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Choose You is a free local service to help you build healthy habit

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Choose You is a free local service to help you build healthy habit

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Quit smoking, lose weight and feel healthier - Choose You

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Free support in Bedfordshire and Milton Keynes to quit smoking, lose weight, and build healthy habits.

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Karma Nirvana: Honour Based Abuse Website and Helpline

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Karma Nirvana: Honour Based Abuse Website and Helpline

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Our goal is to end Honour Based Abuse in the UK. We run a national helpline, offer training to professionals, gather data to inform policies and services, and campaign for change.

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Galop works with and for LGBT+ victims and survivors of abuse and violence in the UK

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Galop works with and for LGBT+ victims and survivors of abuse and violence in the UK

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Galop works with and for LGBT+ victims and survivors of abuse and violence in the UK

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This factsheet explains what a non-molestation order is, how it can protect victims of domestic abuse, and how to apply for one.

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Domestic Abuse Helpline for Men | Men's Advice Line UK

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The Men's Advice Line is for male victims of domestic abuse. We offer confidential advice, non-judgmental support, practical information and help

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Women's Aid provides support and information for victims of domestic abuse

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Women's Aid provides support and information for victims of domestic abuse

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Abuse costs us all. But it shouldn't cost this much.Take action today Abuse costs us all. But it shouldn't cost this much.Take action today We're working together against domestic abuse until wo...

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MK Act is a Milton Keynes based charity that provides support services to families experiencing domestic abuse. 

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MK Act is a Milton Keynes based charity that provides support services to families experiencing domestic abuse. 

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We understand. You are not alone. You do have choices. MK-ACT Domestic Violence Intervention Services Managed by MK Women’s Aid If you are experiencing domestic abuse and you need help Click here for all the different ways you can contact us For enquiries related to the Fresh Start ProgrammeEmail: Freshstart@mk-act.orgCall: 07718767974 If you have fundraising

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Oxford Vaccine Group information on immunisations

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Oxford Vaccine Group information on immunisations

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Medical content reviewed by Professor Sir Andrew Pollard .Please click here to contact us if you have comments about the Vaccine Knowledge website. We can't answer all the individual queries we get, but we will use your suggestions and questions to improve the website.

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you think you or your child have missed any vaccinations

you or your child have a vaccination appointment - but you've missed it or cannot attend

Your GP surgery can book or rearrange an appointment.

It's best to have vaccines on time, but you can still catch up on most vaccines if you miss them.

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A full list of the routine vaccinations offered on the NHS and when they should be given.

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Immunisation information for health professionals and immunisation practitioners.

Documents

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Details

The schedule was revised in September 2023 to include changes to the human papillomavirus ( HPV) and shingles programmes.

Translated versions of the schedule will be available soon.

For older versions of the complete routine immunisation schedules, see the UK Government web archive:

Translated versions of the schedule are available to download as a PDF in:

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Immunisation information for health professionals and immunisation practitioners.

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Evidence based practical advice - download 2025 version here

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Understanding your mental health and emotional wellbeing (fathers)

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Understanding your mental health and emotional wellbeing (fathers)

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Understanding your mental health & emotional wellbeing (mothers)

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Understanding your mental health & emotional wellbeing (mothers)

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Talking Therapies for Mental Health Support

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Talking Therapies for Mental Health Support

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If you think you might be stressed, anxious or depressed, you can refer yourself to our service or you can ask your GP or a healthcare professional for a referral.

We also offer a range of free wellbeing webinars on demand that include helpful wellbeing tips and techniques to help you feel better.

If English is not your first language, let us know and we can arrange for an interpreter to be present for your sessions.

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If you think you might be stressed, anxious or depressed, you can refer yourself to our service or you can ask your GP or a healthcare professional for a referral. We also offer a range of free wellbeing webinars on demand that include helpful wellbeing tips and techniques to help you feel better.

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Are you pregnant or have recently given birth? Are you struggling with your mental health?

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Are you pregnant or have recently given birth? Are you struggling with your mental health?

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How to get urgent mental health support 

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How to get urgent mental health support 

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you are not able to speak to your local NHS urgent mental health helpline

you need help urgently for your mental health, but it's not an emergency

you're not sure what to do

111 will tell you the right place to get help if you need to see someone.

You may be able to speak to a nurse, or mental health nurse, over the phone.

A GP can advise you about helpful treatments and also help you access mental health services. You may be able to refer yourself to some services.

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Where to get urgent help for mental health

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You may need urgent help for mental health for many different reasons. Some people call it a crisis, an emergency or a breakdown. It's important to know that support is available, whatever you're going through.

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Vitamin supplements

The government recommends all children aged 6 months to 5 years are given vitamin supplements containing vitamins A, C and D every day.

Babies who are having more than 500ml (about a pint) of infant formula a day should not be given vitamin supplements. This is because formula is fortified with vitamins A, C and D and other nutrients.

Babies who are being breastfed should be given a daily vitamin D supplement from birth, whether or not you're taking a supplement containing vitamin D yourself.

Where you can get baby vitamin drops

Your health visitor can give you advice on vitamin drops and tell you where to get them.

You're entitled to free vitamin drops if you qualify for Healthy Start.

The Department of Health and Social Care only recommends vitamin supplements containing vitamins A, C and D.

But some supplements you can buy contain other vitamins or ingredients. Talk to a pharmacist about which supplement would be most suitable for your child.

Having too much of some vitamins can be harmful. Keep to the dose recommended on the label, and be careful not to give your child 2 supplements at the same time.

For example, do not give them cod liver oil and vitamin drops because cod liver oil also contains vitamins A and D. One supplement on its own is enough, as long as it contains the recommended dose of vitamin D.

Vitamin D

Vitamin D is only found in a few foods, such as oily fish and eggs. It's also added to some foods, such as fat spreads and breakfast cereals. But it's difficult to get enough vitamin D from food alone.

The main source of vitamin D is summer sunlight on our skin. But it's important to keep your child's skin safe in the sun.

Children should not be out in the sun too long in hot weather. Remember to cover up or protect their skin before it turns red or burns.

Young children should still have vitamin drops, even if they get out in the sun.

The Department of Health and Social Care recommends:

Babies from birth to 1 year of age who are being breastfed should be given a daily supplement containing 8.5 to 10 micrograms of vitamin D to make sure they get enough. This is whether or not you're taking a supplement containing vitamin D yourself.

Babies fed infant formula should not be given a vitamin D supplement if they're having more than 500ml (about a pint) of infant formula a day, because infant formula is fortified with vitamin D and other nutrients.

Children aged 1 to 4 years old should be given a daily supplement containing 10 micrograms of vitamin D.

Vitamin A

Vitamin A is important for babies and young children, and some may not be getting enough.

It's needed for a healthy immune system, can help their vision in dim light, and keeps skin healthy.

Good sources of vitamin A include:

dairy products

fortified fat spreads

carrots, sweet potatoes, swede and mangoes

dark green vegetables, such as spinach, cabbage and broccoli

Vitamin C

Vitamin C is important for your child's general health and immune system. It can also help their body absorb iron.

Good sources of vitamin C include:

A balanced diet for babies and young children

It's important for children to eat a wide variety of foods to make sure they're getting all the energy and nutrients they need to grow and develop properly.

Get more advice and information on a balanced diet for babies and young children:

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Find out why vitamins are important for the health of your baby or young child, and which vitamin supplements they should take.

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Need some breastfeeding support? We have a virtual breastfeeding group every Thursday from 10:00 - 11:00. Just click below to join.

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Need some breastfeeding support? We have a virtual breastfeeding group every Thursday from 10:00 - 11:00. Just click below to join.

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Here are some ways to comfort your baby.

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How to manage your baby's umbilical granuloma

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Advice on how to care for your baby's sticky eye

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Red
If your baby has any of the following:

Unable to open eye due to swelling

Severe pain and red eye

Becomes pale, mottled and feels abnormally cold to touch

Has pauses in their breathing lasting more than 10 seconds, is grunting or has blue lips

Is stiff or rigid or makes repeated, jerky movements of arms or legs that doesn't stop when you hold them (a fit or seizure)

Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)

Develops a rash that does not disappear with pressure (the 'Glass Test')

Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

Amber
If your baby has any of the following:

Yellow/green discharge from one or both eyes

Redness of the whites of the eyes/around the eyes

Swelling of the eyes

Worsening symptoms or if you are worried

Difficulty breathing, including breathing fast all of the time; widening their nostrils or pulling in of the muscles below the ribs when breathing

Not interested in feeding and/or looks dehydrated (dry mouth, sunken eyes, no tears, drowsy, no wet nappies in the last 8 hours or sunken fontanelle (soft spot on the head))

Is becoming drowsy (excessively sleepy) or irritable (unable to settle them)

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

Green
If your baby has none of the above features:

It is normal for a baby to have sticky yellow or white discharge in the corner of one or both eyes and can cause the eyelashes to stick together. This can last for several months.

Self care

Continue providing your child's care at home.

It normally clears up on its own, but you may have to clean your baby's eyes regularly with damp cotton wool. Use clean, cooled boiled water and wipe each eye from the corner by the nose outwards. Use a clean piece of cotton wool for each wipe.

Remember to wash your hands before and afterwards and avoid sharing towels.

If you are still concerned about your baby, speak to your health visitor, local pharmacist or call NHS 111- dial 111

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If your baby has any of the following: Unable to open eye due to swelling Severe pain and red eye Becomes pale, mottled and feels abnormally cold to touch Has pauses in their breathing lasting more than 10 seconds, is grunting or has blue lips Is stiff or rigid or

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A wealth of local and national information to keep your baby healthy

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Keeping my child healthy :: Bedfordshire, Luton and Milton Keynes

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We use some cookies necessary to making this website work. We also use additional cookies, such as those to record website analytics, which you can deny the use of. Learn more about our cookies

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Never to early to start with speech, language and communication

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Never to early to start with speech, language and communication

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Activities for 0-3 month olds - BBC Tiny Happy People

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A collection of fun sensory activities and things to do with babies aged 0-3 months. Find loads of baby brain activities that will help you to bond with your newborn and help with their early communication and listening skills.

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You don't need an appointment to attend a child health clinic.  At the clinic you can talk to the member of health visiting team about any concerns or questions you may have and they may put you in touch with another member of the team who can help with specific support, for example with breastfeeding, sleeping or behaviour.

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Water safety advice for babies and pre-school children 

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Water safety advice for babies and pre-school children 

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Royal Life Saving Society UK ( RLSS UK )

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Water Babies' "Top Tips for Water Safety"

Our strategic partnership with Water Babies reflects the wider acceptance that, to deliver our core purpose of preventing drowning and empowering everyone to enjoy water safely, we need to collaborate and innovate with others to pool together skills, passion, innovation and insight.

And just like the RLSS UK, Water Babies believes you're never too young to learn a skill for life.

Water Babies' Aquatics Director Hannah Smith, has compiled some top tips for your little one's water safety, from bath to beach!

Start swimming lessons as early as possible

Fear of the water is a learnt behaviour, so it is important to get your little ones accustomed to the water at a young age, and show them how to respond to this environment in a safe way.

It's really important not to pass on your own fears of the water. At Water Babies we see babies swimming from birth and have had pupils as young as a day old in our classes.

Make bath-time fun

Start introducing water to your baby in a fun environment by making bath time enjoyable with songs and toys. This positive association will then be transferred to the swimming pool and bigger water-based environments. But it's not just about having fun. For instance, did you know, children who take part in baby swimming reach developmental milestones such as counting to 10 much earlier than expected?

Be aware of your surroundings at the poolside

Be aware of the type of pool that your little one is swimming in and check the temperature. This should be a minimum 30 degrees and if your baby is under 12 weeks or 12 pounds, this needs to be 32 degrees or above. Take in the wider surroundings also and check if there is a lifeguard on duty, whether there are any slippery surfaces, where the deep end of the pool is and if there are any cracked tiles; as these are all factors to consider when ensuring water safety.

Kit your baby out in all the gear

There are lots of great things you can kit your baby out in - a floppy sun hat if you're outside, a happy nappy wetsuit if you're worried they might get a little chilly and for older toddlers, a float jacket can give them a little bit of independence (but make sure you don't leave them unsupervised).

Always keep an eye on your children

Always keep a watchful eye on your children, even if there is a lifeguard on duty.

Lifeguards are a great additional resource but do not solely rely on this. Designate an adult who can put their phone away whilst they keep an eye on the children who are both in and around the pool, and always keep non-swimmers within arm's length.

Floatation devices are not life preservers

Floatation devices can be a fun experience for babies, children and grown-ups alike, but they are not life preservers. Even if your little one has floats, you shouldn't take your eyes off them; they can float away with currents and tides, or even tip over with your little one inside.

Paddling pool and beach safety

Paddling pools are great fun in the garden on a hot summer's day, but always keep water safety a priority, even if your children are in a paddling pool with just a few inches of water. Once you're finished, empty out the water and tip the paddling pool over. And at the beach, always check whether there are trained lifeguards on duty, learn what the flags mean and obey them! Look out for signage about the site, and keep in mind possible rip currents and tides.

Learn Basic Life Support (BLS)

When it comes to emergency and survival, every second counts. At Water Babies, all our teachers are qualified lifesavers and are trained to carry out infant resuscitation (a qualification which they renew every two years). All teachers also carry:

First aid kits

First aid books

Mobile phones

Emergency action plans, customised for each pool

Local emergency numbers

If you are abroad, make sure you know the emergency number and it is always advisable to have a first aid kit with you.

Water Babies online

Water Babies believes that everyone should have the chance to build water confidence in their little ones. Whether you're learning in the sink, bath or swimming pool. Water Babies Learn is a series of online videos which contain a Water Babies teacher passing on their knowledge and expertise through handy practical videos, which show you key skills you can teach your little one, wherever you are. From getting baby 'comfortable with water', to 'holding on' and 'first swimming position', Water Babies videos are a valuable resource parents and carers can come back to, time and time again.

See the baby swimming tips and content for yourself on the Water Babies website!

You only have to spend a few minutes of your time watching any of the short, informative videos on the Water Babies website, to get a real feel for the comprehensive structure that goes into creating light-hearted learning and memorable water safety sessions, for the very youngest swimmers.

Lifesaving Academy 0-4-years membership

By becoming a member of RLSS UK, you can play a vital part in our work towards keeping the UK and Ireland free from drowning and ensuring that our future generations enjoy water safely.

Developed for infants and toddlers, our Lifesaving Academy membership initiates the development of a safe and enjoyable relationship with the water for your little one.

One of the many benefits of the membership is you will receive a welcome gift, including £10 Water Babies voucher to spend on products and our unique pack of milestone cards.
Find out more about Lifesaving Academy 0-4-years membership

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Resources for babies and pre-school children

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In partnership with Water Babies, we present top tips to encourage a nurturing relationship with the water and ensure water safety for babies and young children.

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Some parents choose to share a bed (also known as co-sleeping) with their babies. It is important for you to know how to do this safely and that there are some circumstances in which bed-sharing with your baby can be very dangerous.

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Find out how to keep children safe on our roads with our hub of road safety advice and resources to share. Road safety fact sheet It can be hard knowing how best to teach your child to stay safe around roads.

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We all chat with our babies, but did you know

you’re actually building their brain? And we’ve

got tips and advice to help you do it even more

.

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(Read this page in Welsh - Darllenwch y dudalen hon yn Cymraeg)

Just remember to Look, Say, Sing, Play

We've teamed up with Vroom™ to give you some fun and easy tips to help you bring even more Look, Say, Sing and Play into your daily routine with your baby or toddler.

Whether it's bathtime, bedtime or you're washing up, playing with your child, using silly voices, or even singing can build their brain right from birth. It's a great way to have fun while making your bond even stronger.

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Right from birth, every time you talk, sing or play with your child, you're not just bonding, you're building their brain. Get free brain-building tips.

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Skin-to-skin contact - Baby Friendly Initiative

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

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Travelling with a baby or toddler: the basics

If you want to stay put for a while when you have a newborn, that's understandable and totally normal. But when you are ready to head off, you will have all kinds of fun and adventures. Here are some tips to help things go as smoothly as possible.

Baby and toddler travel essentials

Think about what you'll need, particularly if the journey takes longer than planned. Stuff to tick off includes:

drinks and snacks

toys

nappies, wipes and changing mat

change of clothes.

(Which? 2018a, b)

Keep it all easily accessible and prep a few bags with one nappy, a small packet of wipes and some cream for easy dashes to the loo (Which? 2018a, b).

Baby and toddler holiday essentials

Things you'll probably need include:

a lightweight buggy

a baby carrier/sling

a travel cot

a first-aid kit, medicines and sun protection

travel blackout blinds.

If you're formula feeding, you'll also need to think about:

(Which? 2018b)

See our guide to sun safety for more tips.

Travelling with a baby or toddler: top tips

Try to organise your baby's passport in plenty of time (GOV.UK, 2018a). NB: this will involve the most hilarious photoshoot of your life.

If you are travelling to countries where you need a visa, you'll need to sort that out too (GOV.UK, 2012).

It's a good idea to apply for a free European Health Insurance Card (EHIC) for each member of your family if you're travelling in Europe (GOV.UK, 2018b).

Make sure you sort travel and health insurance before you go (annual family policies are often the best value) (GOV.UK, 2012).

Find out about required travel vaccinations (GOV.UK, 2012; Fit for travel, 2018)

Try not to rush - this will make journeys way more stressful.

It might be easier to go when your baby is young. Small babies are portable and often a lot more flexible than their toddler buddies. Usually infants must be at least two weeks old before they can travel although some airlines allow seven-day old infants on board. The booking policy differs from one airline to another, so it is important to check directly with the airlines (Which? c). But three to seven months is a great window (The Guardian, 2005).

Book outside the school holidays if you can - way cheaper and less crowded.

By plane

You can make full use of the facilities: lots of airports have dedicated areas for entertaining children and have buggies you can use. Some airlines also let you keep your own pushchair with you right up to the boarding gate.

Try to keep stuff you need for your baby or toddler in your hand luggage.

It's always good to check the weight limit for your airline before you travel.

Children under two years old usually sit on your lap, so taking a cushion or blanket can help.

On long-haul flights, you can request a bassinet for them to sleep in. Travelling at night can help them stick to their usual routines too.

A baby carrier or sling for very young children and a back/hip carrier for toddlers is great for walking babies up and down the aisles. It also keeps your hands free.

It's good to find out from the airport and your airline about the rules for fluids allowed through security and in cabin baggage.

If you need transfers from the airport, check with your airline about taking your baby car seat, or arrange to hire one when you get there.

If possible, sit in an easily accessible seat on the plane.

Changing cabin pressure during take-off and landing can be uncomfortable for your children, you can ease the discomfort by feeding babies, giving toddlers a dummy and older children a sweet to suck on.

Attach a luggage label to your child's clothing with their name and flight number on it.

(Baby Can Travel, 2018b; Which? 2018a, b)

By train or bus

Always try to avoid rush hour. This means the carriages and buses are less crowded and there will be extra seats.

You'll thank yourself for checking which train stations have lifts for pushchairs.

It's best if you can avoid sitting in quiet zones on trains - other passengers may not be sympathetic to a chatty toddler or crying baby.

Try to use a sling or baby carrier rather than a buggy. It can be overwhelming arriving at a train station with a buggy, whereas using a sling will keep your hands free to find things like tickets.

Sit near the toilets on trains as there's often more space and flip-up seats for pushchair space. When you get off the train, watch gaps and get off backwards as it's often safer.

Plan the most direct route to avoid awkward train changes.

Reserve a seat, choosing a window seat for older babies and toddlers to look out of.

Pack a light bag with nappies, snacks and toys so you can stow other luggage in the rack.

Plan how you get from the train station to your final destination, e.g. whether you need to book a taxi with a baby seat.

(My Train Ticket, 2018; TFL, 2018).

By car

Try to time your journey around nap times and stop for breaks if you need.

If you need to, dispatch one parent to the back seat to keep your child company.

Take window blinds for bright sunshine and music for bored children. Warning: be prepared for long stints of Twinkle Twinkle.

Make sure you keep toys handy.

Stock up on essentials like snacks, water, formula, extra bottles, extra soothers.

Make sure your car seat meets all the safety criteria for your baby or toddler. Read our guidelines here and how to fit it here.

(Baby Can Travel, 2018c)
This page was last reviewed in March 2019
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about labour and life with a new baby.

Baby Can Travel. (2018a) Airline perks for families with babies. Available at: https://www.babycantravel.com/2015/11/11/airline-perks-for-families-with-babies/ [Accessed 15th October 2018]

Baby Can Travel. (2018b) Inflight entertainment for babies and toddlers. Available at: https://www.babycantravel.com/2017/04/27/inflight-entertainment-for-babies-and-toddlers/ [Accessed 15th October 2018]

Baby Can Travel. (2018c) Road trip with a baby: 7 essential tips. Available at: https://www.babycantravel.com/2015/09/14/road-trip-with-a-baby-7-essential-tips/ [Accessed 15th October 2018]

Fit for travel. (2018) Travel health advice. Available at: https://www.fitfortravel.nhs.uk/home Accessed 15th October 2018]

GOV.UK. (2012) Checklist for travelling abroad. Available at: https://www.gov.uk/government/publications/checklist-for-travellers--2 [Accessed 15th October 2018]

GOV.UK. (2018a) HM Passport Office. Available at: https://www.gov.uk/government/organisations/hm-passport-office [Accessed 15th October 2018]

GOV.UK. (2018b) Apply for a European Health Insurance Card. Available at: https://www.gov.uk/european-health-insurance-card [Accessed 15th October 2018]

My Train Ticket. (2018) Travelling by train with children. Available at: http://www.mytrainticket.co.uk/travelling-with-children [Accessed 15th October 2018]

TFL. (2018) Getting around with your buggy. Available at: https://tfl.gov.uk/transport-accessibility/getting-around-with-your-buggy [Accessed 15th October 2018]

The Guardian. (2005) Have baby, won't travel? Available at: https://www.theguardian.com/travel/2005/oct/22/familyholidays.family.guardiansaturdaytravelsection [Accessed 15th October 2018]

Which? (2018a) Top 10 baby and child travel tips. Available at: https://www.which.co.uk/reviews/travelling-with-children/article/travelling-with-children/top-10-baby-and-child-travel-tips [Accessed 15th October 2018]

Which? (2018b) Baby products to take on holiday. Available at: https://www.which.co.uk/reviews/travelling-with-children/article/travelling-with-children/baby-products-to-take-on-holiday [Accessed 15th October 2018]

Which? (2018c) What are my rights when flying with a baby? Available at: https://www.which.co.uk/consumer-rights/advice/what-are-my-rights-when-flying-with-a-baby [Accessed 15th October 2018]

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Baby and toddler travel: what you need to know before going ahead

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If you want to stay put for a while when you have a newborn, that's understandable and totally normal. But when you are ready to head off, you will have all kinds of fun and adventures. Here are some tips to help things go as smoothly as possible.

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Your baby will spend more time sleeping during their first two years than they will awake. Although it might not feel like it when you're yawning through a 3am feed. So getting things right with their sleeping environment is pretty crucial.

Watch our video to find out about safe sleep guidelines for babies.

What type of cot should I choose?

To keep your baby as safe as possible in their cot, check that it conforms to British Safety Standards BS EN 716:2008. You'll also need to follow these guidelines so they don't get trapped or climb out:

The distance between the top of the mattress and the top of the cot sides should be at least 50cm.

Cot bars should be vertical and the distance between them no more than 6.5cm.

If your cot has a solid head and footboard with shapes cut out, check that your baby's limbs can't get caught in them.

(Sengölge and Vincenten, 2013)

Second hand cots: are they safe?

Yes - if you stick to a few checks and rules:

Make sure the cot - even if old - conforms to current safety standards.

If it's vintage, it might need to be stripped down and repainted with paint that you've checked does not recommend against use on items like cots. Make sure it thoroughly dries. Cots made before 1973 could have been painted with leaded paint, which is toxic.

If the cot has a drop-down side mechanism, it's important to make sure it works properly. You should be confident it's secure and won't drop accidentally. If in doubt, it's safer not to use the cot.

Remove any stickers and transfers: they could be choking hazards.

Check there is nothing sticking out of the top rail that may catch on your baby's clothes.

Check that there is nothing your baby could use as a foothold to climb out with.

(Sengölge and Vincenten, 2013; ROSPA, 2019)

Does it matter where I put the cot?

As your baby is less able to control their temperature than you are, don't put it near a radiator or sunny window, for starters. Nearby blind cords should be secured safely and curtains and baby monitor cables need to be out of reach too (Sengölge and Vincenten, 2013).

Do I need to get a new mattress for my baby?

Ideally, you should buy a new mattress for any new baby.

However, the main reason for that is because of a possible small increased risk of SIDS in mattresses brought in from another home (Lullaby Trust, 2018).

So if the mattress has only been used by other children in your family, check that it:

has not got any cracks or tears

is firm, with no sagging

fits the cot snugly with no gaps

is clean and dry.

(Lullaby Trust, 2018)

You should also give the waterproof layer a clean before you use it and put a fresh sheet on the mattress.

What mattress should I choose for my baby?

Whatever sort of mattress you choose, it should conform to safety standards BS 1877-10:1997.

Mattresses come in either standard or continental size and go in their equivalent sized cot. Choose one that feels firm because your baby needs support while sleeping.

The mattress needs to be kept clean and dry so get one with a wipe-clean covering or a removable top panel that you can wash at a high temperature. Or use a mattress protector so that if (well, when...) your baby dribbles or their nappy leaks, the mattress won't get wet (Tappin et al, 2002; Lullaby Trust, 2016)

Baby bedding: what should I use?

When it comes to baby bedding, think the opposite to your pillow and duvet-laden cosy king size. Instead, your baby's cot should be as free from stuff as possible. Pillows and duvets are not safe for babies under one year old (Lullaby Trust, 2018).

Go for a fitted sheet and a light blanket tucked in below your baby's shoulder level. They should have their feet at the bottom of the cot or baby sleeping bag so they don't wriggle down (Nelson et al, 1989; Beal and Byard, 1995; Schellscheidtet al, 1997; Mitchell et al, 2008)

Are cot bumpers really unsafe?

Cot bumpers are not considered safe because of the risk of accidents once your baby can roll and move in their cot. Your baby can also climb onto them (Scheers et al, 2015).

What's the best way to protect my baby against SIDS?

Your baby should sleep on their back for all sleeps (see below).

Keep your baby in your bedroom for the first six months.

Keep your baby smoke-free during pregnancy and after birth. According to The Lullaby Trust, Around 60% of sudden infant deaths could be avoided if no baby was exposed to smoke during pregnancy or around the home.

Never sleep on a sofa or armchair with your baby.

Don't co-sleep with your baby if you or your partner has been drinking, is a smoker, has been taking drugs or is extremely tired.

Keep your baby's cot clear. All they need is a flat surface and simple bedding.

Make sure your baby doesn't overheat. The ideal room temperature is between 16°C and 20°C. And never use hot water bottles or similar products.

(Stanton, 1984; Nelson et al, 1989; Fleming et al, 1990; Blair et al, 1999; Fleming et al, 2000; Carpenter et al, 2004; Lullaby Trust, 2016)

What position should my baby sleep in?

Babies should sleep on their back with their feet at the foot of the cot to stop them wriggling down under the covers

(Beal and Porter, 1991; Beal and Byard, 1995; Schellscheidt et al, 1997; Fleming et al, 2000; Mitchell et al, 2008).

Can my baby sleep with a pillow or duvet?

Again, less is more for sleeping babies. Babies should not have any duvets or pillows (Lullaby Trust, 2018).

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

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

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

The Lullaby Trust has lots of useful information and support for parents about safe sleep.

Beal S, Porter C. (1991) Sudden infant death syndrome related to climate. Acta Paediatr Scand. 80(3):278-287. Available from: https://www.ncbi.nlm.nih.gov/pubmed/2035322 [Accessed 30th July 2018].

Beal SM, Byard RW. (1995) Accidental death or sudden infant death syndrome? J Paediatr Child Health. 31(4):269-271. Available from: https://www.ncbi.nlm.nih.gov/pubmed/7576879 [Accessed 30th July 2018].

Blair PS, Fleming PJ, Smith IJ, Platt MW, Young J, Nadin P, Berry PJ, Golding J. (1999) Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. CESDI SUDI Research Group. BMJ. 319(7223):1457-1462. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28288/ [Accessed 30th July 2018].

Carpenter RG, Irgens LM, Blair PS, England PD, Fleming P, Huber J, Jorch G, Schreuder P. (2004) Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet. 363(9404):185-191. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14738790 [Accessed 30th July 2018].

Fleming PJ, Bacon C, Blair PS, Berry PJ. (2000) Sudden unexpected deaths in infancy. The CESDI SUDI studies 1993-1996. London: The Stationery Office. [Accessed 30th July 2018].

Fleming PJ, Gilbert R, Azaz Y, Berry PJ, Rudd PT, Stewart A, Hall E. (1990) Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case-control study. BMJ. 301(6743):85-89. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1663432/ [Accessed 30th July 2018].

Galliers L. (2018) Second-hand cots. Available from: https://www.which.co.uk/reviews/cots/article/second-hand-cots [Accessed 30th July 2018].

Mitchell EA, Thompson JM, Becroft DM, Bajanowski T, Brinkmann B, Happe A, Jorch G, Blair PS, Sauerland C, Vennemann MM. (2008) Head covering and the risk for SIDS: Findings from the New Zealand and German SIDS case-control studies. Pediatrics. 121(6):e1478 - 1483. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18519451 [Accessed 30th July 2018].

Nelson EA, Taylor BJ, Weatherall IL. (1989) Sleeping position and infant bedding may predispose to hyperthermia and the sudden infant death syndrome. Lancet. 333(8631):199-201. Available from: https://www.ncbi.nlm.nih.gov/pubmed/2563105 [Accessed 30th July 2018].

Public Health England, Metropolitan Police, The Lullaby Trust. (2015) London child safety update - sudden unexpected deaths in infancy: Advice for people working with children, young people and families. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/431396/London_sudden_deaths_in_infancy_update_factsheet.pdf [Accessed 30th July 2018].

ROSPA. (2019) Bedtime: a safe cot. Available from: https://www.rospa.com/Resources/Hubs/Keeping-Kids-Safe-(1)/Bedtime.aspx [Accessed Jan 2020].

SATRA. (2018) Testing the safety of cot mattresses. Available from: https://www.satra.com/spotlight/article.php?id=475 [Accessed 30th July 2018].

Scheers NJ, Woodard DW, Thach BT. (2016) Crib bumpers continue to cause infant deaths: A need for a new preventive approach. The Journal of Pediatrics. 169:93-97. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26621044 [Accessed 30th July 2018].

Schellscheidt J, Ott A, Jorch G. (1997) Epidemiological features of sudden infant death after a German intervention campaign in 1992. Eur J Pediatrics. 156(8):655-660. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9266202 [Accessed 30th July 2018].

Sengölge M, Vincenten J. (2013) Child safety product guide: Potentially dangerous products. Birmingham: European Child Safety Alliance, EuroSafe. Available from: http://www.childsafetyeurope.org/publications/info/product-safety-guide.pdf [Accessed 30th July 2018].

Stanton AN. (1984) Sudden infant death. Overheating and cot death. Lancet. 324(8413):1199-1201. [Accessed 30th July 2018].

Tappin D, Brooke H, Ecob R, Gibson A. (2002) Used infant mattresses and sudden infant death syndrome in Scotland: case-control study. BMJ. 325:1007. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC131017/ [Accessed 30th July 2018].

The European Child Safety Alliance. (2013) Child product safety guide. Available from: http://www.childsafetyeurope.org/publications/info/product-safety-guide.pdf [Accessed 30th July 2018].

The Lullaby Trust. (2018) The best mattresses and bedding for your baby. Available from: https://www.lullabytrust.org.uk/safer-sleep-advice/mattresses-and-bedding [Accessed 30th July 2018].

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Cot safety, bedding and bumpers: your questions answered

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Your baby will spend more time sleeping during their first two years than they will awake. Although it might not feel like it when you're yawning through a 3am feed. So getting things right with their sleeping environment is pretty crucial.

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Baby milestones: Parenting tips | UNICEF

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UNICEF Baby friendly guide to Maximising breastmilk and supporting re-lactation

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UNICEF Baby friendly guide to Maximising breastmilk and supporting re-lactation

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First Steps Nutrition - simple guide Breastmilk and Breastfeeding 

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First Steps Nutrition - simple guide Breastmilk and Breastfeeding 

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First Steps Nutrition Trust is an independent public health nutrition charity. We endeavour to fill practical and policy-relevant information gaps and provide resources for health workers supporting eating well from pre-conception to five years.

Our Mission

To influence policies which enable the safe, appropriate and optimal feeding of infants and young children in the UK, and to protect them from commercial interest.

To ensure that the importance of good nutrition from pre-conception to age five remains on everyone's agenda.

To provide conflict of interest-free information on infant milks marketed in the UK, and to promote better regulation and marketing of breastmilk substitutes.

To provide resources for health workers to support them in their work with pregnant women and young families.

Our Resources:

Are put together by nutrition experts and are regularly updated.

Can be used in Unicef UK Baby Friendly Initiative accredited settings.

Are available as free pdf downloads for use by anyone promoting better public health on a not-for profit basis.

Everyone who works at First Steps Nutrition Trust feels passionately about the need for better information and support for good nutrition - and good food - from pre-conception to five years.

First Steps Nutrition Trust is supported by generous individual donations and conflict of interest free grants. First Steps Nutrition Trust does not work with organisations or individuals that work with, or take funding from, the breastmilk substitute industry and we reserve the right not to sell them our subsidised resources.

First Steps works with and supports a number of organisations including Unicef UK Baby Friendly Initiative, the Baby Feeding Law Group, the Obesity Health Alliance, the Children's Food Campaign and the APPG on Infant Feeding and Inequalities.

First Steps Nutrition Trust host and regularly update their partner site infantmilkinfo.org which contains comprehensive information about infant milks (for 0-12 month olds) available on the UK market.

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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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It is recommended that you avoid travelling in cars with pre-term and young babies for long distances. Research into the link between car seats and SIDS found young babies may be at risk of breathing difficulties if they sleep in a seated position for too long.

If your trip involves driving for long periods of time, you should stop for frequent breaks. This will allow you to check on your baby, take them out of the car seat and let them stretch and move around.

Ideally, a second adult should travel in the back of the car with your baby, or if travelling alone use a mirror to keep an eye on your baby. If your baby changes their position and slumps forward, then you should immediately stop, take them out of the car seat and sit them upright before continuing on your journey.

It is essential for safety that babies travel in a rearward-facing baby seats. Rearward-facing seats provide greater protection for the baby's head, neck and spine than forward-facing seats.

Babies should not sleep in car seats for long periods

Car seats are designed to keep babies safe while travelling, not as a main sleeping place. Car seats should only be used for transport and not as an alternative for cots or high chairs. It's OK for your baby to fall asleep in a car seat when travelling, but they should be taken out as soon as you get to your destination, and placed onto a firm, flat surface to sleep.

Overheating

Babies that get too hot are at a greater risk of SIDS. We advise removing any hats or outdoor clothing such as snowsuits and coats once your baby is in the car. The best way to check your baby isn't getting too hot is to feel their tummy or back of their neck. If their skin feels clammy or sweaty they are too hot, so remove a layer of clothing.

Make sure you have the right car seat for your baby's weight and it is fitted properly (many shops will help with this).

It is recommended that you do not buy or use a second-hand car seat as you cannot be certain of its history. It could have been involved in an accident and the damage may not be visible.

Car seats must conform to safety standards - United Nations standard, ECE Regulation 44.04 (or R 44.03) or to the new i-size regulation, R129. Look for the 'E' mark label on the seat.

Car seats and SIDS FAQs

Are babies at a greater risk of SIDS in a car seat?

Click here to open this question

Avoid travelling in cars with pre-term and young babies for long distances. Research published in 2016 by the University of Bristol looked at the health effects on babies of travelling in car seats. The study found pre-term and young babies may be at risk of breathing difficulties if travelling in an upright position in car seats for a long period of time.

You can read the findings of the research here: https://fn.bmj.com/content/102/2/F136

My baby often falls asleep in their car seat - can I leave them in there?

Click here to open this question

It's OK for your baby to fall asleep in a car seat when travelling, but they should be taken out of the car seat as soon as you get to your destination, and placed onto a firm, flat surface to sleep such as a cot or Moses basket.

For more information, download our car seats and SIDS fact sheet
Further safer sleep information available here

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It's OK for your baby to fall asleep in a car seat when travelling but research does show a link between car seats and SIDS

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Contraception and Breastfeeding - The Breastfeeding Network what are my options?

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This information can also be viewed as a PDF by clicking here.
The information provided is taken from various reference sources. It is provided as a guideline. No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used. Clinical decisions remain the responsibility of medical and breastfeeding practitioners. The data presented here is intended to provide some immediate information but cannot replace input from professionals.
According to the Family Planning Association ( www.fpa.org.uk/home) lactational amenorrhoea (LAM) can be up to 98 per cent effective (RCOG suggest over 98%) in preventing pregnancy if all of the following conditions apply:

you are fully breastfeeding - this means you are not giving your baby any other liquid or solid food and

your baby is less than six months old and

you have no periods.

The risk of pregnancy increases if:

you start breastfeeding less often especially if there are long intervals between feeds - both day and night, or

you stop night feeds or

you use a dummy/pacifier or

you give any artificial supplements

Even if a woman expresses breast milk, or if she is separated from her baby by more than a few hours, she cannot expect a high level of contraceptive protection (Valdes 2000, http://irh.org/projects/fam_project/lactational-amenorrhea-method-lam/). Dummy/pacifier use which may decrease feeding frequency increasing the risk of return of fertility (Ingram 2004). Once your baby is over six months old the risk of getting pregnant increases, so even if you don't have periods and are fully breastfeeding, you should use another contraceptive method (FPA).

During the pandemic many Trusts began providing Long acting reversible contraception (LARC) immediately after delivery as many women were having difficulty obtaining contraception. This is being adopted widely (https://www.fsrh.org/standards-and-guidance/documents/fsrh-ceu-provision-of-contraception-by-maternity-services-after/). If changes in supply/difficulty in establishing a full breastmilk supply please submit a yellow card report https://yellowcard.mhra.gov.uk/.

The progesterone only contraceptive pill (mini-pill) is generally recommended during breastfeeding. It needs to be taken at the same time every day continuously - a delay of more than 3 hours may mean contraceptive protection is lost. The POP is generally started a minimum of 3 weeks after delivery but ideally no less than 6 weeks to avoid interfering with milk production. Vomiting and severe diarrhoea can interfere with absorption. New UKMEC guidelines (2016) suggest that use from birth will not diminish supply. This is at variance with the experience of many breastfeeding workers and is currently a cause for concern. Decisions should be made with mothers fully informed about the risk of initiating contraception early.

Oral progestogen-only contraceptives can be started up to and including day 21 postpartum without the need for additional contraceptive precautions. If started more than 21 days postpartum, additional contraceptive precautions are required for 2 days. In most cases contraception is initiated at the 6 week post natal check. Initiation too early after delivery may interfere with priming of prolactin receptors.

Normally, the POP does not affect lactation but I have had anecdotal reports from quite a few women who have noted a rapid drop in milk supply after beginning it. Anyone noticing such an effect should report it to the MHRA via http://yellowcard.mhra.gov.uk/

Brand names; Desogestrel (Cerazette®), Ethynodiol diacetate (Femulen®), Norethisterone (Micronor ®, Noriday®), Levonorgestrel (Norgeston ®)

The progesterone depo injection is often given to new mothers, particularly younger ones who value not having to remember to take a tablet daily. Medroxyprogesterone acetate (Depo Provera®) can be used 6 weeks after delivery in breastfeeding women (5 days after birth if not breastfeedig) and repeated every 12 weeks. It is used 5 days after delivery for mothers who do not intend to breastfeed. Too early use may interfere with prolactin priming.

Norethisterone enantate (Noristerat®) is not advised if baby has symptoms of severe or persistant jaundice - it is repeated every 8 weeks.

Etonogestrel releasing implant (Nexplanon®) consists of a single, radiopaque, rod-shaped implant. It must be removed no later than by the end of the third year. It can be inserted 28 days post-partum.

In light of the response of some mothers to oral preparations of progesterone it may be advisable to try one month of tablets before using any depo product to rule out any lowering a milk supply.

Intra- uterine Progestogen-only contraceptives release levonorgestrel directly into the uterine cavity. The Mirena® system is used as a contraceptive method for women with excessively heavy periods. It can be inserted 6 weeks after delivery and is effective for 5 years. As with the depo injection in light of the response of some mothers to oral preparations of progesterone, it may be advisable to try one month of tablets before using the coil.

An IUD is a small plastic and copper device that is inserted into the uterus. There are different types and sizes of IUD to suit different women. An IUD can stay in for 5-10 years, depending on type. An IUD is sometimes called a 'coil'. Simple coils can be used in breastfeeding mothers without complication as no medication is involved.

See separate fact sheet.

According to the most recent UKMEC guidelines (2016) "Based on breastfeeding status alone, CHC can be used by breastfeeding women safely after 6 weeks following childbirth"

This is at variance with the previous guidelines that the combined pill is not suitable for a breastfeeding mother in the first 6 months after delivery and with the experience of many breastfeeding workers and is currently a cause for concern. Decisions should be made with mothers fully informed about the risk of initiating contraception early.

In theory after this time the supply is established and will not be lowered by the oestrogen content of the combined pill. However, some mothers do notice an effect so the decision to use it should not be undertaken lightly if you want to carry on breastfeeding. If you take it and do notice your supply diminishes you can stop taking it (remember to take additional precautions!) and re-stimulate your supply with frequent breastfeeds.

Brand names: Gedarel® 20/150, Mercilon®, Femodette®, Millinette® 20/75, Sunya 20/75®, Loestrin 20®, Gedarel® 30/150, Marvelon®, Yasmin®, Femodene®, Katya 30/75®, Millinette® 30/75, Levest®, Microgynon 30®, Ovranette®, Rigevidon®, Loestrin 30®, Cilest®, Brevinor®, Ovysmen®, Norimin®,Norinyl-1®, Femodene® ED, Microgynon 30 ED®, Triadene®. Logynon®. TriRegol®, BiNovum®, Synphase®, TriNovum®, Logynon ED®, Qlaira®

The contraceptive patch contains Ethinylestradiol with Norelgestromin (Evra®) so is a combined oral contraceptive which may reduce supply depending on the time when it is first used. The instructions are: apply first patch on day 1 of cycle, change patch on days 8 and 15; remove third patch on day 22 and apply new patch after 7-day patch-free interval to start subsequent contraceptive cycle.

Barrier methods of contraception such as condoms, diaphragms and caps have no implications for breastfeeding. Lubricants and spermicides are also compatible with breastfeeding.

If mothers notice lowered milk supply with early use of progesterone only contraception or combined oral contraception, a yellow card report should be filed https://yellowcard.mhra.gov.uk/. Until evidence is collected to support the concerns of breastfeeding advocates breastmilk supply may be put at risk in mothers who have not had the opportunity to make fully informed decisions.

Hale Medications and Mother's Milk (online access Jan 2017) "Clinicians should suggest that the mother establish a good milk production prior to beginning oral contraceptives. Avoid combination (estrogen-progestin) contraceptives it at all possible. Use oral progestin-only preparations initially preferably after 4 weeks postpartum. Warn mothers that even progestin-only preparations may suppress milk production and to discontinue them at the first sign of low milk supply. Use medroxyprogesterne (Depo-Provera) only in those patients who have used it previously and have not experienced breastfeeding problems, or in those who have used progestin-only mini pills without problems. Attempt to wait for 4 weeks postpartum prior to using medroxyprogesterone. The transfer of progestins and estrogens into breastmilk is exceedingly low, and numerous studies confirm that they have minimal or no effect on sexual development in infants.
Suggestions for OC therapy

1. Always start with an oral progestin-only pill first, if only for a month. If milk production is sustained, then continue on the oral preparation, or a sustained release preparation like Depo medroxyprogesterone may be suitable.

2. Avoid using any form of progesterone the first week postpartum, as these may suppress early milk production.

3. Avoid estrogen-containing preparations, particularly early postpartum. While controversial, extensive clinical experience with these preparations suggest caution as signficant loss of milk supply has been frequently reported.

4. We have numerous reports of loss of milk supply following placement of Mirena IUDs. While one suggests no such loss, caution is recommended until this is clear"

5. World Health Organization (WHO) Task Force on Oral Contraceptives. Effects of hormonal contraceptives on breast milk composition and infant growth. Stud Fam Plann. 1988 NovDec;19(6 Pt 1):361-9. "Breast milk volume and composition and infant growth were measured at three- and four-week intervals, up to six months, in a multicenter randomized double-blind trial comparing a low-dose combined oral contraceptive (OC) with a progestogen-only OC. A nonrandom group using nonhormonal methods was also studied in the three centers: Szeged, Hungary; Bangkok, Thailand; and Khon Kaen, Thailand. A fourth group, users of depot-medroxyprogesterone acetate (DMPA) was included in the two Thai centers. Altogether, 341 women were recruited into the study. Combined OCs caused a significant decrease in milk output and total energy content as well as widespread changes in milk constituents. In the DMPA group, no significant changes were observed in milk volume, and only minor shifts occurred in milk composition, which varied between centers. No differences were found between the progestogen-only pill and DMPA. No hormonal contraceptive was associated with any significant difference in infant weight or fat fold, nor in the rate of discontinuation for failure to gain weight. This study reiterates the need to avoid combined OCs during the first few weeks or months of lactation. Both norgestrel and DMPA appear to be safe for use in both developing and developed countries, at least when the nutritional status of the mother and infant are adequate, but further research is needed on the safety of these contraceptives in populations with malnutrition."

6. Lopez LM, Grey TW, Stuebe AM, Chen M, Truitt ST, Gallo MF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2015 Mar 20;(3):CD003988. doi: 10.1002/14651858.CD003988.pub2. Older studies often lacked quantified results. Most trials did not report significant differences between the study arms in breastfeeding duration, breast milk composition, or infant growth. Exceptions were seen mainly in older studies with limited information. For breastfeeding duration, two of eight trials indicated a negative effect on lactation

Mothers should be enabled to make an informed decision based on their own family circumstances, the risk of pregnancy and be aware of the need to be alert for lowered milk supply. Breastfeeding advocates world wide seem to be aware of anecdotal reports of lowered, lost milk supply but these reports do not appear to have been published leading to variance with academic researchers.

With thanks to Sarah Panzetta for her valuable input on fertility awareness and LAM.

©Dr Wendy Jones MBE, MRPharmS and the Breastfeeding Network May 2021

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Contraception and Breastfeeding - The Breastfeeding Network

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This information can also be viewed as a PDF by clicking here. The information provided is taken from various reference sources. It is provided as a guideline. No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used.

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Positions for Breastfeeding - Breastfeeding Series

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The NBH is open 9.30am to 9.30pm every day of the year. It is staffed by trained volunteers and offers friendly, non-judgemental, independent, evidence based breastfeeding support and information to anyone the UK who needs it.

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National Breastfeeding Helpline - Helpline

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Resources about infant feeding in other languages

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Resources about infant feeding in other languages

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Using straightforward language and simple illustrations to aid understanding, these infosheets on breastfeeding and bottle feeding are available in multiple languages and can be used to support parents with the basics of feeding and responding to their baby.

The infosheets are free to download and print, and are currently available in:
Please note: Following feedback, these translations were updated in 2019 to ensure the language used was as straightforward as possible.
The English versions of these resources are available below for reference:

Breastfeeding guidance: English (for reference)

Bottle feeding guidance: English (for reference)

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Foreign language resources - Baby Friendly Initiative

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These infosheets are available in multiple languages and can be used to support parents with feeding and responding to their baby.

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Why and what is breast compression?

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Breast compression is a way of gently squeezing the breast during a breastfeed to put pressure on the milk glands causing them to release more milk and increase milk flow. Breast compression simulates a milk let-down (milk ejection reflex). Increasing milk flow in this way encourages a baby to keep sucking actively because he will be rewarded with more milk and this makes for more effective breastfeeding. As well as keeping a baby feeding actively at the breast for longer, breast compression can help to increase a milk supply by ensuring the breasts are more thoroughly emptied. The more frequently and thoroughly a baby breastfeeds and empties the breasts, the more milk will be made.

How do I do breast compression?

Breastfeed your baby as usual with a deep latch and good breastfeeding position.

During the breastfeed, watch for the moment when your baby stops sucking actively (the deep jaw movements slow down and you can't hear any swallows).

Using a free hand, cup and squeeze the breast between thumb and fingers e.g. with the thumb on top of the breast and the fingers of the same hand below it. Alternatively, some mothers press the breast against the chest wall or have their fingers on top of the breast and their thumb below.

Place your hand far enough behind the nipple and areola so you don't disturb your baby's latch but close enough to apply gentle pressure on the milk glands in the breast.

Avoid sliding your thumb or fingers along the breast and do not press so firmly that it is uncomfortable or painful.

Once milk starts to flow again, due to breast compression, your baby will start swallowing again. Maintain the pressure while he is still sucking and swallowing and then release the pressure and rest your hand when your baby pauses.

Repeat the compressions until there is no active swallowing.

Once baby stops actively sucking on the first breast even with compression, offer the other breast and repeat.

Pictures of breast compression

In the picture below, the baby is feeding in rugby hold on the left breast, and the mother uses her right hand to compress the breast and increase milk flow.

In the next picture the baby is feeding in cradle hold. The mother may need to move her thumb closer to her baby before compressing the breast but she can experiment to see what works for her.

Finding the right pressure

A little practice will reveal how much gentle pressure is needed to reproduce a let down. The principle is similar to filling a rubber glove with water and squeezing it to find the leak-when you apply just enough pressure, water will spurt from any tiny holes in the rubber. Breast compression is sometimes compared to hand expressing breast milk into your baby's mouth.

Jack Newman-Canadian paediatrician and breastfeeding expert-popularised this technique, he explains:

Excerpt from

Breast Compression, Jack Newman, updated June 2017 [accessed Sep 2017]

As long as it does not hurt your breast to compress, and as long as the baby is "drinking" ("open mouth wide-pause-then close mouth type" of suck), breast compression is working.

Keep the pressure up until the baby is just sucking without drinking even with the compression, and then release the pressure.

Will breast compression cause a blocked duct?

In the past mothers have often been cautioned against pressing on the breasts during a breastfeed for fear of causing a blocked duct. However, when done correctly and gently-to get baby sucking again, breast compression is a very useful technique for increasing milk flow and does not appear to cause problems. The key is not to press into the breast constantly throughout a feed, but to squeeze and release the breast at intervals as outlined above.

When do I need to use breast compression?

If breastfeeding is going perfectly well and your baby is getting enough milk and gaining weight you won't need to worry about using breast compression. However if you have a low milk supply, a baby who is not gaining weight or a sleepy baby, breast compression can be very useful to maximise your baby's milk intake. Jack Newman has a list of the times when breast compression is particularly useful:

Excerpt From

Breast Compression, Jack Newman, updated June 2017 [accessed Sep 2017]:

The technique may be useful for:

1. Poor weight gain in the baby

2. Colic in the breastfed baby

3. Frequent feedings and/or long feedings

4. Sore nipples in the breastfeeding parent

5. Recurrent blocked ducts and/or mastitis

6. Encouraging the baby who falls asleep quickly to continue drinking not just sucking

7. A "lazy" baby, or baby who seems to want to just "pacify". Incidentally babies are not lazy, they respond to milk flow, so that if flow slows, babies may start to fall asleep, or if they are older, may pull away from the breast.

Videos of breast compressions

In the video clip below, Dr Jack Newman explains when to do breast compressions during a breastfeed. The mother cups her breast with her hand, her thumb rests on top of the breast and her fingers are below it. When baby is not swallowing the mother compresses her breast and her baby starts drinking well. Mother rests her hand when her baby stops drinking.

In this second video clip from Global Health Media breast compression is discussed as one of a range of ideas to increase milk supply. To jump to breast compression go to 2:05. Note the mothers in this video are using slightly different techniques to achieve breast compression compared to the first clip.

Summary

Breast compression is a useful technique to keep breast milk flowing during a breastfeed by gently squeezing and compressing the breast. Breast compression can increase milk flow, keep a baby feeding longer and, by emptying the breasts more thoroughly, it also helps to increase milk supply.

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Breast compression is a way of gently squeezing the breast during a breastfeed to put pressure on the milk glands causing them to release more milk and increase milk flow. Breast compression simulates a milk let-down (milk ejection reflex).

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Urgent Safety Alert issued for baby self-feeding pillows Self-feeding pillows/prop feeders present a risk of serious harm or death from choking or aspiration pneumonia.

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Urgent Safety Alert issued for baby self-feeding pillows Self-feeding pillows/prop feeders present a risk of serious harm or death from choking or aspiration pneumonia.

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Self-feeding pillows/prop feeders present a risk of serious harm or death from choking or aspiration pneumonia.

The Office for Product Safety and Standards has issued an Urgent Safety Alert for baby self-feeding pillows and is urging the public to stop using them immediately and dispose of them safely.

Businesses selling these products must immediately remove them from the market as they cannot comply with the safety requirements under the General Product Safety Regulations 2005.

Baby self-feeding pillow products are designed to be attached to a bottle so that the baby may be positioned on its back to self-feed without the assistance of a caregiver holding the bottle and controlling the feed.

This is inconsistent with NHS guidance in relation to safe bottle feeding.

When used as intended, even whilst under the supervision of a caregiver, it could lead to immediate, serious harm or death from choking or aspiration pneumonia.

Consumers, local authority trading standards services and businesses are asked to take specific action to cease use or remove these products from the market as advised below.

Action

OPSS has identified that this category of products will always be dangerous due to their design and intended use and can never be made safe.

Consumers

Consumers should immediately stop using these products and dispose of them safely.

Businesses

Must immediately remove these products from the market as they cannot comply with the safety requirements under the General Product Safety Regulations, 2005.

Must comply with their obligations under product safety law.

Local Authority Trading Standards and Northern Ireland Environmental Health

Should identify and take appropriate action against businesses that sell baby self-feeding pillows as they do not comply with the safety requirements set down in the General Product Safety Regulations, 2005.

Visit the Office for Product Safety and Standards web pages on GOV.UK for further information and contact details.

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Caring for your baby at night and when sleeping

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Caring for your baby at night and when sleeping

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If you need contraception, testing or treatment for sexually transmitted infections, HIV testing or related advice we can help.

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If you're looking for contraception, testing or treatment for sexually transmitted infections, HIV testing or related advice in Milton Keynes, we can help.

We also work with Terrence Higgins Trust, who provide sexual health education and community outreach services including free condoms, health promotion and targeted education.
Looking for routine sexual health screening?
It's never been easier to have a routine sexual health screen; simply order a kit by clicking on the image and it will be delivered to your door in plain packaging. Then complete the test and pop it back to us freepost. Alternatively you can pop into clinic and pick up a kit to take away.

However, if you can't order a kit online, please call us on 0300 300 3030.

To find out more about what we offer in Milton Keynes, please click the tile below.

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If you're looking for contraception, testing or treatment for sexually transmitted infections, HIV testing or related advice in Milton Keynes, we can help. We also work with Terrence Higgins Trust, who provide sexual health education and community outreach services including free condoms, health promotion and targeted education. Looking for routine sexual health screening?

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The body's hormones naturally go up and down. The hormonal methods of contraception work by levelling the ups and downs, and by stopping an egg being released (ovulation). The hormones in contraception are very similar to the body's natural hormones, but the levels are steady instead of up and down.

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Contraception after birth should be discussed during your pregnancy and again soon after giving birth. If you do not wish to become pregnant again, contraception will be needed after your baby reaches the age of 21 days. There are many choices available for women. If you feel your family might be complete, long-acting methods or sterilisation should be discussed. If you want to have more children soon, choose an option that is easily stopped.

The time for fertility to return is very variable between women. It is important not to take any risks, if you do not want to become pregnant again. Therefore, you should decide on the type of contraception you are going to use as soon as possible after birth, or even during your pregnancy - your midwife can discuss this with you. You will need contraception from 21 days after your baby is born.

Your periods usually return about four to ten weeks after your baby's birth if you are bottle-feeding, or combining breast and bottle. If you are breastfeeding then your periods may not start until much later. For some women this might be after you have stopped breastfeeding.

You can have sex as soon as you and your partner feel ready to. Some people find it takes a while to feel ready, both physically and emotionally. If you have had stitches, these are usually dissolvable so will not need removing. If you are having any discomfort from these then you should see your doctor or midwife. Some women find they need to use some vaginal lubricant if they feel more dry than normal.

If you had your baby in hospital, you might have discussed contraception with your midwife before you were discharged home. You will also be asked about contraception at your six-week (or eight-week) postnatal check. You can discuss it at any time with your health visitor, midwife, GP or local family planning clinic. In some areas, the clinics that used to be called 'family planning' are now called 'CaSH' (contraception and sexual health).

When you breastfeed, a hormone called prolactin is produced by your body, which stimulates the production of your milk. Prolactin also blocks the release of the hormones which make you produce an egg. This means that you are less likely to become pregnant whilst you are breastfeeding.

You can use breastfeeding (the lactation amenorrhoea method) for contraception if you are:

Fully breastfeeding, meaning:

Your baby is not having any solids or any other liquid; or

You are nearly fully breastfeeding - you are mainly breastfeeding and only giving your baby other liquids very infrequently.

You are feeding at least every four hours during the day and at least every six hours at night;

AND not having periods.

AND six months or less since having your baby.

Fewer than 2 women in every 100 using this will become pregnant within those six months. This is less reliable than some other methods - for example, the implant for which only one woman in every 2,000 will become pregnant per year.This method becomes even less reliable once you start dropping feeds, particularly night feeds. When you stop fully (or nearly fully) breastfeeding, you can become pregnant. Many women decide to use some contraception in addition to breastfeeding, to reduce their risk of an unplanned pregnancy. There are methods available that will not affect your ability to produce milk.

All the methods of contraception listed below are effective but none is 100% reliable. Reliability of each method is written in terms of how many failures there are for each 1,000 women using it. For example, between 2 and 60 women in 1,000 women using the contraceptive injection for a year will become pregnant. When no contraception is used, more than 800 in 1,000 sexually active women become pregnant within one year.

The effectiveness of some methods depends on how you use them. You have to use them properly or they are less effective. For example, 3 women in 1,000 using the 'pill' perfectly for a year will become pregnant. Nearer to 90 women in 1,000 using the pill normally or typically (ie not perfect usage) will become pregnant. Examples of 'not perfect use' might be missing a pill or being sick (vomiting). In these situations it becomes less effective. Other 'user-dependent' methods include barrier methods, the progestogen-only pill (POP) and natural family planning, which has a very high failure rate of around 240 women in 1,000.

Some methods are not so 'user-dependent' and need to be renewed only infrequently or never. These methods include the contraceptive injection, contraceptive implant, intrauterine contraceptive devices (IUCDs), and sterilisation.

When you choose a method of contraception after birth you need to think about:

How effective it is.

Possible risks and side-effects.

Plans for future pregnancies.

Personal preference.

Whether or not you are breastfeeding.

If you have a medical condition, or take medicines that interact with the method.

The types of contraception after birth can be divided into short-acting, long-acting and permanent. If you are planning on having another baby in the next year or so then you should consider a short-acting contraceptive.

See the separate leaflets on each method for more details.

Combined oral contraceptive (COC) pill

The COC is often just called 'the pill'. It can be started from 21 days after the birth if you are not breastfeeding, although a woman who starts at three weeks is at a slightly higher risk of blood clots than one starting at six weeks. Previous guidance stated that you should not use combined hormonal contraceptive (CHC) methods until your baby is 6 months old, if you are breastfeeding. This was because it was thought to affect your milk supply. Research has shown this is not the case; breastfeeding women can now start any method of CHC at six weeks. Generally, if you wish to use CHC methods such as the pill, patch or vaginal ring, the benefits to you will outweigh the risks. This is however not the case for some women - for example, those with a strong family history of blood clots, or who have a particular type of migraine called migraine with aura. Your healthcare professional can assess your individual risk and advise you on whether it is safe to use CHC.

Progestogen-only pill (POP)

The POP used to be called the 'mini-pill'. It is commonly taken, especially if CHC methods are not suitable, such as in breastfeeding women if their baby is less than 6 weeks old, smokers over the age of 35 and some women with migraine.

The POP can be started immediately after the birth. It is safe for women who are breastfeeding. Studies have shown that a very small amount of the hormone can be present in breast milk but that it does the baby no harm.

Contraceptive patch

This contains the same hormones as the COC, but in patch form. It is as effective as the COC pill at preventing pregnancy. It can be started from 21 days after the birth if you are bottle-feeding, although this carries a slightly higher risk of blood clots than starting at six weeks. It may be used after six weeks when you are breastfeeding, as the benefits generally outweigh the risks.

The contraceptive vaginal ring

The contraceptive vaginal ring is a flexible plastic ring which you put into your vagina. It contains similar hormones to those in the COC pill. It can be used from 21 days after your baby is born if you are bottle-feeding although this carries a slightly higher risk of blood clots than starting at six weeks. You may be able to use this method after six weeks if you are breastfeeding, as the benefits generally outweigh the risks.

Barrier methods

These include male condoms, the female condom, diaphragms and caps. They prevent sperm entering the womb (uterus). You can use male and female condoms as soon as you feel ready to have sex after your baby is born. If you are concerned about sexually transmitted infections then it is always sensible to use a barrier method as well as any hormonal contraception.

Natural family planning involves fertility awareness. There is a great variation in how effective it is because it depends on the user doing it right. There are various apps that can be used to assist with natural family planning.

The lactation amenorrhoea method is a suitable form of contraception for the first six months after having a baby, if you are only breastfeeding and do not have a period. 2 women in 100 will conceive during those six months using this method.

These are more suitable forms of contraception for women who do not want to get pregnant again or for a few years.

Contraceptive injection

The contraceptive injection contains a progestogen hormone which slowly releases into the body. It is very effective and can be started immediately after the birth.

Contraceptive implant

The contraceptive implant is a small device placed under the skin. Each implant lasts three years. The implant can be inserted immediately after the birth of your baby.

Intrauterine contraceptive device (IUCD)

The IUCD is a small device made of plastic and copper which is put into the womb. It lasts 5-10 years, depending on the type. An IUCD can be inserted in the first two days after giving birth, or four weeks after giving birth. The risks of inserting one between two days and four weeks after giving birth generally outweigh the benefits. It can be inserted in the delivery room after a normal delivery, or in the operating theatre after a caesarean section.

Intrauterine system (IUS)

The IUS is a plastic device that contains a progestogen hormone. It is put into the womb, and lasts for either three,five or six years, depending on the brand used. An IUS can be inserted in the first two days after giving birth, or four weeks after giving birth. The risks of inserting one between two days and four weeks after giving birth generally outweigh the benefits. It can be inserted in the delivery room after a normal delivery, or in the operating theatre after a caesarean section.

This involves an operation. It is very effective but this can vary from surgeon to surgeon. Male sterilisation (vasectomy) stops sperm travelling from the testes. Female sterilisation prevents the egg from travelling along the Fallopian tubes to meet a sperm. These methods are often used when your family is complete. You should be sure of your decision, as they are difficult to reverse and the NHS will not usually fund reversal.The failure rate of female sterilisation is 5 per 1,000 per year and the failure rate of male sterilisation is 1.5 per 1,000 per year.

If you have your baby by caesarean section, the surgeon may sometimes sterilise you at the same time. This is only done if you are very sure of your decision. Or you can return later when you and your partner have decided. Sterilisation at the time of caesarean section carries a slightly higher risk of failure than sterilisation at any other time.

Emergency contraception can be used at any time if you had sex without using contraception. Also, if you had sex but there was a mistake with contraception. For example, a split condom or if you missed taking your usual contraceptive pills.

There are two types of emergency contraception:

An IUCD - inserted by a doctor or nurse, this can be used for emergency contraception up to five days after unprotected sex, or up to five days after the likely date of making an egg (ovulation) if you are sure of your cycle dates. It can be used from four weeks after the birth of your baby. This is the most effective method of emergency contraception.

Emergency contraception pills. An emergency contraception pill works either by preventing or postponing ovulation or by preventing the fertilised egg from settling in the womb (uterus). They can be used at any time after the birth of your baby. You take it as one single pill. There are two types of emergency contraceptive pills:

Levonelle® must be used within 72 hours (three days) of unprotected sex. It can be used when you are breastfeeding. It can be bought at pharmacies or prescribed by a doctor.

EllaOne® can be used up to 120 hours (five days) after having unprotected sex. You should not breastfeed for a week after using ellaOne®. It can be prescribed by your doctor or at a family planning clinic. You must not start any other form of hormonal contraception within five days of taking EllaOne®, or the EllaOne® is more likely to fail.

You will not need emergency contraception if you have unprotected sex within 21 days of having your baby. You cannot get pregnant so soon after childbirth.

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Contraception after birth should be discussed during your pregnancy and again soon after giving birth. If you do not wish to become pregnant again, contraception will be needed after your baby reaches the age of 21 days. There are many choices available for women.

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Information on Chestfeeding for trans or non-binary parents

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Information on Chestfeeding for trans or non-binary parents

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Chestfeeding if you're trans or non-binary

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

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Intimacy following the birth of your baby

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Intimacy following the birth of your baby

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Having a baby is a major change in any couple's relationship, with many parents feeling less happy in their relationship after the birth of a baby. This isn't surprising, as a new baby means less sleep, extra work and less time for each other.

We know that this can lead to changes in a couple's sex life, with one third of couples continuing to experience sexual difficulties up to four years after birth. Sex and intimacy is one of the issues that parents argue about after they have a new baby, but it is also one of the areas that gets talked about the least.

These parent top tips bring together a collection of evidence-based tips that new parents can put into practice today.

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PT - Sex and intimacy: understanding changes to your sexual wellbeing following the birth of your baby - IHV

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Having a baby is a major change in any couple's relationship, with many parents feeling less happy in their relationship after the birth of a baby. This isn't surprising, as a new baby means less sleep, extra work and less time for each other.

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Unicef UK Baby Friendly Initiative | Importance of relationship building

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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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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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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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Information on parenting through challenging times including arguments, separation, divorce, co-parenting, child contact

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Support for Parents from Action For Children

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Parenting and relationships - Support for Parents from Action For Children

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Advice and support on relationships, parent wellbeing, separation and divorce.

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Support and advice for parents from the NSPCC

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Support and advice for parents from the NSPCC

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Finding childcare, running a childcare business, financial support, data collection, local authority obligations.

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From pregnancy to advice on your child's teeth.

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Pregnancy, baby and parenting

Welcome to Better Health - Start for Life.

We may have a new name and look, but don't worry, you will still find all the trusted NHS advice and guidance you need to help you have a healthy and happy baby during pregnancy, birth and parenthood.

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Get trusted NHS advice during pregnancy, birth and parenthood. Start for Life is your essential guide for having a healthy, happy baby.

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The Dog Safety Code encourages everyone to be alert, aware and - most importantly - safe around dogs.

We are a nation of dog lovers and dogs are often part of the family, so it is vital that both parents and children are equipped with the knowledge they need to enjoy spending time with dogs safely.

We know that sometimes dog bites can happen because of certain circumstances or because we miss important signals from dogs. Being dog safe and following the Dog Safety Code can help to prevent that from happening.

Images kindly provided by CattleDog Publishing, a division of Veterinary Information Network, Inc www.cattledogpublishing.com
PRACTICAL TIPS FOR CHILD SAFETY AROUND DOGS
It is important that families are equipped with the knowledge and skills they need to enjoy spending time with dogs safely. Close supervision of children and dogs is key.
Be alert:

Close supervision is the most important thing to keep children safe.

Watch, listen and remain close when your child and dog are together. Never leave them alone together

If either your dog or child seems unhappy, positively and calmly separate them. You can throw your dog a treat or toy, or lead your child away.

Be aware:

Understand your dog's body language so you can spot signs they feel uncomfortable or stressed.

When you know you'll be distracted during busier times, use safety gates to keep children and dogs separate or, take your child or dog with you.

Be Safe:
Trigger times - teach your child to leave your dog alone when they are:

Sleeping - no-one likes to be woken up suddenly.

Eating or having a treat - they might think you're going to take their food.

Have a toy or something else they really like - they might not want to share

For more practical tips read the Child Accident Prevention Trust's dog safety fact sheets: https://capt.org.uk/dogs-and-children Spread the word about #DogSafety
We want as many people as possible to display and share dog safety resources to get the #DogSafety message out there.

Download and share the digital version of the D og Safety Code

Download and share the digital version of the Do g Safety Code (triangle version)

Download and share the printable version of the Dog Safety Code

Download and share the printable version of the Dog Sa fety Code (triangle version)

Download and share the GIF version of the Dog Safety Code

Download and share the Safety around dogs factsheet

Download and share the Your dog and your new baby factsheet

Download and share the Instagram post for Dog Safety

Download Be Alert for Child Safety Image - PNG

Download Be Aware for Child Safety Image - PNG
Want More Information? CFSG Dog Safety Library Dogs and Children | Top tips to keep them safe and happy together (capt.org.uk) Dogs and children: living safely together | Dogs Trust The Kennel Club - Safe and Sound PDSA - Canine communication: recognising stress in your dogs PDSA - Children and dogs: How to keep them happy and safe PDSA - Paws for posties RSPCA - Dogs and children RSPCA - Keeping children safe around dogs RSPCA - Six Golden Rules for keeping your child safe and your dog happy RSPCA - How to help your dog behave well RSPCA - Aggression in dogs Blue Cross - Be Safe with Dogs: A guide for families Dogs Trust - Safety Dogs Trust - Building confidence around dogs Merseyside Dog Safety Partnership - Public resources Know the signs
Download Be Safe for Child Safety Image - PNG

Download the Dog Safety Poster

Dogs will show signals through their body language to you. Below you can see some of the most used signals dogs give us to show us if they are worried, scared or need some space.

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The Dog Safety Code encourages everyone to be alert, aware and - most importantly - safe around dogs. We are a nation of dog lovers and dogs are often part of the family, so it is vital that both parents and children are equipped with the knowledge they need to enjoy spending time with dogs safely.

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Baby Check App

Baby Check features 19 simple checks that parents can do if their baby is showing signs of illness. Each check tests for a different symptom and when completed, a score is calculated that tells parents or carers how ill their baby is. The app then lets parents know whether their baby needs to see a doctor or health professional.

Download for FREE from Google Play or the App Store.

Buy posters, business cards and other materials to help promote Baby Check to your clients and patients

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The Baby Check App helps parents decide if their baby needs to see a doctor or health professional

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Hand expressing is a really useful technique for mothers to know about. It can be used to relieve fullness to help baby latch onto the breast, resolve a blocked duct to express for a baby to take milk in a bottle.

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Unicef UK Baby Friendly Initiative | Hand expression

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HPV vaccine: Beating cervical cancer

If you're starting Year 8 this Autumn Term, you will start to hear more about the HPV (Human Papilloma Virus) vaccine. When girls are aged 12 to 13 and are in year 8 at school, they are offered this vaccine to protect them against cervical cancer.

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If you're starting Year 8 this Autumn Term, you will start to hear more about the HPV (Human Papilloma Virus) vaccine. When girls are aged 12 to 13 and are in year 8 at school, they are offered this vaccine to protect them against cervical cancer.

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Center on the Developing Child at Harvard University

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Early experiences affect the development of brain architecture, which provides the foundation for all future learning, behavior, and health.

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Infant Milks - First Steps Nutrition Trust

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Whether you're a health worker or a parent or carer, First Steps Nutrition Trust focuses on providing clear advice and information around the safe use of infant milks in the UK.

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Vitamin D drops are recommended for all breastfeeding infants as well as those who are combination feeding and taking less than 500ml infant formula per day.

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This information can also be viewed as a PDF by clicking here.
The information provided is taken from various reference sources. It is provided as a guideline. No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used. Clinical decisions remain the responsibility of medical and breastfeeding practitioners. The data presented here is intended to provide some immediate information but cannot replace input from professionals.
In 2012 the Chief Medical Officer in the UK made recommendations about supplementing all pregnant and breastfeeding mothers and children with Vitamin D. There seems to remain a lot of confusion as to who should take these supplements, why this is necessary and how to obtain them. The recommendations were updated in July 2016 in line with the SACN recommendations on vitamin D and health.

Breastfed babies from birth to one year of age should be given a daily supplement containing 8.5 to 10mcg of vitamin D as a precaution (SACN 2016)

Breastfeeding Mothers should also take a daily Vitamin D supplement of 10 µg per day

Vitamin D deficiency in the UK is a consequence of our weather and the latitude at which we live.

Breastmilk is perfect for babies

Vitamin D drops should be given to babies on a teaspoon as droppers are hard to sterilise

Healthy Start Vitamins remain an excellent, economic source of vitamin D and are provided free of charge in many areas. The daily dose of 5 drops contains 10µg www.healthystart.nhs.uk/for-health-professionals/vitamins/

Babies born to mothers with low vitamin D status are at risk of developing rickets. Taking into account that MOST of us are deficient between October and April at best and MANY of us will have low levels throughout the year, the recommendation that ALL pregnant women should take a supplement of 10 µg Vitamin D per day throughout pregnancy is sensible and cost effective (Prevention of rickets and vitamin D deficiency in Birmingham: the case for universal supplementation).

Babies born to mothers who have not taken a vitamin D supplement in pregnancy are likely to be born with low vitamin D status. Levels of vitamin D in that mother are also likely to be low and even if she begins to take a supplement herself at that time, cannot redress the baby's deficiency by breastfeeding. So the recommendation is that the baby should receive its own oral vitamin D drops containing 7-8.5µg per day from 4 weeks of birth until the age of 5 years. Waiting until the baby is 6 months may be too late to prevent development of symptoms. Mothers may also develop symptoms of deficiency themselves.

Although it was thought that levels of vitamin D stores laid down in pregnancy by a mother who has taken vitamin D supplements in pregnancy would be sufficient for a few months,
new recommendations (July 2016) are that breastfed babies from birth to one year of age should be given a daily supplement containing 8.5 to 10mcg of vitamin D, to make sure they get enough ( www.nhs.uk/Conditions/vitamins-minerals/Pages/Vitamin-D.aspx). In addition breastfeeding mothers should take a daily Vitamin D supplement of 10 µg per day - in fact as more and more conditions are linked with lack of vitamin D most of us would benefit from taking it regularly.

In children; rickets, delayed tooth eruption, increased risk of infection, decreased bone mass, hypocalcaemic seizures, delay in walking.

In adults; osteomalacia, muscle weakness, bone pain plus possible association in many other conditions.

Mothers who are diagnosed with vitamin D deficiency may be prescribed very high dose supplements. Papers looking at these doses are scarce. Hollis and Wagner (2004) concluded that "Maternal vitamin D intakes of 4000 IU/d appear to be safe and to provide sufficient vitamin D to ensure adequate nutritional vitamin D status for both mothers and nursing infants. Hollis et al 2015 that "Maternal vitamin D supplementation with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy her nursing infant's requirement and offers an alternate strategy to direct infant supplementation.

For information on high dose vitamin D prescribed for breastfeeding women see https://breastfeeding-and-medication.co.uk/fact-sheet/high-dose-vitamin-d-supplements-and-breastfeeding

Oily fish including trout, salmon, mackerel, herring, sardines, anchovies, pilchards, and fresh tuna

Cod liver oil and other fish oils

Egg yolk; 0.5 micrograms (20 IU) per yolk)

Mushrooms

Supplemented breakfast cereals typically contain between 2 and 8 micrograms (80-320 IU) per 100 g

Margarine

The average dietary vitamin D intake of young women in the UK approximates 3 micrograms per day and fewer than 1% consume more than the 10 micrograms (Williams 2007). The National Diet and Nutrition Survey of British adults suggest that if such a threshold were investigated in the UK population data, some 80-90% would be deficient (Henderson 2003).

The main source is Ultraviolet B sunlight exposure; more than 90% of mankind's vitamin D supply is derived from exposure UVB in sunlight. Deficiency of vitamin D in the UK is predominantly caused by poor weather, increasing use of high factor sunscreen (more than factor 8), and latitude: those born north of approximately Birmingham (40°N) are unlikely to be able to reach sufficient exposure.

Sunlight exposure needed is 2 hours per day (if only the face exposed), 20-30 minutes a day if the face, arms and neck are exposed without sunscreen. Sun protection factor in excess of 8 prevents absorption of the UVB sufficient to make vitamin D. Need increases for those with darker skins. In all cases it is important to avoid sunburn, particularly in babies.

Those who are eligible for Healthy Start vouchers receive free vitamin tablets and drops containing the correct dose of vitamin D for mothers and children.

Those not eligible for Healthy Start may purchase vitamin supplements form pharmacies and Health Food Stores - please check that they contain 10µg for adults and at least 7-8.5µg for children (usually 10 µg).

Vitamin D deficiency in the UK is a consequence of our weather and the latitude at which we live. The addition of vitamin D to formula milk does not make it better than breastmilk - it does not contain all the immunological properties that make breastmilk specific to cater for each baby's needs.

Some mother and infant groups have been shown to be at increased risk, including:

Babies of mothers with darker skin types

Pregnant and breastfeeding women.

Babies born in the winter months and not exposed to the sun

Babies and mothers who wear concealing clothing, preventing skin exposure to sunlight

Babies and mothers who spend a lot of time indoors or use sun creams, reducing exposure to sunlight

Babies of obese mothers (BMI >30)

Babies of mothers with gestational diabetes.

Ahmed SF et al. Recent trends and clinical features of childhood vitamin D deficiency presenting to a children's hospital in Glasgow. Arch Dis Child 2011;96:694-6 http://adc.bmj.com/content/96/7/694.full.pdf+html

American Academy of Paediatrics Prevention of Rickets and Vitamin D deficiency in infants, children and adolescents 2008 http://pediatrics.aappublications.org/content/122/5/1142.full.pdf+html

CMO Vitamin D supplements for at risk groups. dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_132508.pdf

Department of Health. Vitamin D an essential nutrient for all, but who is at risk of vitamin D deficiency? http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_111302.pdf

Henderson L, Irving K, Gregory J, et al. The National Diet and Nutrition Survey: adults aged 19 to 64 years. Vol 3. Vitamin and mineral intake and urinary analytes . London: Stationery Office, 2003: 1-160.

Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr. 2004;80(Suppl 6):1752S-1758S

Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG,Taylor SN, Morella K, Lawrence RA,Hulsey TC, Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics 2015;136 (4):

Jones W. Breastfeeding and Medication Routledge 2018

Michie C. Managing vitamin D deficiency in children. London Journal of primary care July 2010 londonjournalofprimarycare.org.uk/articles/3186685.pdf

NHS Choices. nhs.uk/news/2012/01January/Pages/vitamin-d-medical-advice-and-supplements.aspx

Prevention of rickets and vitamin D deficiency in Birmingham: the case for universal supplementation. infantfeedingwm.org.uk/documents/Website_VitD.pdf

SACN Update on Vitamin D 2007. sacn.gov.uk/pdfs/sacn_position_vitamin_d_2007_05_07.pdf

SACN Vitamin D and Health 2016 www.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf

©Dr Wendy Jones MBE, MRPharmS and the Breastfeeding Network June 2020

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Vitamin D and Breastfeeding - The Breastfeeding Network

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This information can also be viewed as a PDF by clicking here. The information provided is taken from various reference sources. It is provided as a guideline. No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used.