up or defrost breast milk. This can cause hot spots, which can burn your baby's mouth.

Storing breast milk if your baby is in hospital

If you're expressing breast milk because your baby is premature or sick, ask the hospital staff caring for your baby for advice on how to store it.

Read more about breastfeeding a premature or sick baby

If you're having difficulty expressing breast milk

If you're finding it difficult or uncomfortable to express your breast milk:

Ask your midwife, health visitor or breastfeeding supporter for help. They can also tell you about other breastfeeding support available near you.

Search online for breastfeeding support in your area.

Call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm daily).

The Bliss website also has advice about expressing milk for a premature or sick baby

Community content from HealthUnlocked

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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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Maximising milk production with hands on pumping

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Maximising milk production with hands on pumping

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This material was developed by Jane Morton, MD and produced for educational purposes only. Reproduction for commercial purposes is prohibited. Utilization of the materials to improve care of pregnant women and their newborns is encouraged with proper citation of source.

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This material was developed by Jane Morton, MD and produced for educational purposes only. Reproduction for commercial purposes is prohibited. Utilization of the materials to improve care of pregnant women and their newborns is encouraged with proper citation of source.

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This Padlet is a collection of useful resources which include documents, webpages, leaflets and videos.Under each heading is an icon and list of contents.                                                                                                 Scroll RIGHT for topics and                                       Scroll DOWN each column for additional links                                                                                                                                           

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This Padlet is a collection of useful resources which include documents, webpages, leaflets and videos.Under each heading is an icon and list of contents.                                                                                                 Scroll RIGHT for topics and                                       Scroll DOWN each column for additional links                                                                                                                                           

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Keeping your baby safe. Food, family and environment

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Specialist feeding teams - Drop-ins (health visiting)

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Specialist feeding teams - Drop-ins (health visiting)

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breastfeeding
bottle feeding
baby feeding
mother and baby
infant feeding
breastfeeding support
breastfeeding support sussex
breastfeeding sussex

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The Infant Feeding Services provide mothers and families with specialist advice and support to make informed feeding decisions.

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Worthing 07808099816
St Richard's 07808099829

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The Milk spot drop-in group, for feeding information and support Chichester. Please see website for dates and times.

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Royal Sussex County Hospital
01273 664 794

Princess Royal Hospital
01444 448 608

Worthing hospital/St Richards Hospital
01903 285 269

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Benefits of breastfeeding

Safe sleeping

Caring for your baby at night

Infant formula milk information

Guide to bottle feeding

Storing breastmilk

Medications and breastfeeding

Newborn jaundice

Breast health

Sling use

Crying babies ICON

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It's never too early to start thinking about how you're going to feed your baby. But you do not have to make up your mind until your baby is born.
Some of the benefits of breastfeeding are:

your breast milk meets all of your baby's nutritional needs

breast milk protects your baby from infections and diseases

breastfeeding provides health benefits for you

breast milk is available for your baby whenever your baby needs it

breastfeeding can build a strong emotional bond between you and your baby

Formula milk does not provide the same protection from illness and does not give you any health benefits.

Health benefits of breastfeeding for your baby

Breastfeeding has long-term benefits for your baby, lasting right into adulthood.

Any amount of breast milk has a positive effect. The longer you breastfeed, the longer the protection lasts and the greater the benefits.

Breastfeeding can help to reduce your baby's risk of:

Giving nothing but breast milk is recommended for about the first 6 months (26 weeks) of your baby's life.

After that, giving your baby breast milk alongside solid foods for as long as you and your baby want will help them grow and develop healthily.

Breast milk adapts as your baby grows to meet your baby's changing needs.

Health benefits of breastfeeding for you

Breastfeeding and making breast milk also has health benefits for you. The more you breastfeed, the greater the benefits.

Breastfeeding lowers your risk of:

Got a breastfeeding question?

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

Get Better Health: Start for Life

Sign up for Start for Life weekly emails for expert advice, videos and tips on pregnancy, birth and beyond.

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Breastfeeding has lots of health benefits for your new baby, including fewer infections and a lower risk of obesity, as well as protecting you from some cancers and other health problems, too.

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The Lullaby Trust raises awareness of sudden infant death syndrome (SIDS), provides expert advice on safer sleep for babies and offers emotional support for bereaved families

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Guide to bottle feeding leaflet - Baby Friendly Initiative

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This leaflet provides families and health professionals with key information about bottle feeding and how to make up feeds safely.

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The safest cot is a clear cot

The safest cot for a baby is a clear cot. That means removing anything that isn't essential. Babies need just two items in their cot:

It's important to remove anything that isn't essential because items such as toys, blankets and bumpers could cover their face and obstruct their breathing.

When preparing your baby's sleep space, remember:

No pillows or duvets

No cot bumpers

No soft toys or comforters

No weighted or bulky bedding

No products designed to keep your baby in one sleeping position, such as wedges or straps

No pods or nests, rolled up towels or anything soft placed on top of the mattress.

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Safer sleep overview - The Lullaby Trust

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An easy guide to practicing safer sleep for your baby and reducing the risk of sudden infant death syndrome (SIDS, or cot death).

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

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

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

Caring for your Baby at Night and when Sleeping

A Guide for Parents

Download now

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

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

Further resources

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

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

Safer Sleep for Babies: A Guide for Parents

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

Safer Sleep for Babies: Quick Reference Card

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

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Caring for your baby at night leaflet - Baby Friendly Initiative

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

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Comprehensive information about infant formula milk

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Comprehensive information about infant formula milk

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Infant milks for parents & carers — First Steps Nutrition Trust

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First Steps Nutrition Trust is a charity which provides clear, evidence-based and independent information and support for good nutrition from pre-conception to five years of age.

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

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

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

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

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

Your breastmilk

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

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

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

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

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

Expressing breastmilk

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

When might I need to express?

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

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

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

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

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

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

Hand Expressing

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

Remember to wash your hands first.

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

Relax with a warm drink, music or TV.

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

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

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

Take care not to drag your skin:

Stroke with your fingertips

Roll using your knuckles.

Try using circular movements.

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

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

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

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

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

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

Good hygiene is very important:

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

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

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

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

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

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

Storing expressed breastmilk

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

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

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

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

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

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

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

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

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

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

Safe Storage of breastmilk in the home

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

Why are there variations in recommendations for storing expressed breastmilk?

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

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

Feeding baby expressed breastmilk

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

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

Defrosting frozen breastmilk

How do I defrost my milk?

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

How long can I keep defrosted breastmilk?

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

Why can't I defrost breastmilk in a microwave?

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

Travelling with expressed breastmilk

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

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

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

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

Re-heating expressed breastmilk

How do I re-heat expressed breastmilk?

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

If the milk smells sour DO NOT USE.

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

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

Finding a breast pump

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

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

References

(links checked May 2023)

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

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

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

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

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

Page reviewed and updated November 2019

Variations in Recommendations for Storing Expressed Breast Milk

Written by Anabel Hands

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

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

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

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

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

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

References

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

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

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

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

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

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

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Expressing and storing breastmilk - The Breastfeeding Network

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

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Expressing and storing breastmilk - The Breastfeeding Network

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

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Human milk protects both mother and baby

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Your baby needs lots of love and cuddles

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Comforting your baby helps them manage their emotions and their brain development

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Components of human milk and formula

Vitamin D advice

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Supporting infant brain development

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Booking antenatal classes

Antenatal colostrum collection

Skin to skin

The golden hour

Hand expressing and colostrum snacks

Breastfeeding video collections

How lactation works

Positioning and attachment

Comfortable breastfeeding

Feeding twins and multiples

Breastfeeding a baby with Down Syndrome

Laid back feeding

Is getting enough milk?

Expressing

Baby's weight

Infant formula milk information

Mastitis

Postnatal support contacts

Resources from: Friends, Families and Travellers

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Brighton and Hove

West sussex

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Meeting your baby

Babies need to feel safe and supported

Babies cant be spoiled by too many cuddles

Supporting new mothers

Relationship building

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Did you know your baby can hear you from at least 16 weeks and perhaps even earlier?

Babies hear their mother's voice most clearly, but anyone can talk and sing to them.

Hearing and getting to know voices helps them feel secure and safe and is good for their development.

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The constituents of breastmilk and formula (mgr version 2)

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Hand expressing breastmilk during your pregnancy

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Hand expressing breastmilk during your pregnancy

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University Hospitals Sussex NHS Foundation Trust

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Download and print as a PDF (788kB pdf)

On this page

1. What is this information about?

2. Why is hand expressing breast milk in pregnancy helpful?

3. How to hand express your breast milk?

4. How to store your expressed milk?

5. Transporting your expressed colostrum

6. Further sources of information and advice

7. Sources used for the information here

What is this information about?

Antenatal Hand Expressing: a leaflet to inform mothers who would like to do antenatal hand expression of breast milk, from 36 weeks of pregnancy.

At the Brighton and Sussex University Hospitals Trust, we are working towards the Baby Friendly Initiative Global award. An important part of this work involves showing mothers the skill of hand expressing breast milk.

Antenatal hand expression is not new and dates back to medieval times. Over the last few years more and more trusts have been revisiting this age old skill to support infant feeding.

Why is hand expressing breast milk in pregnancy helpful?

It may increase your awareness of how your breasts work

It may increase your confidence in your ability to produce milk and breastfeed

Colostrum collection (where this is possible) enables you to give colostrum to your baby in preference to manufactured milks, when there are early challenges

Colostrum collection enables the prevention or treatment of hypoglycaemic (low blood sugar) episodes in at risk babies (breast milk achieves and maintains blood sugars, more efficiently than manufactured milks)

Supports exclusive breastfeeding

Avoids or reduces risk associated with manufactured milks

Colostrum is rich in nutrients and antibodies that help to protect your baby from infection

How to hand express your breast milk?

Applying some warmth to the breast before expressing may help (hot flannels or a shower)

Wash hands before starting

Collect with 1-2 ml oral syringes or when expressing larger quantities, a clean and sterilised container can be used Syringes and stoppers can be obtained from your community midwife

Take your time, relax and think about your lovely bump and how pleased your baby will be to meet and be cuddled by you

Cup the breast using your thumb and index finger in a 'C' shape, about 2.5 cms away from the base of the nipple.

Compress your finger and thumb together, this should not hurt

Relax and repeat the action, developing a rhythm

Avoid sliding your fingers over the skin, dragging the skin, or pinching the nipple

You may not see any colostrum, you may see a few drops; some women will produce a lot

Volumes seem to increase with repeated expressions

After a few minutes or after the flow of milk has stopped, rotate finger and thumb around and express again (thinking of the numbers on a clock and expressing on all the numbers can be helpful)

Move to the other breast when rotation fails to bring a new flow of milk

Just one hand expression a day is sufficient to practice the technique, but you can do more

Things to be aware of:

You may experience mild tightenings (your uterus going hard and then relaxing when you express). This is called Braxton Hicks and is nothing to worry about.

If it starts to feel like period pains or a mild contraction then stop hand expressing. This is very unusual but if you think that you could be in early labour then ring the labour ward.

How to store your expressed milk?

Your syringes can be labelled with your name, date of birth and date/time of collection. When collecting colostrum, you can build up to expressing a few times each day. Keep the syringe in the fridge between expressing sessions and use a fresh syringe each day and freeze it immediately. Syringes can be put into a box or bag together. If you do not have a freezer it can be stored in the fridge between 2 to 4 degrees Celsius for up to 5 days.

Transporting your expressed colostrum

It is best to freeze your colostrum as you collect it at home and bring it into hospital at the time it is needed

Use a cool bag with an ice pack for transporting it into hospital and ask a midwife to put it in the designated freezer as soon as possible on arrival

Frozen colostrum must be used within 12 hours of thawing so to avoid wasting colostrum that has thawed but not been used, it is best to only bring a few syringes at a time

Further sources of information and advice

If you have any more questions about antenatal hand expessing, please speak to your community midwife or phone the hospital on telephone 01444 441881 (Princes Royal Hospital) or telephone 01273 696955 (Royal Sussex County Hospital) and ask for the maternity day assessment unit

The Breastfeeding Network: Expressing and storing breastmilk

Sources used for the information here

National Institute for Health and Clinical Excellence, CG63 'Diabetes in pregnancy: management of diabetes', March 2015

Breastfeeding Review, 'Expressing and storing colostrum antenatally for use in the newborn period', 2006

Journal of Diabetes Nursing, 'Colostrum harvesting and type 1 diabetes', 2005

Expressing your milk antenatally. Sandwell and West Birmingham Hospitals NHS Trust. 2014

Expressing milk before birth: A tool for use in special circumstances. Breastfeeding USA. 2014

Effect of antenatal expression of breast milk at term to improve lactational performance: a prospective study. The Journal of Obstetrics and Gynaecology of India, vol. 59.No 4: July/August 2009

How to teach a mother the technique of hand expressing. Midwives magazine: Issue 5: 2011

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Hand Expressing Breastmilk During your pregnancy - University Hospitals Sussex NHS Foundation Trust

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Information for mothers who would like to do antenatal hand expression of breast milk from 36 weeks of pregnancy.

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We will support you to hand express towards the end of your pregnancy. If you manage to collect some, you can bring this colostrum with you to give to your baby. We will encourage you to frequently hand express, until your milk comes in (between 2-4 days after birth usually)even if feeding is going well.

Regular colostrum snacks in the early days will:
***Get lactation off to a great start
***Increase stooling and decrease jaundice
***Reduce unnecessary formula supplements
***Reduce significant weight loss

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How much vitamin D to take

If you're breastfeeding, you should consider taking a 10mcg daily vitamin D supplement.

If your baby is only having breast milk (no first infant formula top-ups), you should give them a daily vitamin D supplement of 8.5 to 10mcg.

Vitamin D is found in certain foods - including oily fish like salmon, sardines and mackerel; red meat; and some breakfast cereals - but it's hard to get enough from food alone.

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Find out which vitamins mum and baby need when breastfeeding.

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University Hospitals Sussex NHS Foundation Trust

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Download and print as a PDF (422kB pdf)

What this information is about

Establishing breast feeding can be really challenging. Your baby may want to feed very frequently and this can feel really hard especially when you are very tired, during the night and if your nipples are sore. We are here to help support you during this time to establish breastfeeding, both on the post natal wards and at home. This leaflet offers some useful tips and practical advice about breastfeeding in the first few days that we hope you will find useful.

Frequency of Feeding

Babies vary in the frequency of their feeding in the first 48 hours. Many feed frequently for short periods, whilst others may not feed very much in the first 24 hours and then want to feed a lot. A baby's stomach at birth is tiny (about the size of a hazelnut) and it does not need much to fill it. Even though you may think that you are producing only small amounts it matches the size of the baby's stomach.

Night feeds

Night time feeds are particularly valuable because the milk-producing hormone Prolactin is present in larger quantities at night. So night feeds are really important for building up your milk supply. Surprisingly, night feeds also have a relaxing effect; the quality of sleep improves due to the breastfeeding hormones produced. It has been proven that women who breastfeed have a better quality of sleep and get back to sleep quicker than mothers who bottle feed. If it is your first baby, and the baby has fed a lot at night, have a lie in the following morning.

Sore nipples

Sore nipples are caused by the baby being incorrectly attached to the breast, rather than suckling itself. When positioning and latch are corrected, feeding will immediately become more comfortable, and even very tender nipples will heal quickly.

Reading your baby

Babies have many ways of letting you know they need food. They only begin to cry to be fed once the other signals they have given have not been recognised. Some newborn babies will not have the energy to cry and may just go back to sleep if the feeding cues are not responded to.

Infant feeding cues

Rapid eye movements seen under closed eyelids

Flexing of arms while still asleep

Making sighing noises

Lip sucking

Mouth gaping

Rooting and putting hand to mouth

Following their hand with gaping mouth

Waking and making quiet eye contact

This sequence of non-verbal cues lasts for approximately fifteen minutes. If the above body language is not responded to, most babies will cry. Some, however, will simply go back to sleep to conserve energy.

It is recommended that you respond to the early cues. Babies that are learning to breastfeed, often feed better when they are coming out of a sleep, rather than very hungry and upset. This is called responsive feeding and allows for babies to find comfort as well as food at the breast.

We now know that keeping our babies close and responding to their cues for food, comfort and love is important for their brain growth and this closeness helps to foster close family relationships, which are good for long term health and wellbeing.

How an artificial feed may affect breastfeeding

Breastfeeding works on a supply or demand basis. The more the baby feeds the more milk is produced. If a baby is given an artificial feed it will take longer to digest and she or he will not want to suckle for some time. This affects this natural balance of supply or demand and thus less milk is produced

If the baby does not breastfeed often enough, your breasts may become full. This can be painful and may make it difficult for the baby to attach correctly

Artificial feeds alter the bacteria in the baby's gut. This may increase the risk of your baby developing infections

Artificial feeds may potentially increase the risk of asthma, diabetes obesity and allergies, particularly if there is a family history

A baby uses the tongue, jaws and mouth differently when sucking on a bottle. If a baby is given a bottle at this early stage, she/he may find it more difficult to learn to suckle at the breast as a very different technique is practised when bottle feeding

Breast milk: how much does my baby need?

Your baby's tummy is tiny at birth, with a stomach capacity of around 5 to 7 millilitres. It is about the size of a hazelnut. This increases over the first few days to 22 to 27 millilitres at 3 to 5 days. By 10 to 12 days the capacity expands to 60 to 85 millilitres (about the size of a walnut!).

Don't worry about your milk production, providing that the baby is feeding regularly at the breast or you are expressing 8 to 12 times a day our milk supply will increase to match your baby's growing appetite.

Count the number of wet nappies: baby should be producing at least two on day two, three on day three, four on day four and at least six wet nappies a day thereafter. The volume of urine in the nappy should increase along with the increase in number of wet nappies. Note the colour of dirty nappies. The stool should be changing from the sticky, dark meconium by day three, be brown by day four and become a yellow colour by the fifth day.

If your baby does not have a dirty nappy for more than 24 hours or the stools are not changing colour in the first five days, you should seek advice from a midwife.

The following is a guide for mothers who need to express milk for their babies.

Breastmilk: Average volume produced

Hand expressing

You can practice the technique toward the end of your pregnancy from 36 weeks, so that you feel comfortable with it. Start again as soon as possible after your baby is born, while you are on labour ward, during skin to skin. This may stimulate your baby to feed and if not, provide valuable colostrum, you can express onto babies lips. Every drop is precious.

Hand expressing is really useful when you have a sleepy baby who needs colostrum in the first 24 to 48 hours, but is not able to feed.

It is also helpful when your baby has been admitted to Special Care at the PRH or the Neonatal Unit at the RSCH. By hand expressing you can stimulate your milk supply and your colostrum will be given to your baby. When the baby is well enough to breastfeed you will have a ready supply. It is recommended that you start hand expressing within 6 hours of the birth.

What do you do?

Hair brushing and shoulder massage before and during your expressing will relax you and increase Oxytocin levels. Massage your breasts for a few minutes. Use flat of fingers, and gently move around the breast, gradually work your way towards the nipple and areola. Do not drag your fingers over your skin. About five minutes of massage will help the milk to flow. Some women make a fist and gently knead the breast, do not drag the skin, move around the breast in circular movements, gradually working down to the areola. Rolling your nipple between your finger and thumb stimulates Prolactin output.

When you are ready to start expressing, place your thumb on top of your breast approximately 2cms away from the base of the nipple, place your index finger the same distance away from the base of the nipple, underneath your breast.

Push back into breast tissue a little, and then gently compress the breast. You can move finger and thumb, around the breast so that you express all areas. Ask a member of staff to talk you through it.

Do not be concerned if you do not see anything at first, just keep trying and it will come. To establish your milk supply, if baby is not feeding in the first 24 to 48 hours try to hand express for about 100 minutes in 24 hours. This sounds a lot, but if you hand express for five minutes every hour, you will be doing fine, and if you were able to do more, so much the better. The trick is not to be put off if you do not see anything at first, the repeated hand expression will trigger the production of colostrum as the day goes on, and in the course of a day you can go from nothing, to a few beads by lunchtime to collecting colostrum into a syringe for baby by late afternoon! Babies only need small amounts of colostrum in the first day and even tiny beads of colostrum are packed with components which reduce risk of infection; increase baby's ability to use alternative energy stores in the first two days, and help protect against future illness.

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Breastfeeding in the first few days - University Hospitals Sussex NHS Foundation Trust

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Useful tips and practical advice about breastfeeding in the first few days.

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Please ensure any expressed colostrum/breastmilk is brought in to hospital labelled, dated and frozen. It must be then put straight into our freezer on arrival, as once thawed needs to be used within 24 hours but kept chilled at all times.

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Having a new baby can be tough at times - see advice on breastfeeding, weaning, sleep and wellbeing to make things a little easier for you.

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

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

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

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

Personal stories

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

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

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Unicef UK Baby Friendly Initiative | Hand expression

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Expressing breastmilk can relieve breast fullness, soften the breasts, and make it easier for the milk to flow. It is also important to maintain a mother’s milk supply during separation and make milk available for someone else to feed the baby. This video shows how to hand express breastmilk.

Join the Conversation

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How to Express Breastmilk - Video - Global Health Media Project

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Expressing breastmilk can relieve breast fullness, soften the breasts, and make it easier for the milk to flow. It is also important to maintain a mother’s

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

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

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

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

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

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This leaflet offers advice and information for parents on getting to know their baby and setting up the foundations for a close and loving relationship.

We now know that building a strong relationship between parents and their new baby will give them the best possible start in life and will help them to grow up happy and confident. This leaflet is free to download and helps parents to develop that strong relationship, starting in pregnancy and continuing into the early days, weeks and months of a baby's life.

Health professionals may want to use this leaflet in conjunction with the Baby Friendly guide to antenatal and postnatal conversations and accompanying signature sheets.

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

Building a Happy Baby: A Guide for Parents

Baby Friendly standards

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Breastfeeding is a gift you can give your baby. A healthy, full term baby is likely to know instinctively what to do at the breast.

During the early weeks skin-to-skin contact helps your baby connect to their instinctive breastfeeding skills and helps you and your baby enjoy breastfeeding. Each person discovers what works for them, and what works for one may not work for another. Mary Renfrew wrote in Journal of Human Lactation that learning to breastfeed is like mother and baby learning a dance. Use what works in these suggestions and tailor them for you and your baby. Trust that you know what works for you and your baby. You will know when the positioning is ideal for you, when you and your baby are comfortable. When positioning is right for you, your nipples stay healthy and your baby can feed most efficiently. Concern about sore nipples or breastfeeding comfortably is a common reason to contact La Leche League. Improving positioning helps eliminate many cases of sore nipples.

You may have noticed this description is long. Be assured that many nursing parents have successfully accomplished breastfeeding their babies for centuries and you too will learn how to best position your baby. These suggestions are not meant to tell you that if you follow all the steps the position will be "right". The suggestions are meant to gives you ideas on how you and your baby can learn to breastfeed and enjoy the breastfeeding experience.

However, like other seemingly simple tasks, it takes a lot of words to describe what other mothers have found works well for them. LLL Leaders are experienced in guiding mothers and other nursing parents through the positioning process. If you feel overwhelmed by preparing to breastfeed your baby, contact your local Leader for information and support. They will be happy to simplify matters for you.

In the first three to five days after birth, if you experience nipple soreness beyond a slight tenderness when your baby latches on, it may be a sign that something isn't right with the baby latch, position, or suck. An adjustment to the latch or positioning can help your baby be more comfortable. When you have mastered the "dance" of breastfeeding, sore or cracked nipples are allowed to heal.

If nipple pain worsens after the early days of breastfeeding your nipple pain may be due to other causes like thrush, bacterial infection, or tongue-tie. Contact an LLLeader for help if you need further assistance to improve your sore nipples. See information on sore nipples for more information.

Learn to recognize your baby's early feeding cues so you have time to get in a good position before he becomes desperately hungry. Early cues include your baby opening their mouth, moving their head side to side - also known as the rooting reflex or sucking on hands and fingers. Don't wait for baby to cry to let you know they are hungry. Crying is a very late hunger cue.

Basic Steps for Positioning

We will discuss several different positions. If you have pain or feel uncomfortable, try a different position. Adjusting the position can significantly improve breastfeeding pain.
Some general tips are:

1. Position yourself comfortably with back support, pillows supporting your arms and your baby, and your feet supported by a footrest or a large book.

2. Position your baby close to you, with their hips flexed, so that they do not have to turn their head to reach your breast. Their mouth and nose should be facing your nipple. Their body should be so close that they is touching you. If possible, ask a helper to hand you your baby once you are comfortable.

3. Support your breast so it is not pressing on your baby's chin. Your baby's chin should touch your breast, then the baby's nose.

4. Attach or latch your baby onto your breast. Encourage your baby to open their mouth wide and pull your baby close by supporting their back (rather than the back of their head) so that your baby's chin touches your breast first. His nose will be touching your breast. Your hand forms a "second neck" for your baby.

5. Enjoy! If you are feeling pain, detach your baby gently and try again.

These steps may need to be repeated frequently during the early weeks. You and your baby will find a technique that works for you after some practice.

Going Beyond the Basics

As you and your baby become more experienced at breastfeeding, you will find that breastfeeding positions can be altered in many ways, even from feeding to feeding. As long as you are comfortable and your baby is nursing successfully, use what works for you. Try experimenting with the four positions below.

Remember, in any of these positions, it is usually important to bring your baby to your nipple height.

Leaning over your baby can often cause backaches, neck/shoulder strain or sore nipples.

Laid-back Breastfeeding or Biological Nurturing

Laid-back breastfeeding, or Biological Nurturing, means getting comfortable with your baby and encouraging you and your baby's natural breastfeeding instincts.

Dress yourself and your baby as you choose. You and your baby skin-to-skin is good option too.

Position yourself comfortably in bed, on the couch, or in a recliner with back support, and pillows to also support your head, shoulders, arms. Lean back, with your pillows for support. When you comfortably lean back, and put your baby on your chest, gravity will keep your baby in position with their body molded to yours.

Let your baby's cheek rest somewhere near your bare breast. Rub your nipple on your baby's upper lip to encourage them to open wide. Bring your baby close. Have their chin touch your breast first, and then their nose will touch your breast.

Position your baby close to you, with hips flexed, so that they do not have to turn their head to reach your breast. Your baby's feet need to be supported by your body so they don't dangle in the air.

Use one hand to hold your breast as needed and the other hand to support baby's thigh or bottom.

If you feel pain, detach your baby gently by using your finger to touch the corner of your baby's mouth and try again.

Relax and enjoy each other.

Cradle Position

The cradle position is most commonly used after the first few weeks. The cross-cradle position (see below) gives you more control.

To nurse your baby while cradling or holding them across your lap, your baby should be lying on their side, resting on their shoulder and hip with their mouth level with your nipple. The whole front of their body should touch the front of your body.

Use pillows to lift your baby and support your elbows to bring your baby up to nipple height, especially during the first few weeks.

Support your breast with either the "U" hold" or "C" hold as described in the "Breast Support Techniques" section below.

Your baby's head will be on your forearm and their back will be along your inner arm and palm. When you look down, you should see his side.

Your baby's mouth should be covering at least a half inch of the dark area around your nipple. Make sure your baby's ear, shoulder and hips are in a straight line. As a newborn, your baby's head and bottom should be level with each other.

Cross-cradle Position

During the early weeks, many mothers find a variation of the cradle position, called the cross-cradle position to be useful.

To nurse your baby in this position, your baby is supported on a pillow across your lap to help raise them to your nipple level. Pillows should also support both elbows so your arms don't hold the weight of your baby; they will tire before the feeding is finished.

If you are preparing to breastfeed on the left breast, your left hand supports that breast in a "U" hold. If you are breastfeeding on the opposite breast, reverse hand used. (See the "Breast Support Techniques" section of this FAQ for a description of this hold.)

Support your baby with the fingers of your right hand.

Do this by gently placing your hand behind your baby's ears and neck with your thumb and index finger behind each ear. Your baby's neck rests in the web between the thumb, index finger and palm of your hand, forming a "second neck" for baby. The palm of your hand is placed between your baby's shoulder blades.

As you prepare to latch your baby on to you, be sure their mouth is very close to your nipple from the start.

When your baby opens their mouth wide, you push with the palm of your hand from between the shoulder blades. Their mouth will be covering at least a half-inch from the base of your nipple.

Clutch or Football/Rugby Position

This is a good position if you have had a Cesarean birth, as it keeps the baby away from the incision. Most newborns are very comfortable in this position. It also helps if you have a forceful milk ejection reflex (let down) because your baby can handle the flow more easily.

In the clutch position you support your baby's head in your hand and their back along your arm beside you. You support your breast with a "C" hold. (See "Breast Support Techniques" section of this FAQ for a description of this hold.) Your baby is facing you, with their mouth at nipple height. Your baby's legs and feet are tucked under your arm with their hips flexed and their legs resting along your back so the soles of their feet are pointed toward the ceiling. (This keeps your baby from being able to push against your chair.) Pillows help bring your baby to your level.

Side-lying Position

For some people, this position works best after the early days of breastfeeding. The other positions may be easier to learn first. Practicing this position during the daytime can be very helpful.

You may find lying down to nurse is a comfortable position, especially at night. Both you and your baby lie on your sides facing each other. You can use pillows behind your back and behind or between your knees to help get comfortable. A pillow or rolled blanket behind your baby's back will keep them from rolling away from you. Your baby can be cradled in your arm with their back along your forearm. Having your baby's hips flexed and their ear, shoulder and hip in one line helps your baby get milk more easily.

Breast Support Techniques

As you hold your baby in any of the above positions, you may need to support your breast with your free hand. This removes the weight of your breast from your baby's chin, allowing them to breastfeed more effectively.

"C" hold-See the cradle hold illustration above. Support your breast with your thumb on top, away from your areola (the darker skin surrounding the nipple) and the fingers underneath. Your fingers should also be well back from your baby's mouth. This hold is helpful when breastfeeding in the clutch or football position as well as the cradle position.

"U" hold-Place your fingers flat on your ribcage under your breast with your index finger in the crease under your breast. Drop your elbow so that your breast is supported between your thumb and index finger. Your thumb will be on the outer area of your breast and your fingers will be on the inner area. This hold is helpful when breastfeeding in the cradle and cross-cradle positions.

Is My Baby Latched on Well?

When latching on your baby, use your nipple to tickle the center of your baby's bottom lip. This will encourage your baby to open their mouth wide (like they are yawning). Aim your nipple slightly towards the roof of their mouth, bringing your baby to you, chin first.

Good latch-on checkpoints for your baby include:

Your baby's nose is nearly touching your breast, that is, no further away than a credit card edge

Your baby's lips are flanged

At least ½ inch of your breast around the base of your nipple is in your baby's mouth.

If the latch is uncomfortable or painful, gently place your finger in your baby's mouth, between his gums, to detach him and try again.

A baby who is offered the breast will suck without swallowing as they position the nipple in their mouth and tells your breast they are ready for the milk to let down. When your baby begins to receive milk, you will see their jaw working all the way back to their ear. your baby's temples will wiggle. You will also hear them swallowing, quickly at first, then more slowly, as their appetite is satisfied.

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Breastfeeding Positions, Latch, and Positioning

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Learn about breastfeeding positions, including the importance of the latch, steps for positioning, and common breastfeeding positions with images and tips.

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Good attachment will help a baby get more milk and make breastfeeding more comfortable. This video shows why good attachment is so important to breastfeeding success and what a mother can do to deeply attach her baby to her breast.

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

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

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Best Beginnings - creators of Baby Buddy

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From Bump To Breastfeeding:  Introduction

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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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Baby Buddy App

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We develop simple, educational and interactive tools to support parents-to-be and new parents so every child in the UK has the best start in life.

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School of Health & Social Care, Swansea University

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How you can Help Support a Breastfeeding Mum...

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Feeding cues
Responding to your baby's needs
Frequent feeding
Infant formula
Responsive bottle feeding
Dummy information

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Expecting a baby? - Find out how your milk making Superpower works! Check out our fab new video explaining all about how lactation works.

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Babies have many ways of letting you know they need food. They only begin to cry to be fed once other signals they have given have not been recognised. Some newborn babies will not have the energy to cry and may just go back to sleep if their feeding signals are ignored. Newborn babies need to feed regularly so look out for their feeding cues.

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Babies have many ways of letting you know they need food. They only begin to cry to be fed once other signals they have given have not been recognised. Some newborn babies will not have the energy to cry and may just go back to sleep if their feeding signals are ignored. Newborn babies need to feed regularly so look out for their feeding cues.

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0:00 / 5:25•Watch full video

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College of Human and Health Sciences, Swansea University

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College of Human and Health Sciences, Swansea University

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Why you might want to put the baby books down...

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Night feeds                                                                       It is not only normal but essential for your baby to feed during the night.  Your baby is growing fast and has a tiny stomach which means they need to feed around the clock to meet their needs. This can be challenging and frustrating especially when you are tired and your baby wakes often to feed during the night. If you can, try and rest during the day when your baby sleeps.  

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Night feeds                                                                       It is not only normal but essential for your baby to feed during the night.  Your baby is growing fast and has a tiny stomach which means they need to feed around the clock to meet their needs. This can be challenging and frustrating especially when you are tired and your baby wakes often to feed during the night. If you can, try and rest during the day when your baby sleeps.  

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Infant formula and responsive bottle feeding

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Infant formula and responsive bottle feeding

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Find out more about jaundice, a common and usually harmless condition in newborn babies that causes yellowing of the skin and the whites of the eyes.

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Infant milks for parents & carers — First Steps Nutrition Trust

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First Steps Nutrition Trust is a charity which provides clear, evidence-based and independent information and support for good nutrition from pre-conception to five years of age.

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Steady weight gain is one of the signs that your baby is healthy and feeding well.

It's normal for babies to lose some weight in the first few days after birth.

Your baby will be weighed during their first 2 weeks to make sure they're regaining their birthweight. Most babies are at, or above, their birthweight by 3 weeks.

A midwife or health visitor will support you if your baby loses a large amount of weight or does not regain their birthweight by 3 weeks.

They'll talk to you about how feeding is going, possibly ask to observe a feed if you're breastfeeding, and look at your baby's health in general.

How often should my baby be weighed?

After the first 2 weeks, your baby should be weighed:

no more than once a month up to 6 months of age

no more than once every 2 months from 6 to 12 months of age

no more than once every 3 months over the age of 1

Your baby will usually only be weighed more often than this if you ask for it or if there are concerns about their health or growth.

Your baby's length may also be measured at some of their developmental reviews.

Understanding your baby's weight chart

Your child's growth will be recorded on centile charts in their your baby's health and development review. This is also known as the personal child health record (PCHR) or the red book.

These charts show the pattern of growth healthy children usually follow, whether they're breastfed or formula fed, or having a mixture of both.
Examples of baby weight charts are available on the Royal College of Paediatrics and Child Health website
Boys and girls have different charts because boys tend to be a little heavier and taller, and their growth pattern is slightly different.

What the centile lines mean

The curved lines on the charts are called centile lines. These show the average weight and height gain for babies of different ages.

Your baby's weight and height may not follow a centile line exactly. Their measurements may go up or down by 1 centile line, but it's less common for them to cross 2 centile lines. If this happens, talk to a health visitor, who can advise you.

It's normal for your baby to be on different centiles for weight and length, but the 2 are usually fairly similar.

All babies are different, and your baby's growth chart will not look exactly the same as another baby's, even their own brother or sister.

Your baby's weight gain

Usually your baby will gain weight most rapidly in the first 6 to 9 months. Their rate of growth will gradually slow down as they become a toddler and are more active.

If your baby or toddler is ill, their weight gain may slow down for a while. It will usually return to normal within 2 to 3 weeks.

Your toddler's weight and height

Your child's height after the age of 2 gives some indication of how tall they will be when they grow up. If you like, you can use the adult height predictor in your baby's red book to work it out.

Once your child gets to the age of 2, a health visitor may use their weight and height to calculate their body mass index (BMI) and plot it on a centile chart. This is a way of checking whether your child's weight is in the healthy range or not.

If they're overweight or underweight, a health visitor can give you advice about your child's diet and physical activity levels.

You can also use our BMI calculator to check your child's BMI (as long as they are 2 years old or over).

For more information about your baby or toddler's weight or height, talk to a health visitor or GP.

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How your baby's weight and height are monitored, plus how to understand your baby's centile charts.

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Unicef UK Baby Friendly Initiative | Importance of relationship building

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Contact details for your local Health Visiting team

BRIGHTON AND HOVE
Duty Telephone: 01273 266000 (Monday to Friday, 9am-5pm. Excluding bank holidays) This is for advice, support and appointments.

Parentline Text: 07507 331296
(For parents/carers of children aged 0-5)
You can use this anonymous text service at any time and we will return your message within 24 hours, Monday to Friday, 9am-3.30pm, except for bank holidays and weekends. This service is for advice and support only, please do not message to arrange or amend appointments.

WEST SUSSEX
Duty Telephone: 01273 242004 (Monday to Friday, 9am-4.30pm, excluding bank holidays). This is for advice, support and appointments.

Parentline Text: 07312 277163
(For parents/carers of children aged 0-5):  You can use this anonymous text service at any time and we will return your message within 24 hours, Monday to Friday, 9am-4.30pm, except for bank holidays and weekends. This service is for advice and support only, please do not message to arrange or amend appointments.

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NCT breastfeeding volunteer counsellors
Call 0300 330 0700. Every day 8am to midnight

National Breastfeeding Helpline
Volunteer Breastfeeding Network (BFN) and Association of Breastfeeding Mothers (ABM). Every day 9.30am to 9.30pm.
Call 0300 100 0212
Support is also available in Welsh and Polish via the National Breastfeeding Helpline – call 0300 100 0212 and press 1 for Welsh and 2 for Polish.
Breastfeeding support available for Bengali and Sylheti speakers. If a volunteer is not available to take your call, a message can be left and someone will get back to you.

La Leche League

Call your local LLL Leader directly. Please see below a list of all the LLL Leaders in Great Britain who are willing to take local calls. Please respect their wishes and only call directly a Leader who is local to you, at the times and days she stated. LLL Leaders are volunteers who take calls in their own homes.

If you don’t have a local Leader on the list please call our national helpline on 0345 1202918 .Open from 8am to 11pm, every day.

You can also search for your local LLL group to give you a range of ways of making contact with them.