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College of Human and Health Sciences, Swansea University

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

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Information on storing expressed milk

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Guide to choosing infant milk & responsive feeding

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Help with expressing

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Small Wonders Film 4 - SW Using a breast pump

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The fourth film from the Small Wonders DVD shows how mothers can express breast milk for their baby within a few hours of giving birth (if at all possible mothers…

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It's never too early to start thinking about how you're going to feed your baby. But you do not have to make up your mind until your baby is born.
In the UK, more than 73% of mothers start breastfeeding. These are some of the reasons why:

your breast milk is perfectly designed for your baby

breast milk protects your baby from infections and diseases

breastfeeding provides health benefits for you

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

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

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

Health benefits of breastfeeding for your baby

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

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

Breastfeeding reduces your baby's risk of:

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

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

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

Health benefits of breastfeeding for you

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

Breastfeeding lowers your risk of:

Busting some breastfeeding myths

Myth: "Some women do not produce enough breast milk."
Fact: Almost all women are physically able to breastfeed. Early, frequent feeding and responding to your baby's cues give you the best start to establishing your supply. See Is my baby getting enough milk?

Myth: "Breastfeeding hurts."
Fact: Breastfeeding is a natural way to feed a baby and it should not hurt. If you experience pain in your breasts or nipples, it's usually because your baby is not positioned or attached properly. Ask your midwife, health visitor or a breastfeeding specialist to watch a whole feed to help spot the problem.

Got a breastfeeding question?

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

Get Start4Life pregnancy and baby emails

Sign up for Start4Life's weekly emails for expert advice, videos and tips on pregnancy, birth and beyond.

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It's never too early to start thinking about how you're going to feed your baby. But you do not have to make up your mind until your baby is born. In the UK, more than 73% of mothers start breastfeeding.

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Where to find help and support locally

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How do you know if breastfeeding is going well? https://www.nct.org.uk/sites/default/files

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Information on mixed feeding

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When it comes to feeding their baby, some parents decide to exclusively breastfeed and some to exclusively formula feed. Many families decide to combine breastfeeding and formula feeding; this often called combination feeding or mixed feeding (NHS, 2019).

What is mixed feeding?

Mixed feeding usually means mixing breast and bottle feeding. The content of the bottle can be either breastmilk or formula milk.

Watch our video to find out more about mixed/combination feeding.

Why do some families combination feed?

You might start mixed feeding for a variety of reasons.

If you and your baby have some difficulties getting breastfeeding established or if there are concerns about your baby's weight, you might be advised to give some formula feeds alongside breastfeeding.

You might need to leave your baby for periods of time (for example, if you are returning to work).

Your partner might want to be involved with feeding.

You might be bottle feeding and want to start or resume breastfeeding.

It can be helpful to talk to a breastfeeding counsellor, a midwife or health visitor about your options and the potential impact on breastfeeding of mixed feeding (see below). You could also call our infant feeding line on 0300 330 0700.

How do I combine bottle feeding and breastfeeding?

Some families choose to express milk and feed it to their babies through a bottle. They might do this if someone else would like to feed the baby or if the mum has to be away from their baby for a while.

Others choose to substitute some breastfeeds for formula. If you want to do this, you and your baby will adjust more easily if you reduce the number of feeds gradually (NHS, 2019).

You can offer formula feeds before, during, after or instead of a breastfeed. Talk to your midwife, health visitor or a breastfeeding counsellor about this, as different options will suit different circumstances. And will also depend on what you wish to achieve ultimately.

There are some cases when formula might be given before a breastfeed (for example, with babies who are not breastfeeding well). In other cases, the formula feed might be given instead of a breastfeed. This might happen if you're not with your baby and can't breastfeed or if someone else is sharing the feeding.

Gradually cutting down breastfeeding reduces the chance of your breasts becoming uncomfortably engorged. It will also reduce your risk of developing mastitis (NHS, 2019). It helps to reduce the number of breastfeeds slowly, starting with the one which is convenient for you (NHS, 2020). If you substitute a breastfeed with a formula feed, it may take around five to seven days for the amount of milk your breasts are producing to adjust to missing that one feed (NHS, 2017).

If you 'top up' with formula during one or more feeds, rather than replacing an entire feed, this is likely to extend the gap between breastfeeds. It will also signal to your breasts to make less milk (NHS, 2020).

On the other hand, if you've been advised to 'top up' as a temporary measure and want to return to exclusive breastfeeding, it is important to express milk between feeds to prevent a decrease in the amount of milk you make (NICE, 2017). Try and feed your baby any available breastmilk before each formula feed.

What effect will combining breastfeeding and formula feeding have?

Your baby will enjoy the benefits of breastmilk, even if you're not exclusively breastfeeding. For instance, they will still gain some of the antibodies that will protect them against infection (NHS, 2019).

If you want to feed your baby with both breastmilk and formula milk, it is recommended to wait until feeding is firmly established before introducing a bottle (NHS, 2019). This can take up to a month (La Leche League, 2019).

It's best to wait until breastfeeding is established because breastmilk supply is generally driven by frequent, effective removal of milk from the breasts. Giving your baby formula reduces your milk supply, which is particularly important when you are both getting used to breastfeeding. If your baby breastfeeds less often, your breasts produce less milk (Daly and Hartmann, 1995).

You might have heard that babies can get 'nipple confusion' but there is no evidence that this exists (Kotowski et al, 2020).

How many breastfeeds does an older combination-fed baby need?

Older babies, beyond the newborn stage, can maintain your breastmilk supply alongside formula feeding as long as you breastfeed several times a day. Much older babies - from eight or nine months - can breastfeed just a handful of times a day, and there is still a supply.

Very well-established breastfeeding, with a baby who is one year or older, can continue with as few as one or two feeds in 24 hours.

If your baby is over six months they can use a beaker or cup rather than a bottle (NHS, 2020).

Tips to introduce a bottle to a breastfed baby

You might find your baby does not want to take a bottle at first. The different sensations may confuse them and they don't know the bottle contains food. But there are lots of different things you can try to help your baby:

Offer a bottle when your baby is relaxed and happy, rather than very hungry.

Maybe ask someone else to offer a bottle so they can't smell their mother's milk.

Try softening the teat with warm, boiled water.

Hold your baby in a different position from their usual breastfeeding one. It might help your baby get used to the new way of feeding.

Try a different bottle or teat, this might make a difference.

(La Leche League, 2019)

Unicef (2016) recommend feeding responsively, which means following your baby's cues, whether breastfeeding or bottle feeding. They also recommend using paced bottle feeding. The way a baby is fed with the bottle can affect their comfort, their control of the amount of milk they drink, and the transition between breast and bottle (Kotowski et al, 2020).

Tips for paced bottle feeding

Hold your baby upright, close to your body. (If your baby is lying back, they are less able to control how much milk they swallow, so they can overfeed.)

Touch the teat against the baby's top lip to encourage them to pull it into their mouth.

Hold the bottle horizontal, so that when the baby is actively sucking, they get milk and when the baby is pausing, they don't get milk.

Give the baby several breaks by removing the bottle from their mouth.

Watch what the baby is doing, rather than how much milk they have drunk. End the feed when the baby is no longer drinking.

(UNICEF, 2016; La Leche League, 2019)

This all helps to build a close, loving relationship, a responsive feeding relationship, and avoids overfeeding your baby.

Where can I go for breastfeeding support?

If you have questions, concerns or need support, you can speak to one of our breastfeeding counsellors by calling our infant feeding line on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions.

Further information

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

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

UNICEF have produced a summary guide for parents on how to responsively bottle feed babies.

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Mixed feeding: combining breastfeeding and bottle feeding | Baby & toddler, Feeding articles & support | NCT

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When it comes to feeding their baby, some parents decide to exclusively breastfeed and some to exclusively formula feed. Many families decide to combine breastfeeding and formula feeding; this often called combination feeding or mixed feeding (NHS, 2019). Mixed feeding usually means mixing breast and bottle feeding.

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Attaching Your Baby at the Breast – Breastfeeding Series

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https://www.bestbeginnings.org.uk/the-early-days-and-weeks/234d1d5f-cbf4-41c7-8f71-e39bc88cd318

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Newborn Baby Girl Early Wake Up & Stretching

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n this video by Best Beginnings, new mums Angela and Teresa talk about the early weeks with their babies and their experiences of breastfeeding Tips for new parents http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/being-a-parent.aspx

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Laid back breastfeeding

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

Breastfeeding positions for newborns

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

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

Here's how to get started...

Preparing to feed

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

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

Laid-back, relaxing position

Sitting in a chair

Underarm or rugby ball

Lying down

Breastfeeding positions for a fast milk flow

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

Breastfeeding your baby as they get heavier

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

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

Breastfeeding position tips

Whichever breastfeeding position you choose, remember...

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

Tuck your baby in closely to you.

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

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

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

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

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

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

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

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

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

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Breastfeeding positions: which are best for you?

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

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Local weekly support group

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SUSPENDED until further notice
News is shared on our Facebook Page "LLL Clapham and Wandsworth Notices Page"
Local mothers are invited to join our closed Facebook community "LLL Clapham and Wandsworth Chat Group" for chat about all things breastfeeding, moderated by LLL Leaders.

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LLL Clapham and Wandsworth Mums' Coffee Mornings in SW17 - La Leche League GB

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SUSPENDED until further notice News is shared on our Facebook Page "LLL Clapham and Wandsworth Notices Page" Local mothers are invited to join our closed Facebook community "LLL Clapham and Wandsworth Chat Group" for chat about all things breastfeeding, moderated by LLL Leaders.