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If you want to explore further after the session, these resources are a good place to start.

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If you want to explore further after the session, these resources are a good place to start.

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This video shows and explains really clearly how to breastfeeding in a natural way and avoid pain. Well worth watching.

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A useful video showing an ideal position to start learning to breastfeed in.

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This video clip begins with a still image for about 30 seconds. In this time you can note the reclined and fully supported position of the mother and the baby 'tummy ON mummy' working with gravity. This mother seems to be enjoying holding her sleeping baby and the initiation of breastfeeding is not hurried and set in a relaxed atmosphere.

Biological Nurturing Scenario from S Colson on Vimeo.

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Sample of Biological Nurturing - Biological Nurturing

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This video clip begins with a still image for about 30 seconds. In this time you can note the reclined and fully supported position of the mother and the baby 'tummy ON mummy' working with gravity. This mother seems to be enjoying holding her sleeping baby and the initiation of breastfeeding is not hurried and set in a relaxed atmosphere.

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Video of a baby breastfeeding with an ideal latch

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Video of a baby breastfeeding with an ideal latch

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Notice how tight in the baby's mouth and nose are. Both cheeks are touching the breast. The baby's spine is fully inline (no head turning to the side) and the baby's chin is free from his chest. The mother is using gravity to create a sustainable position.

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Hand expression is not essential but can be very useful particularly in the first couple of days if breastfeeding is not going well. There is no need to supplement with formula milk if you can hand express and give your baby milk that way. You can also use this technique to express colostrum antenatally if you want to. Practical part of the video starts at 1:33. https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html

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

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

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Skin to skin has many benefits for all parents and babies and can help with getting breastfeeding established too.

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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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This video shows really clearly how you can make small adjustments during feeding to get a good latch.

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The Thompson Method Breastfeeding | Learn How to Breastfeed Pain-Free with The Thompson Method

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A series of videos that gives you a good feel for what it's like to breastfeed a baby. It includes topics such as the first few weeks, feeding out and about, expressing, starting solids and going back to work.

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

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

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

Angela is back home with baby Cameron and breastfeeding is going well. "It's a great feeling to be able to sit there and watch him feeding away. It's a really special bond," she says. Teresa is making sure she has plenty of contact with Rufus, ensuring her body is supplying enough milk for him. Breastfeeding can protect you against ovarian cancer and give you stronger bones in later life.

How to make sure your baby is attaching well at the breast.

Meet four mums whose babies have been breastfeeding for a little while and hear their experiences. Linda was troubled by breastfeeding outside the home - until she tried it. "I thought, 'nobody breastfeeds in public,'" she says. "What I realised is, loads of women breastfeed in public, you just don't realise it's happening."

Find out about overcoming challenges like uncomfortably full breasts and mastitis, and how to position your baby so he or she feeds properly.

Linda and Heidi have fed their babies breast milk for six months. Now their babies are ready to try their first solids.

Join a class with specialist midwife Bella Dale, who explains how breastfeeding works and how mums' bodies start preparing to feed their babies before birth.

Three mums tell us how they overcame hurdles with breastfeeding. Thomasina overcame sore nipples, while Lowri encountered mastitis, both of which were caused because their babies weren't attaching properly at the breast.

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

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

Follow three mothers as they share their tips on the joys and challenges of feeding twins.

Latest

The Impact Lead will focus on developing Best Beginnings' frameworks for monitoring and evaluating our national and international work ensuring that learning continues to be captured in ways that can be shared and used for effective advocacy and influencing. The successful candidate will also play a pivotal role influencing policy and its implementation within the maternity, early years, digital health and public health context.

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Your guide to breastfeeding and how to do it successfully.

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Leaflet with information about jaundice and a helpful chart about what to expect in terms of numbers of feeds and wet and dirty nappies in the first few days

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This is a useful article if you are concerned that your baby is not getting enough milk or if you have been advised to supplement your baby with additional milk. It includes how to know if your baby is getting enough, how to increase the milk your baby is getting at the breast and how to supplement if needed without undermining breastfeeding.

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Does your baby need more milk?
How to know your baby is getting enough breastmilk
Increasing your milk production
If supplements are needed
Feeding methods
Expressing your milk

Does your baby need more milk?

Although most mothers are able to produce enough milk for their babies' needs, you may have concerns about your own milk production. Perhaps you and your baby had a difficult start, or were not given the support you needed to establish breastfeeding. Or maybe things were going well until your baby's weight gain faltered.

If others question your milk production and your baby is fussy, wants to feed much of the time, seems small, or gains weight slowly, you may be wondering whether you have enough milk.

Follow your baby not the book

Young babies need to nurse frequently to get enough milk and establish their mother's milk production. Following feeding schedules, using regular supplements, nipple shields, or a dummy can really reduce your milk production.

Breastmilk is also a drink and frequent nursing is normal. Adults rarely go longer than two hours without a drink, snack or meal. Your baby's tummy is tiny and breastmilk is quickly digested, so they need frequent feeds to help them grow. It is recommended that your baby is weighed no more than once a month for the first six months, unless there are concerns.

Sleepy Baby
A baby who sleeps a lot rather than waking to feed every 2-3 hours may need to be woken up to nurse, particularly if they have jaundice or aren't gaining enough weight. If this is difficult or your baby is lethargic, ask your midwife, health visitor or GP to check that all is well.

See our article Sleepy Baby - why and what to do for more information.

How to know your baby is getting enough breastmilk

Weight gain
It is normal for newborns to lose up to 7% of their birth weight in the first few days. Once your milk production increases, usually on day 3-4, expect your baby to begin gaining weight. Most babies regain their birth weight by the age of 10-14 days. You may also find it helpful to see Is my baby getting enough milk?

Plot your baby's weight gain on a UK-WHO growth chart based on the growth rates of breastfed babies (see examples below and Further Reading). Although they will be growing at their own individual rate, it will give you an indication of how they are doing.

Monitor your baby's weight over a period of time rather than week by week. Your baby's weight may generally follow the chart, or climb up, crossing the percentile lines. A gradual drop from one percentile line to the next (or the equivalent distance) is unlikely to be a problem unless their weight is low for their age. Heavier newborns often show 'catch-down' growth - they gain weight steadily but drop gradually against the chart lines.

Dropping against the chart is more of a worry for lower weight babies
If your baby's growth curve drops across two lines of the chart (or the equivalent distance), or if their weight is below the lowest line of the chart:

Follow the suggestions here to ensure they get more milk.

Seek help from your GP to rule out an underlying medical reason for your baby's slow weight gain.

If you have doubts about your baby's growth, you may find it reassuring to talk to an LLL Leader.

Wet and dirty nappies
If your baby receives enough milk, the thick and sticky black meconium poos will be passed within three days of birth, followed by at least 6-8 wet and 3-5 dirty nappies in each 24 hours. Expect yellow, loose, unformed poos at least the size of a 2p coin. From about six weeks, some babies have abundant poos once every few days. This isn't a problem when a baby has plenty of wet nappies.

Look at your baby
You may instinctively know how your baby is doing. Are they nursing vigorously? Is their skin firm? Do they look healthy and seem active and alert? Are they meeting developmental milestones?

Remember
Even if your breasts feel empty, there's always some milk there. Full breasts and engorgement slow milk production - you may need to nurse more often. Removing even small amounts of milk from soft breasts increases milk production.

Babies nurse for comfort as well as for food. Those little 'snack' comfort feeds can really increase your milk production and their calorie intake.

Expect your baby to want to breastfeed very often from time to time. Your breasts will quickly adjust to making more milk if you follow your baby's cues.

Every baby has a unique feeding pattern. If your baby is gaining weight adequately, following their own feeding pattern is the best way of ensuring you are meeting their needs. It's rare that a mother cannot produce enough milk for her baby, and there are lots of ways to increase the amount of breastmilk your baby gets.

Increasing your milk production

After the first few weeks, supply and demand drives milk production. To increase your milk supply, focus on feeding more often and getting more milk out at each feed. For more information about how breasts make milk, see our article How milk production works and also How to increase your milk supply.
Breastfeeding basics

Breastfeed as often as possible - at least 10 times in 24 hours. Wake your baby if necessary.

Switch sides when your baby's suck-swallow pattern starts to slow. Continue to switch sides (four times or more) until they reject the breast.

Use breast compression (see below).

Instead of breastfeeding at set intervals, encourage 'cluster feeding' - breastfeeding very often at times when your baby is willing to.

Encourage breastfeeding for comfort as well as for food. It can really help your milk production. Stop using dummies - breastfeed instead.

Ensure you are meeting your baby's needs for milk during the night, feeding at least once every four hours.

Cut back a little on your baby's solid foods if your milk production is dropping (see below).

An effective latch
A baby may spend a long time at the breast but not get very much milk if they are not latched on effectively. Check your baby is well attached - watch and listen for swallowing which is frequent at the start and then slows down.

Contact an LLL Leader for one-to-one support and see Further Reading for more information. It's important to seek skilled help early on if you are finding breastfeeding difficult, uncomfortable or painful.

Take a 'baby moon'
Get some help with the housework and eat simple, easily-prepared meals for a week or two so you can concentrate on breastfeeding your baby. A couple of days' bed rest together, feeding your baby on demand can really boost your milk production. Or at least take some time each day to rest with them and concentrate on breastfeeding.

Try laid-back breastfeeding
Many babies instinctively seek the breast and feed frequently if they can snuggle up close to their mother's chest.

Try letting your baby lie on your body, skin to skin (with a blanket if needed) as you recline, so both their chest and tummy are against you. This close body contact gives your baby lots of opportunity to breastfeed, even in a light sleep, and boosts levels of the hormones that increase your milk. A soft carrier or sling helps to keep your baby close and encourages breastfeeding. (see Positioning and Attachment for more on laid back breastfeeding)

Breast compression
This technique puts pressure on the milk ducts and can help to make feeding more efficient:

1. Support your breast with one hand - thumb on one side, fingers on the other.

2. Wait while your baby breastfeeds actively, their jaw moving all the way to their ear. When their swallowing slows, compress your breast firmly to increase milk flow and encourage swallowing. Hold it squeezed while they continue nursing actively, then release your hand.

3. Rotate your hand around the breast and repeat step 2 on different areas of the breast.

Go gently - this should not hurt.

Other foods
Babies need only human milk for the first six months (human milk is higher in calories than many weaning foods). Too much solid food replacing human milk can affect weight gain in older babies. Breastfeed before offering solid foods if your baby is under 12 months old. Even at 12 months, both human milk and solids are equally important. Breastfeed frequently and, rather than spoon-feeding, offer your baby a variety of foods, letting them feed themselves to ensure they take only what they need.

Continued low milk production
If you've tried all these suggestions and your milk production has not increased enough, there may be a medical reason. Some medical conditions can lead to low milk production, though appropriate treatment can reduce the impact. These situations are rare, but you can discuss possibilities with an LLL Leader. For more information see our article How to increase your milk supply and Further Reading.

Signs your milk is increasing
Watch for weight gain and an increase in your baby's wet and dirty nappies. Your breasts may feel fuller before feeds and begin to leak.

Looking after yourself
Don't forget to be kind to yourself, especially if you're feeling under pressure. Now is the time to call in favours from friends and relatives so you can concentrate on your baby. If your baby needs more milk, talking to your local LLL Leader will help. You can share your concerns with other mothers at an LLL meeting, who will be able to give you encouragement and support.

If supplements are needed

It can be a challenge fitting in breastfeeding, supplementing and expressing. You could try the following approach, aiming for at least 8 feeds in 24 hours. At each feed:

1. Start with breastfeeding, observing your baby's swallowing pattern. Use breast compressions to maximise the flow. When swallowing slows, switch sides and repeat. If your baby has enough energy, you can repeat this process (known as 'switch nursing'). This part of the feed might take 10-30 minutes, but use swallowing as your guide. A baby who is not swallowing isn't taking in any milk so move to step 2.

2. Give your supplement with a spoon, syringe, nursing supplementer, finger feeding tube, or bottle. Give stored breastmilk first, then supplement with other milk. Follow your baby's lead until they are satisfied. A baby who is underweight may become extra hungry for a while. By giving them extra milk, you will help them gain weight and get the energy they need to breastfeed better. To save time, this step could be done by your support person while you express. For more on ways to give your baby more milk, see our article on Bottles and other tools.

3. Express both breasts using a combination of pumping and hand expression, switching back and forth as milk flow slows. Store this milk in the fridge ready for the next feed. By removing the milk your baby couldn't, you build your future milk production and have milk to supplement the next feed. This is an important step, especially if you are working to eliminate formula supplements.

4. Finish at the breast. The whole feed may take 60-90 minutes. If it works for you, you might offer the breast at the end of the feed so your baby associates the breast with being calm, happy and satisfied. Suckling can help them settle to sleep, too.

Keep a record of the amounts of each supplement your baby takes at each feed and also what you express. This can help you see your progress and maybe useful for anyone supporting you with breastfeeding.

Feeding methods

Cup, spoon and syringe feeding can work when small amounts are needed.

A nursing supplementer can be used to give larger amounts while your baby is at the breast. Another option is finger feeding, using an infant feeding tube. One end of the tube is taped to your finger. As your baby sucks on your finger, milk flows along the tube from a container which can be raised or lowered to change flow. An LLL Leader can help you find out more and choose an option that works best for you.

If using a bottle, paced bottle feeding can help ensure your baby doesn't take more milk than they need.

A smaller teat hole prevents a baby taking milk too quickly.

Hold them in an upright position, using your hand to support their neck and head.

To encourage your baby to open wide, place the teat across their lips with the tip between the upper lip and nose.

Allow your baby some control. Let them take the bottle teat into their mouth themself. Avoid pushing the teat into their mouth.

Tilt the bottle just enough to fill the tip of the teat and give a gentle flow so your baby isn't overwhelmed with milk. As the bottle empties, gradually tilt the bottle more and lean your baby back.

Encourage frequent pauses to mimic breastfeeding, and allow your baby to decide when they have had enough.

For more information see Bottles and other tools.

Expressing your milk

A baby nursing well at the breast is more effective than any pump. But while your baby isn't breastfeeding well or you're giving supplements, expressing your milk will stimulate milk production. Give any expressed milk before you give infant formula, so none of your precious breastmilk is wasted.

Nurse your baby frequently so they get the extra milk you make. An increase in the amount you can express is a sign that you can reduce supplements if your baby is nursing well and often.

Hospital-grade pumps are the most effective for mothers needing to increase their milk, but any pump that works well for you is fine.

Try hands-on pumping: use breast massage and breast compressions while pumping, then hand express afterwards to get the last few drops of milk. For more on hand expressing see our article: Hand expression

Pumping on both sides at the same time boosts milk-producing hormones. When pumping one side at a time, switch back and forth several times as milk flow slows.

Consider power pumping: experiment with pumping very frequently for short periods to mimic cluster feeding.

Wash your pump with hot soapy water, or sterilise it once a day. Pump equipment can be left at room temperature for short periods, or stored in the fridge for longer periods. For more information, see our article Expressing Your Milk.
Good times to express milk

After feeds while your baby sleeps - 'putting in an order' for more milk later. Milk expressed after a feed may be small in quantity, but is high in calories.

Between feeds if your baby is too sleepy to nurse frequently.

While holding your baby, or with them nearby. Expressing little and often can be better than long sessions. Try some 'power pumping' during the evening, or fit in some extra pumping sessions one day. You should notice an increase in milk production a couple of days later.

Using donor milk and formula to support breastfeeding
The use of donor milk or infant formula is sometimes essential to meet a baby's nutritional needs. You may need to use donor milk or formula as a short-term measure while you work to increase your milk production. See our article Using donor milk & formula to support breastfeeding for more information.

Supplementing with donor milk or formula without protecting your milk supply may reduce the duration of your breastfeeding journey.

Powdered infant formula is not a sterile product. To reduce health risks associated with using infant formula, carefully follow the NHS guidelines for preparing it. La Leche League does not recommend the use of homemade formula. The NHS guide to bottle feeding is available online (see Further Reading).

Written by Karen Butler and mothers of LLLGB

Further Reading

How to increase your milk supply
How milk production works
Using donor milk and formula to support breastfeeding
Dummies and Breastfeeding
Hand expressing of breastmilk
Comfortable Breastfeeding
Is my baby getting enough milk?
Nursing Supplementers
Positioning & Attachment
Rhythms and Routines
Safe sleep and the Breastfed Baby
Sleep baby - why and what to do
Storing your milk
After a difficult start

Books
The Womanly Art of Breastfeeding, LLLI. London: Pinter & Martin, 2010.
Making more milk, second edition, Marasco, L. and West, D. New York: McGraw-Hill Education, 2019.
Other websites
Natural (laid-back) breastfeeding naturalbreastfeeding.com
Biological nurturing™ www.biologicalnurturing.com
Maximising milk production when expressing https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html
UK-WHO Growth Charts These charts are based on the growth rates of breastfed babies and can be found in your baby's Personal Child Health Record (red book). Further copies, the more detailed hospital 0-4 charts and specialised charts for low weight babies can all be downloaded from: www.rcpch.ac.uk/growthcharts
NHS guide to bottle feeding

This information is available to buy in printed form from our shop.

Copyright LLLGB 2022

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My baby needs more milk - La Leche League GB

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Does your baby need more milk? How to know your baby is getting enough breastmilk Increasing your milk production If supplements are needed Feeding methods Expressing your milk Does your baby need more milk? Although most mothers are able to produce enough milk for their babies' needs, you may have concerns about your own milk [...]

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Being an involved non-breastfeeding parent of a breastfed baby

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Being an involved non-breastfeeding parent of a breastfed baby

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

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

Why is breastfeeding important?

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

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

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

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

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

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

What do I need to know about breastfeeding?

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

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

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

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

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

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

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

Women enjoy feeding more when they are comfortable and relaxed.

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

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

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

Here are 10 tips:

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

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

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

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

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

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

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

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

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

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

(Rempel et al, 2010)

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

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

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

Tips for being a hands-on partner with your baby

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

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

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

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

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

How can I share feeding our baby?

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

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

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

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

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

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

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

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

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

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

At the end of the day...

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

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

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

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

Visit our breastfeeding support contacts page.

NHS Choices breastfeeding information.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Information to help you prevent sore nipples and identify possible causes

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Sore nipples when breastfeeding | Baby & toddler, Feeding articles & support | NCT

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Sore nipples can be a problem in the early days of breastfeeding and beyond. This article discusses causes of sore nipples and how to ease the pain.

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Breasts can sometimes become painfully full, particularly in the early days. Here's some information to help avoid and treat this issue.

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Engorged breasts are painful. They feel heavy, hard, warm and sensitive -as if they are ready to burst! As well as being painful, engorgement can lead to other breastfeeding problems if not treated. Being able to recognise engorgement will help you to treat it promptly, avoiding complications.

Most mothers experience some engorgement in the first weeks after birth. With changing hormone levels, your breasts swell and enlarge as milk production increases. It may seem as though they are filling up with milk, but engorgement is more than milk storage. Your body directs extra blood and fluids to your breasts to boost milk production. This causes congestion and swelling which will decrease as your body adjusts.

Minimizing early engorgement
Treat engorgement to...
When to treat engorgement
After the first few weeks
Causes of engorgement
Treating engorgment
Be sure your baby is sucking effectively
Reverse pressure softening
Keep comfortable
Watch out for signs of mastitis

Minimizing early engorgement

New mothers vary in how engorged their breasts become in the weeks after birth; some experience little engorgement, others describe their breasts as feeling like watermelons!

Try these suggestions

Breastfeed your baby frequently from birth: at least 8-12 times in 24 hours. Keeping your baby close makes it easier to nurse every hour or two.

If your baby is sleepy, perhaps from a medicated birth, you may need to wake him and encourage him to nurse.

Aim to be comfortable while breastfeeding, and learn how to get your baby latched on well.

If your newborn is unable to breastfeed, electric hand express frequently until your milk 'comes in', then combine with using a hospital-grade help establish your milk production and relieve engorgement. Your milk breastpump to can be given to your baby until he is able to nurse.

Treat engorgement to...

Make breastfeeding easier
Even if you feel as though you have lots of milk, engorgement can make it harder for your baby to latch on to your breast and feed well. A poor latch-on can give you sore nipples. Your baby may also have trouble coping with the flow of milk from engorged breasts.

Protect milk production
When milk isn't removed from your breasts, you will produce less milk. Treating engorgement gives your baby more milk now and helps protect milk production for when your baby is older.

Avoid blocked ducts or mastitis
Engorgement can result in blocked ducts leading to mastitis.

When to treat

Take action to relieve engorgement if your breasts feel firm, hard, shiny or lumpy. When milk is removed, blood circulation improves and swelling reduces. Use the suggestions below to reduce swelling and keep your milk flowing. Many mothers have a slight temperature when their breasts are engorged. Temperatures under 38.4ºC are not usually associated with infection. Keep your baby close and continue breastfeeding.

Engorgement after the first weeks

Treat as outlined below while working out the cause so you can prevent it happening again.

Common causes of engorgement are:

A missed feed or expressing session.
This can easily happen during holidays and festivities or when visitors arrive. Encourage your baby to feed more often, or express more frequently if you're apart from your baby.

Feeding a baby on a schedule
Recent research has revealed that mothers vary in how much milk their breasts can store without becoming uncomfortable. Mothers following routines often suffer from engorgement, mastitis and low milk production because their breasts are not drained often enough.

Expressing milk.
Some books advise expressing to keep milk production one step ahead of a baby's needs. However, making more milk than your baby needs can increase your risk of engorgement and mastitis, especially if you go for several hours without feeding or expressing.

A baby who is unable or unwilling to nurse well for any reason
Expressing milk frequently until your baby can nurse well will help you maintain milk production and avoid blocked ducts or mastitis.

Weaning from the breast too quickly
If you experience engorgement duringweaning, you may need to slow down the process. This will give your breasts time to adjust to the reduced demand for milk. If breastfeeding more often is not an option, try expressing just enough milk to relieve the fullness by hand or pump.

Treating engorgement
Reduce swelling and keep milk flowing:

Aim to breastfeed every 1½ to 2 hours during the day, and at night every 2-3 hours from the start of one feed to the start of the next. Let your baby finish on the first breast before switching to the second

Avoid using bottles or dummies. If a supplement is needed try using a spoon, flexible feeding cup or syringe.

Between feeds, apply ice for 15-20 minutes at a time between feeds to reduce swelling. Use an ice pack, crushed ice in plastic bags or bags of frozen vegetables (that can be refrozen several times before being thrown away). Wrap them in a lightweight towel to protect your skin.

Just before feeding, apply moist warmth to your breasts for up to two minutes to help milk flow. Try a warm wet towel, warm shower or immersing breasts in a bowl of warm water. Then, express to comfort if your baby isn't ready to feed.

Use gentle massage from the chest wall toward thenipple area in a circular motion.

Be sure your baby is sucking effectively:

Position your baby with his chest and tummy in full contact with your body. With his cheek in close contact with your breast, your baby can easily tip back his head to latch on. This way he'll take a large mouthful of breast. Listen for swallowing as he feeds.

If your baby is finding it hard to latch on - when your baby bobs his head and licks the nipple, he naturally makes it easier to latch on.

For more information on getting your baby positioned and attached comfortably see here.

Reverse pressure softening

works by moving fluid away from the nipple area.

Press all five fingertips of one hand around the base of the nipple. Apply gentle steady pressure for about a minute to leave a ring of small dimples on the areola.

You can also press with the sides of fingers. Place your thumb on one side of the nipple and two fingers on the other side where your baby's lips will be.

If this isn't enough, gently hand express a little milk before feeding to soften the areola. If you choose to use a breastpump, set it to minimum suction.

Keep comfortable:

Ask your midwife or GP to recommend an over-the-counter, anti-inflammatory medication suitable for breastfeeding mothers to relieve pain and swelling.

A well-fitting, supportive bra may help. Avoid bras (and underwires) that are tight or put pressure on specific areas of the breast.

Cold, raw cabbage leaves worn inside a bra can be soothing. Change when they become wilted or after about 2 hours. Use only until swelling goes down as long-term use may reduce milk supply. Stop use if a skin rash or other signs of allergy appear.

Watch out for symptoms of mastitis:

Inflamed, hot, red or darkened localised areas of your breast, depending on your skin tone. Changes in breast appearance may be harder to spot in darker skin. You may still have engorged breasts without a noticeable red or darkened area.

Temperature over 38.4ºC or flu-like symptoms.

Weaning can make a breast infection worse so continue to breastfeed frequently especially on the affected side and treat as for engorgement. Rest and drink fluids. If fever persists, continue breastfeeding and check with your GP as you may need antibiotics. More information on mastitis.

Engorgement should improve within a day or two. If not, contact an LLL Leader for further suggestions. You may need to improve your baby's breastfeeding technique or find ways to reduce your milk supply. These are not difficult problems to solve, especially if treated promptly.

Written by Karen Butler, Sue Upstone & mothers of La Leche League Great Britain

Further Reading

The Womanly Art of Breastfeeding. LLLI. London: Pinter & Martin, 2010.

Beginning Breastfeeding
Comfortable Breastfeeding
Dummies and Breastfeeding
Hand Expression of Breastmilk
Mastitis
My Baby Won't Breastfeed
Nipple Pain - why and what to do
Positioning and Attachment
Sleepy Baby - why and what to do

This information is available to buy in printed format from our shop

Copyright LLLGB 2016

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Engorged Breasts - avoiding and treating - La Leche League GB

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Engorged breasts are painful. They feel heavy, hard, warm and sensitive -as if they are ready to burst! As well as being painful, engorgement can lead to other breastfeeding problems if not treated. Being able to recognise engorgement will help you to treat it promptly, avoiding complications.

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An increasing number of mothers and health professionals have sought to find more information on the levels of medicines passing through milk to the baby. Standard reference books such as the British National Formulary (BNF) provide little information for professionals and parents to make decisions on individual situations. BfN endeavours to provide information to enable mothers to breastfeed their babies for as long as they wish and to provide information on the safety of medicines for each mother and baby pair.

Please use the below links for more information

We are constantly reviewing the information available on drugs and breastfeeding as new research is conducted. Therefore, from time-to-time the information on this website may be updated - please be sure to check regularly for any new information and changes to the drug information fact sheets and leaflets.

What is the Drugs in Breastmilk Information Service?

The original Drugs in Breastmilk Helpline was set up by BfN in response to the number of calls we were receiving that concerned medication.

In 2017 we noticed that majority of enquiries from parents and professionals to the Drugs in Breastmilk Helpline were coming via email or social media. As a charity operating on reducing funds we need to run the service in the most efficient and effective way possible without compromising the needs of parents. As a result we decided to run the Drugs in Breastmilk service via email and social media enquiry only.

You can still access information on taking prescription drugs while breastfeeding by sending a private message via our Facebook page or via . Please provide as much information as possible (age of baby, dose, frequency and name of medication or drug). All enquiries are answered as soon as possible by one of our small, volunteer team of qualified pharmacists or breastfeeding supporters. As we can't guarantee a response time, in an emergency situation, please do not wait for our reply, but access help from a trained healthcare professional.

If you call the old Drugs in Breastmilk helpline 0844 number, you will hear a recorded message with information about where to access alternative support. Calls won't be answered live and there is no voicemail service available.

If you still have the Drugs in Breastmilk helpline number on any materials or web pages please could you remove it and replace it with the following information:
'If you have specific questions about medications or treatments, please message the Drugs in Breastmilk information service Facebook page or email druginformation@breastfeedingnetwork.org.uk. If you require breastfeeding support, please call the National Breastfeeding Helpline on 0300 100 0212."

The service is open to mothers and professionals. As the time available to deal with breastfeeding support of mothers is limited, professionals are encouraged to find out the information to enable them to support the mothers themselves.

Evaluation of the Drugs in Breastmilk Information Service

In 2019, BfN commissioned Swansea University to undertake an evaluation of the DIBM service we offer. The executive summary of this report can be found and the full report can be found .

Become a Friend of Drugs in Breastmilk

Please click here for more information on how you can help support this vital service.

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Drugs In Breastmilk - Is It Safe? - The Breastfeeding Network

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An increasing number of mothers and health professionals have sought to find more information on the levels of medicines passing through milk to the baby. Standard reference books such as the British National Formulary (BNF) provide little information for professionals and parents to make decisions on individual situations.

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An example of a newborn baby crawling to the breast and starting a feed in the first hour after birth.

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Laura McIntyre - Local NCT Breastfeeding Counsellor

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Laura McIntyre - Local NCT Breastfeeding Counsellor

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You can contact me for support and information by phone or email and I will get back to you as soon as I can.
Tel: 07914456745 (texts only)
Email: LauraNCTFareham@gmail.com

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The NCT Infant Feeding line is available everyday 8am-midnight to help with all difficulties related to infant feeding.

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Details of local breastfeeding groups can be found on the Fareham and Gosport Breastfeeding Facebook page. This is run by the Breastfeeding Network and is a good place to gain support from other local breastfeeding mums.

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Welcome to Fareham and Gosport Breastfeeding The Breastfeeding Network (BfN) aims to be an independent source of support and information for breastfeeding women and those involved in their care....

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Sometimes interventions used in labour can make breastfeeding more challenging in the early days. If you think your baby's feeding may have been affected by one of these interventions, seek support.

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Whatever your birth options, your active participation is a big help in getting breastfeeding off to a good start. Making informed choices about where and how you give birth is the first step.

Even when medical concerns limit your choices, there may be more options available than your medical team shares with you. Take time to do research and discuss your preferences and choices with your birth partner. If you find you can't give birth in your preferred place, you can still follow the suggestions on this page for helping birth go well.

Birth options

Consider a birthing place where you can participate actively, whether you are having a vaginal or caesarean birth. Options may include giving birth in hospital, at home or at a birthing centre. Your choice may affect which midwifery team(s) care for you during pregnancy and labour. Think about giving birth supported by caring people you feel comfortable with. Follow your instincts to find a place where you can feel safe and private during and afterwards. If you feel stressed in labour, your body naturally produces 'fight-or-flight' hormones that may slow down labour and delay birth. If you feel in control, you are less likely to need unnecessary birth interventions that can affect breastfeeding.

Questions to ask

Which midwifery team(s) will be looking after me during my labour?

Will I be able to get to know the midwives beforehand?

Are options such as a low-tech birthing room or birth pool available, and how often are they used?

If I give birth at home or in a birthing centre, what will happen if I need to move to hospital?

Do the staff encourage labour in a variety of positions-for example, walking, standing, kneeling, kneeling while leaning forwards and holding on to something, or being on all-fours?

Will I be encouraged to hold my baby in skin-to-skin contact as soon as he is born and to continue to hold him afterwards as often and as long as I want?

Hospitals

A hospital that is a certified UNICEF Baby Friendly Hospital, or is working towards certification, will be implementing the UNICEF Ten Steps to Successful Breastfeeding programme. It's a good idea to plan a hospital visit before making up your mind. The website www.birthchoiceuk.com also has information on options, including statistics on caesarean section rates. According to The World Health Organisation, caesarean rates of more than 15% do not make birth safer.

Who will support you? In addition to a midwife, many mothers choose to have their partner, friend or other family member as a birth companion. Some mothers employ a doula too. A doula is a trained, non-medical labour-support person who can support you and your partner at home during labour, in hospital and in the days after the birth.

Labour

It can help to think of labour as 'work', with each contraction bringing you nearer the birth. After spending nine months keeping your baby nourished and nurtured in your womb, your cervix has to change tactics and open up for the birth. You'll feel your muscles working hard with the unfamiliar exercise. Most mothers can ease into an unmedicated labour which often has a wave-like natural rhythm. Breathing and relaxation techniques can be a very effective way of coping with the ebb and flow of contractions.

Ways to help labour go well

Preparation: talking to other mothers, reading and attending antenatal birth classes will help you feel more ready. Write down your birth preferences and discuss them with your midwife. But be prepared to go with the flow if your circumstances or feelings change. If you have older children make sure you have organized someone to care for them, wherever you plan to give birth.

Read about LLLGB's Antenatal Breastfeeding Classes here.

Privacy: consider who you want around you during labour, and ask those supporting you to protect you from unwelcome visitors. In hospital, create your own privacy by treating the room as your space. Keep the door closed, bring your favourite music, your own pillow and wear your own clothes if possible.

Eat and drink when you feel like it, especially in the early stages of labour. This gives you more energy to manage your contractions, the birth and those amazing first hours after your baby arrives. Prepare for it to take time: labour gradually develops from the normal Braxton-Hicks 'warm-up' contractions of your uterus, into stronger contractions that usually become painful and harder to ignore. Some women find contractions stop and start over a period of days or even weeks.

Every labour is different, even if you've had a baby before. As labour progresses you'll probably become more inwardly focused, concentrating on the work you are doing and less inclined to chat to the people around you. Your body will release natural pain-relieving endorphins. Towards the end you will feel like pushing.

Listen to your body: move around and change position when you are uncomfortable or if labour doesn't seem to be progressing. Follow your body's urges; lie on your side and rest if you feel tired; wander about or go outside for a walk if you feel like it. You're not ill-and you don't have to labour or give birth in bed. Lying on your back during labour generally delays birth and makes it all harder. It might also mean you need more pain relief medication which can interfere with breastfeeding.

Cutting the cord only after it has stopped pulsating reduces your baby's risk of anaemia in the first year of life.

Labour interventions

Knowing beforehand about possible interventions will help you to ask questions and decide whether to accept what you are offered. You might want to discuss these possibilities with your midwife. However, in the unlikely event of an emergency, medical staff will need to take action quickly to ensure the safety of you and your baby but they will tell you what is happening.

Induction

What can happen: the drug syntocinon (artificial oxytocin) is used to induce or speed up labour. It produces stronger, and possibly more painful contractions than your own naturally produced oxytocin. This often leads to further interventions, such as pain relief medication, an assisted delivery or a caesarean section.
What you can do: avoid routine induction if you and your baby are healthy. Consider whether there is a family history of 'overdue' babies. Review your dates, weigh up the risks and talk to your midwife about waiting a little longer to see if labour will start naturally. Some believe that having sex can help you go into labour.

Medications

What can happen: pethidine, epidural anaesthetics etc cross the placenta into your baby's bloodstream. He may feel groggy and have difficulty coordinating latching on and sucking at the breast for up to two weeks after the birth.
What you can do: Using non-medical pain relief such as water, massage, moving around and TENS can reduce your need for medical pain relief. If your baby is affected by medications, keep him in skin-to-skin contact as much as possible, even when he's asleep. Use Biological Nurturing™ laid back breastfeeding positions so you can watch for baby feeding reflex cues like mouthing movements, lip twitches or sucking whilst asleep and help him take the breast. Until they are feeding well, frequently express drops of your colostrum directly into their mouth.

Intravenous (IV) drips

What can happen: IV drips are used for certain induced births and caesarean births. Fluid from IV drips may cause engorgement in the early days. This makes it difficult for your baby to latch on deeply at the breast and may lead to nipple damage. Their birth weight may also be higher from any excess fluid which they then lose in the first few days.
What you can do: A few hours delay in weighing your baby may give a more realistic birth weight. Frequent feeds will help you avoid or reduce engorgement as your milk volume increases. To relieve engorgement, soften your breast by gently pressing swelling away from the nipple with your fingers (a technique known as reverse pressure softening). You can also hand express some milk.

Birth interventions

Episiotomy and assisted delivery with forceps or ventouse

What can happen: cuts and tears that need stitches may make sitting upright uncomfortable in the days after birth. Forceps or ventouse delivery can also leave your baby feeling sore, bruised and with a headache.
What you can do: m ove around in labour and choose your own positions for the birth: kneeling while leaning forward, being on all-fours etc. When breastfeeding, use Biological Nurturing™ positions to get comfortable and to help your baby recover. These and side-lying positions also limit pressure on your baby's head.

Caesarean section

What can happen: a caesarean is major abdominal surgery. You will take at least six weeks to recover from the birth and need help looking after your baby. Your baby may be affected by the anaesthetic (epidural or general) and be less able to feed well at the breast for the first few days.
What you can do: Insist on skin-to-skin contact with your baby as soon as he is born. You could write this in your birth preferences beforehand, just in case. If a general anaesthetic is required, a family member can be present and hold your baby skin to-skin until you are able to, and help you hold him if you're feeling shaky. Avoid any routine bottles-your baby can wait a short time for you. If possible reading our pages on caesarean birth and antenatal expression of colostrum before you go into labour. Biological Nurturing™ and side-lying positions can help you get comfortable whilst breastfeeding. Or try an underarm rugby hold.

Syntometrine injection

What can happen: once your baby is born, the placenta separates from the uterine wall. A routine syntometrine injection may be offered to assist this as many believe that this injection reduces the risk of excessive bleeding. Following a normal birth, few mothers need the injection. Side effects of syntometrine can include nausea or a headache, which may affect the early hours you spend with your baby.
What you can do: discuss this intervention with your midwife when writing your birth preferences. Keep warm and undisturbed. Skin-to-skin contact with your baby and breastfeeding immediately after birth encourages oxytocin production. Oxytocin contracts your uterus so your placenta is expelled naturally.

Separation

Sometimes and for various reasons you may be separated from your baby following birth. Plan to be in close body contact with your baby as soon as possible as this is the best way to establish breastfeeding. Separation because of health concerns may make breastfeeding harder, but it's still possible.

Hold, or at least touch, your baby immediately after the birth or as soon as you can. Once you are together again make up for lost time by spending as much time as possible snuggling together skin-to-skin or lightly dressed. If your baby is in special care you can still touch and stroke him and may be able to hold him against you in 'kangaroo mother care' for long periods of time. And if he can't feed at the breast straight away then expressing your milk for him is important. Many mothers say that this is the single most important thing they have done while they are waiting to start breastfeeding.

The first 24 hours

Your newborn baby already knows your voice and smell-and you are their whole world. He needs to be in continuous close contact with you and to have your milk as soon as he is ready. Breastfeeding is known as the fourth stage of birth. Lean back with your baby snuggled up against you, skin-to-skin, in full body contact.

Avoid interruptions until after they have had their first breastfeed. Weighing and washing need to wait-this is much more important. Watch as he nuzzles your body and uses their legs to push himself to your breast. They may turn their mouth towards your breast-the rooting reflex. Their head may bob around as he tries to latch on or he may just lick for a while. They may take a look around at their new surroundings. But sometime soon they'll probably take a big mouthful of breast. They may feed for quite a while or they may take a few sucks and fall asleep, waking on and off, sucking and feeding whilst asleep.

Your baby's instinctive feeding responses work when he is asleep too and will h elp him find the breast, latch, suck and drink. Your body will respond by releasing prolactin and oxytocin, the hormones that make and release milk. These hormones also help you bond with your baby making mothering easier and more natural.

Some babies will feed on and off for an hour or two, others more continuously for a shorter time. Keep your baby on your body or close by while he sleeps so you'll notice when he is ready to feed. A young baby's sleep cycle lasts about 60-90 minutes. Transitioning from light to deep sleep may be hard for him and it helps to hold him as he goes into deep sleep.

And so to sleep

If your baby has an enjoyable feed just after birth, they may sleep for up to six hours. This gives you time to rest and eat. Hold your baby as much as you want-ideally skin-to-skin wearing just a nappy and a blanket over their back to keep him warm.

If a baby is wrapped and put down, they won't be reminded to rouse and feed. If you think they need a feed you don't need to wake them. With them snuggled against you it's easy to gently encourage them to latch on while they are in a light (REM) sleep. Watch for rapid eye movements under their closed eyelids, arm and leg movements, sucking activity and changes in their facial expression and then encourage them to latch on.

If your baby doesn't feed within an hour of the birth, they may sleep deeply. Keep them skin-to-skin with you and drip expressed colostrum into their mouth every hour or two until they are ready to latch on.

If your baby doesn't feed frequently over the next few days, hand express colostrum and drip it into their mouth every couple of hours, including at least once between midnight and 5am to boost your milk producing hormones. When your baby is awake, you will probably want to gaze intently at each other and enjoy getting to know one another. Read the section on Wakeful Nights for more on sleep.

If your baby needs special care

You are still the most important person to your baby. They will recognise your voice and smell and they need your milk as soon as they can take food. Breastmilk protects a baby from NEC (gut damage) and other illnesses so ask staff to show you how to hand express. If you are well, start hand expressing within six hours of the birth; if you are unwell, as soon as you feel able.

Until your baby is able to breastfeed:
Express milk 8-10 times in 24 hours to build your milk supply, including once during the night. You can switch to using a pump as your milk increases. Talk to your baby and touch them as much as possible. Ask staff when you can start skin-to-skin contact with them. This helps your milk production and your milk ejection reflex (let-down). It also calms and stabilises your baby and feels wonderful.

Early Days

Day 2
Give your baby plenty of chances to learn to breastfeed by holding them in skin-to-skin contact most of the time. You can wear a gown or loose pyjama top and wrap it round them, or cover them with a blanket. Expect your baby to feed 8 to 12 times in 24 hours, including night feeds. Relax and enjoy these special hours together.

Days 3 to 5
Your colostrum will start to change from golden to bluish-white as you produce more milk. Your breasts will start to feel full, even engorged or sore, making it harder for your baby to latch on well. They need to get a deep latch so feeding won't make your nipples sore, so: breastfeed (or express) frequently. If your breasts feel softer and more comfortable after feeding, your baby is getting milk.

Avoid using bottles or dummies. If a supplement is needed try using a spoon, flexible feeding cup or syringe. Use a cold compress for 15-20 minutes between feeds to reduce swelling, or place cold cabbage leaves inside your bra. Apply moist warmth to your breasts for up to two minutes just before feeding to help your milk flow.

Problems with feeding

If your baby is sleepy from a difficult birth or medications used, they may not feed well. You can drip hand expressed colostrum directly into their mouth or give it to them by cup, spoon or syringe. As you produce more milk, you can use a pump until your baby is feeding well. Ask for help to get breastfeeding established. When they latch on, it should feel comfortable for you (after the first few sucks).

If your baby is finding it hard to latch on

When your baby bobs their head and licks the nipple, it naturally makes it easier to latch on. Reverse pressure softening has a similar effect by moving fluid away from the nipple area: press all five fingertips of one hand around the base of the nipple.

Apply gentle steady pressure for about a minute to leave a ring of small dimples on the areola. You can also press with the sides of fingers. Place your thumb on one side of the nipple and two fingers on the other side where your baby's lips will be.

Falling hormonal levels after the birth can make you feel emotional, upset or weepy. This is absolutely normal and typically lasts just a few days.

Jaundice

Jaundice is common and normal in newborns. Getting breastfeeding off to a good start can prevent it becoming a problem which needs treatment. If your baby has jaundice, frequent breastfeeding and/or expressed breastmilk will help clear the yellow bilirubin pigment. If further treatment is needed, our page Jaundice in Healthy Newborns has more information.

Wakeful nights

While your baby is small, you will find some nights are particularly wakeful, including the second night just before your milk 'comes in'. Your baby may want to feed very frequently, doze off and then wake again, protesting if put down.

Keep your baby close so they can feel your presence and hear your heartbeat, just as in the womb. Let them breastfeed frequently-it will boost your milk production.

If you need to put them down to sleep, wait until they fall into a deep sleep. You could cover them with a sheet or blanket while feeding, then lay them down on the cover to avoid contact with a cool surface.

Avoid using mittens-their hands are familiar and soothing, mittens feel strange. And the touch of their skin on your breast boosts oxytocin and your milk.

It's never too late to try breastfeeding

If your birth is more difficult than anticipated, you and your baby have problems or are separated for any reason after the birth it may take you both a little longer to feel closely connected and get breastfeeding going well.

If this happens to you, keep your baby with you. Decline offers from others to look after him-ask them to do something practical to help you instead. Relax together with your baby snuggled up against you in Biological Nurturing™ laid-back breastfeeding positions, either lightly dressed or in skin-to-skin contact. Spend as much time as possible with their whole body against yours.

Take a warm bath together and focus on just admiring him. Breathe in their special smell, nuzzle and kiss him-some mothers even get an urge to lick their babies. All these can encourage your baby's natural instinct to feed and help you feel more motherly and that you belong together.

How often will my baby need to feed?

Babies have tiny tummies so they can't wait long for food. Even adults rarely go longer than a couple of hours without a drink, snack or meal. Breastmilk is quickly digested so in the early weeks a baby needs to nurse pretty constantly- at least 8-12 times in a 24-hour period, including feeds at night. You release more of the milk-making hormone prolactin during night feeds. Late afternoon/ evening feeds are often closer together too. This 'cluster feeding' is normal.

As your breasts adjust, they will feel softer. It doesn't mean your milk supply has dropped. From Day 3 onwards 3-5 poos (at least the size of a 2p coin) per 24- hours are reassuring signs. Frequent feeds are a gradual transition from continuous feeding in the womb. Hunger is a new sensation for your baby so try not to make him wait until he's too desperate to feed well.

Watch for:

Mouth movements, including smacking or licking their lips.

Sucking on lips, tongue, hands, fingers, toes, toys, or clothing.

Rooting, head bobbing or nuzzling against whoever is holding them.

Fidgeting or squirming a lot.

Fussing.

Crying

Crying is nature's emergency siren and a late sign of hunger. It's designed to summon help quickly. As well as being stressful for you it's stressful for your baby. Crying raises cortisol levels (which can affect brain development) and increases your baby's blood pressure. Life will be happier for everyone if you can respond quickly. Once you get to know your baby better you'll be able to work out what they need most of the time as soon as they start to fuss, long before they need to cry. And thye'll learn to relax knowing that you'll look after them.

Sucking patterns

Watch your baby's pattern of sucking. They will suck rapidly until milk starts to flow. Once the milk is flowing you'll see a pattern of suck-swallow-suck-swallow. The frequency of sucks gradually slows as the feed progresses.

Once swallowing movements start to trail away and your baby relaxes and gets sleepy, it can be useful to change sides. This can prompt them to take some more.
Getting rest
Many mums feed lying down in bed at night (or in the day) to get more rest. Research shows that keeping your baby close while they are asleep protects against Sudden Infant Death Syndrome (SIDS) but you should never sleep on a sofa or chair with your baby. Do not share a bed with your baby if any adult in the bed smokes, has drunk alcohol or taken prescription or other drugs. Talk to an LLL Leader and read our page Safe Sleep & the Breastfed Baby as you decide how best to manage night-times.

Visitors

It's OK to set limits on visiting-in fact it's a really good idea. The first few days are a very special chance for you and your partner to get to know your baby peacefully together. If the birth was difficult it may help to write down your birth story or talk to someone about your feelings to help you come to terms with how it all happened.

Support

No matter how birth goes, with good friends and support, most mothers and babies breastfeed.
Calling an LLL Leader or going to your local LLL Group while pregnant means you'll make breastfeeding friends and have access to support and information right from the start. If you have problems in the first week, or if your baby isn't feeding well, seek help as soon as possible.

As well as your midwife or health visitor, you can contact an LLL Leader. You can also find lots of information on common concerns in the first weeks in our Further Reading section.

Written by Rachel O'Leary, Sue Upstone, Karen Butler and mothers of LLLGB.
Kimberly Seals Allers' photos on this site are used under a creative commons license of Black Breastfeeding 360° http://mochamanual.com/bb/

Further Reading
Adjusting to Motherhood
Caesarean Birth & Breastfeeding
Positioning & attachment
Comfortable Breastfeeding
Engorged Breasts - Avoiding & Treating
Is My Baby Getting Enough Milk?
My Baby Won't Breastfeed
Jaundice in Healthy Newborns
Safe Sleep & the Breastfed Baby
Sleepy Baby - Why & What To Do
Successfully breastfeeding your premature baby
What's the Big Deal With Skin-to-Skin
Mothering through special care

Other websites
www.birthchoiceuk.com
www.biologicalnurturing.com
www.unicef.org.uk/babyfriendly

Books
The Womanly Art of Breastfeeding, LLLI. London: Pinter & Martin, 2010.
Birth: Countdown to Optimal, Donna, S. Chester le Street: Fresh Heart Ltd, 2011

References
An Introduction to Biological Nurturing: New Angles on Breastfeeding, Colson S. Amarillo, TX: Hale Publishing, 2010.
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, TX: Hale Publishing, 2010.
Supporting Sucking Skills, Watson Genna, C. Burlington, MA: Jones & Bartlett, 2012.

This information is available in printed form from our shop.

Copyright LLLGB 2016

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Birth & Breastfeeding - La Leche League GB

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active participation is a big help in getting breastfeeding off to a good start: follow our suggestions for helping birth & breastfeeding go well

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Evidence suggests that having a supportive partner greatly influences the success of breastfeeding.

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New parents need time to adjust to their new roles. Life may change dramatically, especially for a ﬁrst time mother-many women say they didn't feel prepared for the emotional upheaval they experienced on becoming a mother. Even experienced mothers can have difﬁculties juggling the needs of the new baby with those of older children.

At this time a pair of practical helping hands can make a big difference by allowing a mother time to recover from the birth and establish breastfeeding. In the early days, a baby will probably want to breastfeed a lot of the time they are awake. At this stage, a mother may only be managing to eat, sleep and nurse the baby.

This is normal. At ﬁrst their mother and nursing will be at the centre of a baby's world. The security of a baby's bond with their mother is the basis for all other relationships. A breastfeeding mother generally feels an intense connection with her baby, both emotionally and physically, due to breastfeeding hormones and the practical need to stay close to nurse her baby.

This way, babies get what they need to thrive. A baby's wants are a baby's needs-they can't wait like an adult can. By meeting your baby's needs a mother gives them a secure attachment so they can develop into a conﬁdent child.

Why breastfeed?
When can a baby start eating solid food?
When will a baby sleep through the night?
When does breastfeeding stop?
Support for mothers is important
Ways to support a breastfeeding mother
What breastfeeding mothers say when asked what would help
What about partners?
What about dads?
Two women having a baby
What about other family members?
What about visitors?
Other ways to help
When a mum has no support

Why breastfeed?

Breastmilk has everything a growing baby needs in exactly the right amounts and is easy to digest. Research shows that a baby who is not breastfed is more likely to suffer from health problems, both as a child and throughout adulthood. Infant formula increases a child's risk of (amongst many other health problems): SIDS, Cancer, Obesity, Diabetes, and Allergies.

See Amazing milk for more information.

What about breastfeeding in public places?

Babies often want to breastfeed when people around them are eating and drinking-and why not? Mothers breastfeed in many public places and tend to be so discreet you may not even have noticed.

Breastfeeding is also convenient when a mother is out and about. She can spot early feeding cues and offer a feed before her baby gets frantic-well before those around her are even aware. After all, no one notices a baby nestled in mum's arms but a crying baby guarantees an audience!

When can a baby start eating solid food?

Breastmilk is a complete food so a healthy baby needs only breastmilk until about the middle of the ﬁrst year. There's no beneﬁt to be found in introducing solid foods before this time. If a baby seems hungry, more breastmilk usually does the trick-mothers could breastfeed more often, offering both sides. Many babies who start on solid foods from around six months quickly learn to feed themselves and enjoy sitting up with the family at mealtimes.

See Starting Solid Food.

When will a baby sleep through the night?

A baby will need to breastfeed during the night for a number of months to ensure they take in enough milk and to maintain their mother's milk production. Just as there's no ﬁxed age for when a baby is ready to walk or talk, there's no real way of knowing when they will be ready to sleep through the night. Consider whether you sleep through the night now? Many adults wake, turn over and go back to sleep as a matter of course. As a baby grows their sleep cycles will naturally get longer. In the meantime, they will wake and be likely to need the comfort of mother, her co-parent or other family member's presence to help them relax and fall back to sleep.

What about bottles and dummies? Bottles or dummies can confuse a baby's sucking technique, so if a supplement is needed, a spoon, ﬂexible feeding cup or syringe can be used. Giving formula affects a mother's milk production since a baby will take less breastmilk. Some mothers express milk for their partner, or another support person, to give but expressing takes more effort than simply breastfeeding. If a mother is ﬁnding night feeding exhausting you could encourage her to rest during the day, to try feeding lying down and to keep baby close at night so she doesn't have to get up. See our page on Safer Sleep for more information.

When does breastfeeding stop?

When does a baby's need to use nappies or a highchair stop? It's all very individual. It doesn't usually help to push children on to the next stage until they are ready. Breastmilk is just as nutritious as it was when they were tiny and it still protects them from infection. There is no evidence that continuing to breastfeed makes a toddler clingy-in fact the opposite may be the case. A toddler may seem big but emotionally they are still a baby. It's easier on mother and baby to let breastfeeding end gradually.

Breastfeeding bonuses

Nothing compares with breastmilk for growing healthy, clever babies.

No getting up to prepare bottles during the night.

Your baby's nappies won't smell bad.

No feeding equipment and expensive formula to buy for your baby.

Less to take with you when you go out with your baby.

Support for mothers is important

One very real problem is that many mothers don't receive enough support in the early days and months, and simply try to do too much. Most mothers who stop breastfeeding before they want to cite lack of support as the reason. They need time to recover and adjust, especially after a difﬁcult birth. Caring for a newborn really is a full time job, and that's before you add in essential jobs around the house and caring for any older children. All mothers need practical help and support.

The biggest challenges for all mothers are:

Getting enough sleep.

Keeping up with basic housework.

Lack of emotional support.

Isolation

The help you give can make a lot of difference to a new mother, especially when her baby seems to be nursing all the time and is waking at night. Be sensitive to her needs. What you can offer and do will partly depend on whether you are a friend or family member, and the closeness of your relationship. Some mothers will want more practical help, others more emotional help-and a mother may have strong views on what help she will accept and from whom.

Ways to support a breastfeeding mother

You may be her partner, the baby's dad or mum, a family member or friend. All mothers need support, and whatever your relationship to her there are things you can do to help.

With baby:

Walks in the fresh air. Consider wearing baby in a sling or other carrier.

Go out and about; babies are social people.

Read and sing to baby-they'll love hearing your voice.

Take a bath together, or bathe them in the baby bath. Many babies love bathtime!

Sleep with them. Visit our page on Safer Sleep and the Breastfed Baby.

Hold them on your chest while they nap to help your baby feel safe and relaxed.

Nappy changes are perfect for games and chat.

Talk to your baby about things around the house.

Take your baby to their mother whenever they need her.

Use the Magic Baby Hold: with your baby's back against your front, bring your left arm over their left shoulder (one arm on either side of yours), and hold their right thigh.

Try other comfort techniques.

Jiggle and sway. Babies tend to like side- to- side motion.

For the breastfeeding mother:

Make sure she has food and drinks.

Cut her food up for her if she's holding the baby!

Hold the baby so she can take a shower.

Help her get good help if she needs it.

Guard against too many visitors. Let others know when you need to be alone. Protect mum and baby from over-enthusiastic visitors and callers, and try to ensure you all have some peaceful uninterrupted time together. Turn off the phone and put a 'do not disturb' sign on the front door.

Look after older children. Provide fun activities and opportunity for exercise. Try to meet their needs for attention, sleep and healthy food.

Fight off any pressure to separate mum and baby. Help mum and baby spend lots of time snuggling together in the hours and days after birth.

What breastfeeding mothers say when asked what would help

"The best presents for a new mum are home cooked meals frozen in take away tubs- ready meals but real food!"
"Order a box set & takeaway!"
"I need friends supporting me, sharing laughter and tears, coffee and cake"
"Make sure I have water, muslin, remote control, phone, book & cake"
"Bring me snacks that are tasty, healthy and one-handed!"
"When it's really hot and my baby is going through a growth spurt, bring me long, cool glasses of water!"
"The best way anyone can help is by taking care of the pile of washing up!"
"Call me during the day to say 'Hi!' and ask how I'm doing""Please don't try and give my baby formula, the moment you do you undermine my confidence in my body's ability to sustain my baby"
"Give me support & encouragement and tell people who criticise or question me that I'm doing ok"
"Don't tell me it is 'normal' and that I should persevere if I am in pain"
"Pass me the phone with a breastfeeding counsellor on the other end if I'm in pain"
"Never say 'well you are breastfeeding' when I say I'm tired"
"Tell me it's ok to take one feed at a time"
"Give me a thumbs up!"
"Tell me my baby is beautiful""Take my older children to the park"

Below is lots of information about supporting a breastfeeding mother, divided into different sections. You may find useful information in all of the sections regardless of your own role and relationship to mum and baby.

What about partners?
Your baby doesn't need you to feed them.* So what can you do? Anything else! You are The Safe Person Who Is Not Mum.
Whether or not you are your baby's biological parent, and whatever your family looks like, your partner needs your support. In the early days, your baby will probably want to breastfeed a lot of the time they are awake. At this stage, your partner may only be managing to eat, sleep and nurse the baby. This is normal.

At first their mother and nursing will be the centre of your baby's world. Don't worry if you find you don't get to hold your baby for long before their mum is needed again. A baby's bond with their mother is the basis for all other relationships. Encouraging the closeness with mum will strengthen their love for you later. Soon that tiny baby will be reaching out to the rest of the world. They will want all the fun and excitement you can give!

You are different. Your shape, voice, hands, and smell are different. You hold baby differently. You teach them that different can be good, and when they are frazzled you may be just the difference that your baby needs needs.

As life settles down you and your partner will probably both need time to adjust to your new roles as parents. Many women say they didn't feel prepared for the emotional upheaval they experienced on becoming a mother. You'll also find lots of changes in your life.

Breastfeeding mothers often feel an intense connection with their baby, both emotionally and physically, due to breastfeeding hormones and the practical need to stay close to feed the baby. It can be easy to feel a bit left out of this. Try to get involved in practical ways. It will help you bond with your baby-your partner will love you for it and so will your baby.

You may both find that your baby becomes central to your life-their needs being met before either of yours. This is nature's way of ensuring babies get what they need to thrive.

Your first job is to support breastfeeding, not compete with it. A "relief bottle" may seem helpful, but it's more likely to cause breastfeeding problems and health risks for baby. Protect your partner from criticism and tell her she's doing a good job. Protect your partner from well meaning but unhelpful advice that undermines breastfeeding-even if it comes from your own mum!

Admire and praise your baby's mother. Your love and encouragement will work wonders. Firmly resist pressures to feed baby anything other than mum's own milk before he is six months old. Your baby doesn't need other foods until they can sit up and begin to feed themselves. Even then, breastmilk carries on being an important food for older babies and toddlers.

*Some non-gestational mothers do breastfeed their babies. See the section Two women having a baby

What about dads?

Dads feel different, they often have deep voices and a different smell. They move and hold a baby differently. At the end of a long day, dad, with all his special differences, can be just what baby and mother need. Dads are fun and have a special gift for playing with babies. They play the sort of exciting games babies enjoy. Your baby will adore your singing and funny noises (even if mum doesn't). And you'll probably enjoy your baby's toys as much as he does! Dads are just as good at cuddles as mums. A great way to comfort your baby is to use a carrier-babies usually love them and it's a handy way to settle your baby. At times when your baby is fussy or uncomfortable and nothing else works, the colic hold is a dad's speciality.

Caring for your baby teaches them that love comes from interacting with people as well as from food.

Try some of suggestions in the section above Ways to support a breastfeeding mother.

You can support your baby's mother by making the most of your paternity leave. Take as long as you can manage. Take it when the mother and baby would otherwise be at home alone. Concentrate just on the needs of mum, baby and any other children. Let everything else wait.

Meet your baby's need for you. Your baby needs you to be a dad, not a substitute mother. Spend time with your baby and enjoy your unique father-baby relationship.

Two women having a baby

For lesbian couples, if you're the non-gestational parent you may feel left out - especially if you have to explain you are the baby's mother too. Finding support for yourself and your breastfeeding partner is important. Your partner and your baby need you now, and your baby will need you more and more as they grow. You could be entitled to paid leave although your employer may not be aware of this, there are resources in Further Reading that might help.

In some couples two mothers do share breastfeeding; others find different ways to connect, you'll find lots of ideas in the section above Ways to support a breastfeeding mother.

Deciding to share breastfeeding, and how you do that, are personal decisions. You can read about how one couple shared breastfeeding here:

You will find resources in Further Reading, or contact your local LLL Leader who can help you talk about your options.

What about other family members?

Is the new baby in your family breastfed? New research has shown that breastfeeding is important for the baby's health and development and for the mother's health, both now and in the future. It's even good for the environment.

Research has found that breastfeeding works best when the baby is fed in response to hunger cues, not on a schedule. That's usually quite frequently, especially in the beginning. Fortunately, you can't feed too often.

Sore nipples aren't an expected part of breastfeeding; they are a sign that something isn't quite right. With some expert help, the mother should soon be breastfeeding comfortably.

Most medical experts, including the NHS and the World Health Organization, recommend that babies be breastfed exclusively- no formula or solid foods- for six months or so, and continue breastfeeding with solid foods added to their diet into these toddler years-even two years or more.

Much of this may be different from what you learned when you had your own babies. But guess what hasn't changed? New mothers still need lots of help, lots of support, and lots of loving family members around to prepare meals or throw in a load of laundry. They need people to be patient with them as they figure out both breastfeeding and motherhood. And babies still need their grandparents, aunties, uncles, cousins, siblings and other family members to love them. Your practical help and support are a golden investment in your family's future, and in your lives together.

What about visitors?

Prioritise tasks: the needs of people are best dealt with before housework. Avoid trying to take over baby care or expecting to be entertained when you visit. Concentrate on 'mothering the mother' and helping with household jobs.

Offer practical help with housework and essential tasks: grocery shopping, laundry, preparing meals or providing a meal that can simply be reheated, leaving her a sandwich lunch, washing up and cleaning the kitchen, t idying and vacuuming.

Bring her the things she needs while nursing: eg drinks, snacks, pillows, books, the TV remote, her mobile.

Make her a drink and offer your company for a while.

Tell her how well she's doing.

Listen if she is feeling worried, tired, or overwhelmed. She might find it easier to talk to you about her worries than to close family.

Help her ﬁnd another mother to talk to.

Help with the baby and any older children: changing nappies; care for the baby while mum sleeps, goes to the loo, takes a short walk or a bath.

Entertain and care for older children. Perhaps take them out for a walk, to the park or invite them round to play with your children. Help with the school run or taking older children to after school activities.

Other ways to help

Welcome breastfeeding so the mum feels comfortable nursing in your presence, be a breastfeeding advocate. Avoid undermining her conﬁdence by asking negative questions like, "Are you sure the baby is getting enough to eat?" or, "Why aren't they sleeping through the night yet?". Offer a sympathetic ear rather than advice when she complains or seems tired-try to support and encourage.

Find out about what is normal for nursing babies of different ages. Remember that breastfeeding problems have breastfeeding solutions. Bottles or weaning are rarely the answer.

Encourage or help the mum to ﬁnd the support she needs. Mothers can easily get skilled help from an LLL Leader by calling our Helpline.
An offer to take the mother to her local LLL group when she feels ready may be very welcome. It can be hard to get out of the house when you have a new baby.

Many mothers will appreciate having someone familiar with them when they go to a new group for the ﬁrst time, and any woman is welcome at meetings. Some groups may also run meetings for couples.

When a mum has no support

LLL meetings are a great place to meet other mothers and to share experiences. If there is no LLL group in your area you may be able to attend online meetings, and join Facebook groups to get support and share experiences with other breastfeeding mums. Contact us for details.

Homestart are a national charity who help families with young children. Their website has lots of practical ideas and stories, and also details of how to contact Homestart in your area.

Your Health Visitor will have details of local activities including post natal groups. Libraries and playgroups are good places to meet other mums.

If you, or a mum you are supporting, is feeling depressed or down you might find useful information on our Adjusting To Motherhood page.

Written by mothers of LLLGB and adapted by Ellen Mateer. The original text of Supporting a Breastfeeding Mother was sponsored by Jill Welsh in memory of her mother, Rose Wesby, who encouraged her to breastfeed and showed her the gentle art of mothering.

Further Reading
Amazing Milk
Beginning Breastfeeding
Comfortable Breastfeeding
Caesarean Birth & Breatsfeeding
Dummies & Breastfeeding
Is My Baby Getting Enough Milk
Out and About With Your Breastfed Baby
Parenting when you partners breastfeeds
Rhythms & Routines
Safe Sleep and the Breastfed Baby
Smoking & Breastfeeding
Starting Solid Food
Relactation & Induced Lactation
Mothers on ... support from our nearest & dearest
LLL's father concept - it's not just about dads!
Relactation and Induced Lactation
The Womanly Art of Breastfeeding LLLI. London: Pinter & Martin, 2010.

Other online Information
Breastfeeding in a Same-Sex (Female) Relationship
Induced Lactation and the Newman-Goldfarb Protocols for Induced Lactation
Breastfeeding Without Birthing

The information on this page is adapted from Supporting a Breastfeeding Mother and Parenting when your partner breastfeeds which are available to buy in printed form from our shop.

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Supporting a Breastfeeding Mother - La Leche League GB

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New parents need time to adjust to their new roles. Life may change dramatically, especially for a ﬁrst time mother-many women say they didn't feel prepared for the emotional upheaval they experienced on becoming a mother. Even experienced mothers can have difﬁculties juggling the needs of the new baby with those of older children.

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How to tell if breastfeeding is going well.

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How to tell if breastfeeding is going well.

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A simple table to help decide when you can relax and when it might be worth seeking support.

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What goes in must come out! Therefore, you can use your baby's nappy as a guide to how well the feeding is going. If your baby is not producing as many wet or dirty nappies as you would expect, seek support from your midwife, health visitor or a breastfeeding counsellor.

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Newborn baby poo in nappies: what to expect

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Your baby’s nappy can tell you a lot - find out more here.

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Tips to help you cope with a crying baby and recognise what might be wrong.

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How to cope with a crying baby - NCT Matters

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Watch the video for techniques to soothe your baby when it is crying, and tips on helping you cope. For more information on how to deal with a baby that won't stop crying, click here.

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Lots of practical tips for feeding whilst out and about

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Breastfeeding in public can mean breastfeeding in front of a relative or friend in your own home, or in a public place, such as a cafe or shopping centre.
During your baby's first few days, you may prefer to breastfeed only where you feel most comfortable. But, as you get more used to doing it, you're likely to feel more confident about breastfeeding in front of other people when you're out and about.

Most people support women breastfeeding in public. The more it's done, the more normal it will become.

Here are some ideas to help you get started.

Know your rights. You should not ever be made to feel uncomfortable about breastfeeding in public. It is illegal for anyone to ask a breastfeeding woman to leave a public place, such as a cafe, shop or public transport.

Plan ahead. Before you go out, it can help to think about where you will feel comfortable breastfeeding when your baby gets hungry. Ask breastfeeding friends for recommendations.

A midwife, health visitor or peer supporters at a local breastfeeding drop-in will also know of good places in your area where you can feed your baby.

Clothes and bra. What you wear when you're breastfeeding is a matter of personal taste and what you feel comfortable in. For example, some mums like to wear loose tops that can be lifted up.

Others, who prefer to keep their tummy covered, wear two stretchy tops, so that the top layer can be lifted up and the bottom layer can be pulled down. A soft, non-underwired bra can be easily pulled up or down when you want to feed your baby.

Baby slings, scarves and cloths. Some baby slings are designed so you can breastfeed while your baby is in the sling. Some mums feel more comfortable putting a scarf or muslin cloth over their chest while they're breastfeeding.

Take someone with you. It can help to go with a friend who has an older baby and can take you to places that she already knows. You could go with someone else, such as your mum, partner, sister or friend, so that there's always someone to talk to.

Avoid the loos. Do not feel that you should sit in a public toilet to breastfeed. You would not eat in there, so do not feel that your baby should be fed there.

Mums talk about breastfeeding away from home

2 breastfeeding mums talk about their experiences of feeding in public:

Cara, from Banbury

"I thought I would need special nursing tops, but once my baby finally arrived, I realised that my normal clothes (and favourite maternity tops) all worked much better. I could pop my baby under my top to feed her, and she would be tucked up next to my skin.

"It took me a while to get the hang of attaching her easily without looking, but soon I felt confident feeding almost anywhere. I've never had any negative comments from other people. I do not think people realise I'm feeding a baby most of the time."

Claire, from Aberystwyth

"At first, I could not imagine how I would be able to feed the twins away from home. I was really nervous, as they each took half an hour to feed, and I would only be able to feed 1 at a time when I was out. But then I became so confident that I hardly noticed I was feeding them."

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Breastfeeding in public can mean breastfeeding in front of a relative or friend in your own home, or in a public place, such as a cafe or shopping centre. During your baby's first few days, you may prefer to breastfeed only where you feel most comfortable.

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Information on what normal sleep for a baby looks like.

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Information about how often to feed your baby, how long a feed might last and how to know if your baby is getting enough milk

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Many new mums wonder about how often they should be breastfeeding their baby and how long each feed should last. You might hear about feeding to a schedule and giving feeds at certain times of the day and night. The good news is, if you let your baby set the pace for feeding in the early weeks, he'll be happier because he won't be kept waiting when he's hungry.

"Crying increases the level of stress hormones in his body and by responding to his hunger, you will produce the right amount of breast milk for him. If you try to cut down breastfeeds, you may not make enough milk for your baby's needs".

Watch our video for tips on how often and how long to breastfeed your baby for.

How will I know when to feed my baby?

Your baby will make little signals, sometimes known as early feeding cues, such as sucking his fists, licking his lips or wriggling round and opening his mouth searching for your breast. Looking out and responding to these cues is important because the sooner you respond to them, the less frustrated your child will be between feeds.

How long should each breastfeed last?

Every baby is different so how much milk a baby needs per breastfeeding session will vary and it's best to be guided by your child. Your baby will let you know when they have drank enough milk. During each breastfeed, your milk changes slightly so the milk at the end of the feed is more creamy and filling. It is therefore important that your baby gets to this milk as it helps them put on weight and stay fuller for longer. Every feed will be different though; think of your appetite - sometimes you might just need a snack and other days a three-course meal. In the same way, your child might only need a quick feed or a much longer one. The important thing is to follow your baby's signals, which takes time but you will start to recognise them. It does help to keep your child close and it might help for your baby to sleep in the same room with you at night as well.

Breast milk production: Will I produce enough milk?

Breastfeeding works on a supply and demand basis; simply put, the more you breastfeed your baby, the more milk you will produce. If your child is attached properly, you are both comfortable and you are feeding him when he asks for it, usually around eight to 12 times a day in the early weeks, then you will make plenty of milk.

How do I know if my baby has had enough milk?

You will know when to stop breastfeeding because a baby who is well attached will stop feeding when he has had enough. He will usually push out the nipple - he may look sleepy or even drunk or he may be calm and look around. If he is still awake offer him the other breast. He may want some or none of it. Offer that breast first next time you feed. Another way to check whether your child is getting enough milk is the number of wet and dirty (soft, yellow poo) nappies he produces and how much weight they are putting on after the first week.

How often should I breastfeed my baby?

It's normal for young babies to need frequent feeds. Sometimes a baby will have several short feeds clustered together. Feeds will tend to get quicker and more spaced out as your child grows. A newborn child might need eight to 12 feeds a day or more. It's impossible to over-feed a breastfed baby, so relax and let him guide you.

Get support if you need it

Don't be afraid to ask for support and information to help you with breastfeeding. No problem is too small - if something is worrying you, the chances are that other mums will have felt the same. In the early days, asking your midwife or a breastfeeding counsellor to help you position your baby may help boost your confidence and improve feeding for you and your child.

Further information

We support all parents, however they feed their child. 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 0212.

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Breastfeeding tips: how much, how often?

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Many new mums wonder about how often they should be breastfeeding their baby and how long each feed should last. You might hear about feeding to a schedule and giving feeds at certain times of the day and night.

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Follow three mothers as they share their tips on the joys and challenges of feeding twins.

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

From Bump to Breastfeeding

From Bump to Breastfeeding extra films

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The Impact Lead will focus on developing Best Beginnings' frameworks for monitoring and evaluating our national and international work ensuring that learning continues to be captured in ways that can be shared and used for effective advocacy and influencing. The successful candidate will also play a pivotal role influencing policy and its implementation within the maternity, early years, digital health and public health context.

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Follow three mothers as they share their tips on the joys and challenges of feeding twins. Vimeo Video http://www.vimeo.com/11739595 The rest of the DVD can be viewed by clicking through the links below. While they work very well as stand-alone films, From Bump to Breastfeeding is best viewed as a whole: From Bump to Breastfeeding 1.

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A series of videos on premature babies including some about feeding and expressing for a premature baby.

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Small Wonders: A series of films for the parents of premature & sick babies to help them be at the heart of their baby’s care

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Share your videos with friends, family, and the world

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Learning you are pregnant with twins, triplets or more changes your expectations and plans. But you can still plan to breastfeed. Breastmilk is a complete and perfect food for your baby. It is especially important for multiples, who are often small at birth. Breastfeeding also helps you create a spe…

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You do need to register to access some of the resources.

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

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

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

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

Personal stories

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

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

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Feeding will take up a lot of your time in the first few months of your babies' lives.
Whether you breastfeed or formula feed, you'll need to create a routine that suits you and your babies.

Some mothers can feed 2 babies at the same time, while some prefer to feed 1 after the other.

Others feed whenever their babies seem hungry (on demand).

If 1 baby is smaller and needs to feed more often, you will not be able to feed them at the same time at first.

If you want, you can work towards bringing their feeding routines together as your babies grow.

If you have any concerns about your babies' growth, you can take them to your local baby clinic to have them weighed and measured.

Your health visitor can tell you where to find your nearest baby clinic.

Some health visitors will visit you regularly at home to keep an eye on your babies' progress.

Breastfeeding twins or more

It's important not to be put off breastfeeding because you're having more than 1 baby.

Breastfeeding is a great way to soothe your babies and helps you build a strong bond with them.

It's perfectly possible to breastfeed twins, triplets or more. Lots of twins are breastfed until they start eating solid foods.

You may like to try a few breastfeeding positions to see which suits you best.

You'll get support with breastfeeding at the hospital and also when you take your babies home.

The benefits of breast milk for your babies are the same as for single babies.

But as multiple babies are more likely to be born prematurely, there are extra benefits.

Breastfeeding premature twins

Breast milk is better for premature babies as their gut is immature and it's easier for them to tolerate and digest.

Breast milk also contains proteins and antibodies to protect your babies against infections.

If your babies are very tiny or sick when they're born, you may need to express your breast milk to begin with.

Your expressed milk may be fed to your babies through a thin tube that passes through the nose and into the stomach.

Visit the Twins Trust website for more information on breastfeeding twins or more.
Watch videos of mums talking about breastfeeding more than 1 baby

Formula feeding multiples

You may need to combine formula feeding with breastfeeding if, for example, you have triplets or more, or you may choose to only formula feed your babies.

Formula feeding is more expensive than breastfeeding when you have twins or more.

But it does mean that other people can help with feeding your babies.

As with breastfeeding, you'll need to decide whether you're going to feed your babies together or separately.

Bottles need to be freshly prepared for each feed. This can be quite time consuming with twins or more, so you may want to ask your partner or someone else to help with this.

As with breastfeeding, formula feeding your babies can help you build a close and loving bond.

Hold your babies close during feeds, look into their eyes and talk to them.

Learn to notice their cues when they want to be fed and when they have had enough.

Visit the Twins Trust website for more information on formula feeding twins or more.

Weaning twins on to solids

When your babies are around 6 months old, you can give them their first solid foods.

It's not unusual for 1 baby to be ready to begin solids before the other.
Find out more about your baby's first solid foods
If your babies were born prematurely, your health visitor can give you advice on the best time to start solids.

Unless 1 of your babies has a serious infection, it's safe for them to share spoons and bowls.

Visit the Multiple Births Foundation website for more advice on all aspects of feeding twins, triplets or more (PDF, 5.96kb).

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Feeding will take up a lot of your time in the first few months of your babies' lives. Whether you breastfeed or formula feed, you'll need to create a routine that suits you and your babies. Some mothers can feed 2 babies at the same time, while some prefer to feed 1 after the other.

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Information about how milk is produced, colostrum and the let-down reflex.

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How do my breasts produce milk?

As soon as you're pregnant, your body starts to change to support milk-making. You may notice some of these changes in your breasts, like a slight tenderness and maybe a darkening of your nipples and areola. These changes are among the early signs of pregnancy (NHS Choices, 2016b).

Mammary glands

These glands are in your breasts and produce breastmilk. Each mammary gland contains the following parts that help you to make breastmilk (MIDIRS, 2011).

Alveoli

These are small clusters of sacs that develop when you are pregnant and produce your breastmilk (Sternlicht et al, 2006). Muscles that squeeze the milk into ductules surround these sacs.

Ductules

These are small channels carrying milk from the alveoli to the milk ducts.

Milk ducts

These are the network of channels delivering milk from the alveoli and ductules to your baby. When you're pregnant, these ducts grow larger and there will be more of them. The average breast has about nine milk ducts ready for breastfeeding (Geddes, 2007).

When will I start making milk?

During pregnancy your breasts increase in size as the mammary glands grow to support milk production. Sometime during the second trimester your body is ready to produce milk. You might notice a little milk leaking from your breasts in the final weeks of pregnancy (WHO, 2009).

Once your baby is born and you pass the placenta, your body releases the hormone prolactin. This tells your body to produce milk (WHO, 2009).

"You can start to feed your baby immediately after birth as soon as you're both ready."

Skin-to-skin contac t can help to stimulate your milk flow and your baby's natural feeding responses (NHS Choices, 2016b).

What is colostrum?

Colostrum is the first milk your breasts produce in the few days following birth. It is thick and golden yellow in colour (NHS Choices, 2016b). Colostrum is very concentrated and full of vitamins and antibodies. All of this helps your baby grow and fight off infections (NHS Choices, 2016b). It also helps expel meconium - the black, sticky poo babies are born with (NHS Choices, 2016b).

Your baby will only need about a teaspoonful at each feed because colostrum is so concentrated. To begin with your baby may want to feed often, perhaps every hour. They'll begin to have fewer, longer feeds after a few days. The more you breastfeed, the more your baby's sucking will stimulate your supply and the more milk you'll make.

After a few days the colostrum will be replaced by more mature milk, which is more liquid and greater in volume (WHO, 2009). Approximately two to four days after birth you may notice your breasts are warmer and fuller feeling; this is known as your milk coming in (NHS Choices, 2016b).

The let-down reflex

When your baby starts sucking at your breast, this releases the hormone oxytocin, causing the tiny muscle cells around the alveoli to contract and squeeze out breastmilk. This squeezing is known as the let-down reflex (WHO, 2009; NHS Choices, 2016b). Some women get a tingling feeling, which can be quite strong, while others don't feel anything. Both are normal.

You may notice your baby respond when your milk 'lets down'. Their quick sucks will change to deep rhythmic swallows as the milk begins to flow. Babies often pause after the initial quick sucks, while they wait for more milk to arrive (NHS Choices, 2016b). There may be a number of let downs every time you breastfeed, which you may or may not be aware of.

You may also feel some contractions in your belly during the first few days of breastfeeding your baby. These are known as afterpains and feel like mild labour contractions. They are caused by oxytocin shrinking your uterus (womb) back to its pre-pregnancy size (WHO, 2009; NHS Choices, 2016b).

Breastfeeding frequency

Mums start producing mature milk as soon as their baby is born. This happens whether their baby is ever placed at their breast or not. You may notice this surge in production as your milk coming in around two to four days after the birth. Your breasts may look and feel fuller than before (NHS Choices, 2016b).

After this, you continue to make milk as a result of milk being removed from your breasts. This happens either as your baby drinks the milk or by you expressing it with your hands or a breast pump (WHO, 2009).

When breastfeeding is going well, this is what drives the milk supply. As milk is removed, your body gets the signal to make more. Your baby will never fully empty your breasts. If your baby feeds a lot, your body increases the milk supply in response (NHS Choices, 2016b).

Young babies typically feed frequently, at least eight times in 24 hours (or more), often in clusters of feeds with small gaps in between. Counting the feeds is not realistic, as you might not know whether your baby is starting a new feed or ending a previous one (NHS Choices, 2016c).

Changes in your breast milk

The fat content of your milk gradually increases as the milk is removed. So when breasts are less full, the fat content is proportionately higher (Martin et al, 2016). Healthy, effectively feeding babies usually get the right milk intake and type of milk for them (Martin et al, 2016).

When your baby seems to have had sufficient on one breast, you can switch sides and offer the other breast. Your baby may show they've had enough of one breast by coming off it or slowing right down. Not all babies take both sides each time. Some are happy with one, while other babies show they want three, four or more sides at a session (NHS Choices, 2016c; NHS Choices, 2017).

"Breastmilk constantly changes to meet your baby's needs. It is responsive to changes in the mother's diet, bacteria and viruses in the environment and the baby's feeding behaviours."

Breastmilk content also varies according to the time of day. Evening milk contains more components that relax and aid babies sleep, while daytime milk contains different elements that stimulate activity (Sanchez et al, 2009).

Breastmilk can also change in response to the baby or mother's illness, with an increase immune cell levels to aid recovery (Riskin et al, 2012). After your child's first year in the world, the fat and energy content of breastmilk increases to meet their growing needs (Mandel et al, 2005).

Support to help you breastfeed

It can take time for you and your baby to get the hang of breastfeeding. Plenty of help and support is available to help you overcome any challenges. Getting breastfeeding support makes a huge, positive difference.

Contact your local NCT branch or call our Infant Feeding Line on 0300 330 0700 to find out what breastfeeding support is available locally. We have local NCT Breastfeeding Counsellors who can offer a call, virtual visit, or home visit, depending on their availability. You may also have a local drop-in NCT breastfeeding support group. Our breastfeeding support groups are a great place to meet other mums with babies of a similar age. Peer support is really beneficial to new mums.

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

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

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

Visit our breastfeeding support contacts page.

NHS Choices breastfeeding information.

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

Geddes DT. (2007) Inside the lactating breast: the latest anatomy research. J Mid Women's Health 52(6):556-63. Available From: http://breastnbabylactation.com/pdf/11_inside_lactating_breast.pdf [Accessed January 2018].

Mandel D, Lubetzky R, Dollberg S, Barak S, Mimouni FB. (2005) Fat and Energy Contents of Expressed Human Breast Milk in Prolonged Lactation. Pediatrics. 116(3):e432-e435. Available From: http://pediatrics.aappublications.org/content/116/3/e432 [Accessed 1st January 2018].

Martin CR, Ling PR, Blackburn GL. (2016) Review of Infant Feeding: Key features of breast milk and infant formula. Nutrients. 8(5): 279. Available From: http://doi.org/10.3390/nu8050279. [Accessed 1st January 2018].

NHS Choices. (2016) Signs and Symptoms of Pregnancy. Available from: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/signs-and-symptoms-pregnancy.aspx [Accessed 1st January 2018].

NHS Choices. (2016) Breastfeeding the first few days. Available from: http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/breastfeeding-first-days.aspx?tabname=Your%20newborn [Accessed 1st January 2018].

NHS Choices. (2016) Breastfeeding: is my baby getting enough milk? Available from: http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/breastfeeding-is-baby-getting-enough-milk.aspx [Accessed 1st January 2018].

NHS Choices. (2017) Your breastfeeding questions answered. Available from: http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/your-breastfeeding-questions.aspx [Accessed 1st January 2018].

Riskin A, Almog M, Peri R, Halasz K, Srugo I, Kessel A. (2012) Changes in immunomodulatory constituents of human milk in response to active infection in the nursing infant. Pediatr Res. 71(2): 220-225. DOI: 10.1038. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22258136 [Accessed 1st January 2018].

Sánchez CL, Cubero J, Sánchez J, Chanclón B, Rivero M, Rodríguez AB, Barriga C. (2009) The possible role of human milk nucleotides as sleep inducers. Nutritional Neuroscience. 12 (1):2 DOI: 10.1179/147683009X388922. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19178785 [Accessed 1st January 2018].

Sternlicht MD, Kouros-Mehr H, Lu P, Werb Z. (2006). Hormonal and local control of mammary branching morphogenesis. Differentiation 74(7):365-381. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2580831/ [Accessed 1st January 2018].

WHO. (2009) Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals. Geneva: World Health Organization; 2009. SESSION 2, The physiological basis of breastfeeding. Available from: https://www.ncbi.nlm.nih.gov/books/NBK148970/ [Accessed 1st January 2018].

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About breastmilk and breastfeeding | Baby & toddler, Feeding articles & support | NCT

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Curious about what's happening to allow breastfeeding? This article explains how you'll produce breastmilk and how your breastmilk adapts and changes.

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More detailed written information with lots of videos about how to breastfeed.

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Getting your baby positioned and attached comfortably at the breast is an art-mothers often say it takes a little while for breastfeeding to feel entirely comfortable and natural, even if they've breastfed before. In the past girls grew up learning about breastfeeding by watching mothers in their families and communities. These days many of us become mothers having never seen a baby breastfeed.
But breastfeeding has worked for mothers and babies for thousands of years and it can work for you too.
Many babies can find their way to the breast by themselves, especially if they haven't been too affected by birth interventions. Other mums and babies need a little longer to work it out with maybe some help from a skilled breastfeeding supporter such as an LLL Leader.

When all is going well, specific holds and positions don't really matter because you and your baby will work out what suits you best. However if you are finding it awkward, uncomfortable or downright painful then the following information is designed to help you think about where you can make adjustments and get breastfeeding working comfortably for you.

Good positioning and attachment is important for maintaining milk production. A baby who attaches deeply at the breast is able to remove milk effectively. This is important for maintaining milk production. Well-drained breasts make milk quickly. If there is any concern about how much milk you are making, working on improving positioning and attachment is an important first step.

There's no 'right' or 'wrong'. If you are comfortable, your baby is producing plenty of dirty nappies and is gaining weight after the first few days, then breastfeeding is going well for you. There are no rules-but there are a few principles that can help you work out what to do if things aren't going well: see Latching on - getting a good attachment.

Positioning describes how you sit or lie and how you support your baby as he takes the breast. How you hold your baby can make a big difference to how well he can breastfeed. Even small adjustments can be significant. Attachment describes the way he latches onto the breast.

Tips for getting started
The laid-back approach
Latching on - getting a good attachment
Different breastfeeding positions
As time goes by

Tips for getting started

If it hurts then make changes

If it doesn't feel right to you, then it isn't fine, whatever anyone says. Pain is your body's way of letting you know something is wrong. Start by trying to improve positioning and attachment. A few quick adjustments to how you are sitting or lying or how your baby comes towards the breast may be all that are needed.

Sometimes it can take a little longer. You may need to work with one or more skilled breastfeeding supporters over a period of time to get to the point where everything falls into place and breastfeeding starts feeling natural.

Each mother and baby pair is different and what works well for one mother and baby may not work for you. This is one reason why you may hear different suggestions from different helpers. You are the best judge of what is helpful so don't be afraid to use what feels right for you and discard the rest.

Your baby needs to be calm

You can offer the breast at any time when you are both calm. You may even find it easier if your baby isn't obviously hungry. Feed your baby before he needs to cry. Early cues for wanting to eat include suckingtheir hand, smacking their lips, turning their head towards you, or fussing. They won't latch well if they are distressed. If your baby is upset take time to soothe them. Hold them upright against you, stroke them and talk to them. A little expressed colostrum or breastmilk given on a spoon can help to calm them if they are desperately hungry.

Your baby needs full body contact

When your baby is held in full body contact against you, they will feel stable and be better able to coordinate their movements. Laid back positions ensure full body contact. If you're sitting up, you'll need to hug your baby in as tightly as if you were standing up holding them against you. Babies who don't feel stable tend to wave their arms around, which can make latching more difficult. Pillows can get in the way and aren't always necessary. So wait until after your baby's latched on, and then tuck them in only if you need them for support.

Some babies need time

Some babies find it difficult to latch on, or simply nurse ineffectively at the breast. Often a difficult birth or interventions during labour or birth are the cause. Giving a baby time to recover, and using laid-back breastfeeding positions with skin-to-skin contact can maximise your baby's natural instinct to breastfeed. If your baby isn't latching or feeding well seek help from an LLL Leader and read our page My Baby Won't Breastfeed. With time and patience, most babies will breastfeed. In the meantime express your milk for your baby to maintain milk production and give you both the time to work it out.

Laid-back breastfeeding

Many people assume you have to sit up to breastfeed. Not so. In fact evidence suggests humans evolved to breastfeed in laid-back positions with our babies upright against our chests. You may have experienced this type of position when you had your first feed, soon after your baby's birth. There is more and more evidence that laid-back breastfeeding positions (also called Biological Nurturing) help babies breastfeed more effectively and are more comfortable for mothers, especially in the early days and weeks.

Laid back breastfeeding is really useful for those first few days and weeks when you want to rest and recover and your baby needs to be in close contact with you to get breastfeeding established. It can be done skin-to-skin or with you both lightly dressed. You don't have to be in bed; the sofa or a reclining chair is a comfortable alternative.

You can also use laid-back breastfeeding principles when sitting in an upright chair by shifting your weight back onto your tail bone and reclining your body back a little, to open up a space for your baby. This allows more of their weight to be supported by your body and less by your arms. It isn't safe to sleep with your baby on a chair or sofa.

Sleepy babies

If your baby is sleepy, perhaps because of birth interventions, then using laid-back positions with skin-to-skin contact can encourage your baby's interest in feeding. In laid-back positions babies often attach and feed when in light sleep so it helps to spend substantial periods of time with your sleepy baby against you. When you notice the little movements that indicate your baby is moving into a light period of sleep you can encourage them to latch.

How laid back breastfeeding works

You lay back in a comfortable, supported semi-reclining position (not flat) that opens up your body, creating space for your baby.

Your baby lies against you, their whole front against your body, vertically or at any comfortable angle.

Your baby feels stable and secure and their instinctive feeding reflexes are triggered, prompting them to bob their head and seek out the breast.

Gravity helps them latch deeply and stay latched, rather than hindering the process.

Your hands are free to support and caress your baby and help them attach.

Your body releases the hormones that stimulate milk production and make you experience loving feelings towards your baby.

There are no rules-you and your baby are free to work it out between yourselves.

Latching on - getting a good attachment

Your baby needs to tip their head back and reach forward with their lower jaw. As your baby tips their head back their jaw drops and their mouth opens wide, so they can anchor their chin and lower lip firmly against your breast. If they have to tuck their chin in to reach the nipple they won't be able to open their mouth so wide. Tipping their head back also makes a deep latch possible, swallowing easier, and frees up their nose for comfortable breathing. In laid-back positions lay your baby with their head between your breasts. If you are sitting up, keep your supporting hand away from the back of their head. Babies tend to creep forward, so try shifting them so that their eyes and nose are opposite the nipple to encourage them to reach forward and anchor their chin first. In sitting or side lying positions a little push between the shoulder blades with your supporting hand or arm as they latch brings their chest in closer and helps their head tip back.

Their lower jaw needs a clear space to anchor. Think about how you might take a mouthful from a big sandwich by placing your lower jaw first then opening your mouth to accommodate the top of the sandwich-the principle is the same. Your baby's lower jaw needs to be deeply placed on your breast well away from the nipple. Keep the fingers of your supporting hand away from the place where their chin and lower jaw need to be so their lower lip and chin can sink into your breast. Your baby's chin needs to stay firmly in contact with your breast.

Your baby needs a big mouthful. When a baby chews on a nipple, this compresses the milk ducts, prevents milk flowing and hurts. When a baby has a good big mouthful of breast beyond the nipple, breastfeeding is comfortable and milk can flow. Some women like (or need) to hold their breast when nursing. They flatten their breast as they would a big sandwich they were offering to the baby, matching it to the oval of his mouth. This can help their baby grasp more breast tissue. It doesn't matter if fingers are closer to the upper jaw but try to keep the "lower jaw fingers" out of your baby's way. Biological Nurturing™ positions make use of gravity to help a baby get a bigger mouthful.

The exaggerated latch. To get an even deeper latch you could try this optional extra. Place your thumb or finger near the base of the nipple where the middle of your baby's upper lip will be, lined up with their nose. If you press, your nipple will tilt away from your baby, presenting them with your breast rather than your nipple. Avoid pressing your nipple into their mouth. As they open wide, snuggle them in close and use your thumb or finger to tuck the breast into their mouth. Your nipple will be taken in last and unroll in their mouth. You can then slip your finger out.

Our own video below demonstrates flipple technique (aka exaggerated latch), it can be very helpful for getting an effective pain free latch:

Let your breast rest at its natural level. It can be tempting to lift your breast and move it towards your baby's mouth. If you do this, your baby probably won't get a full mouthful, and after a while your hand will get tired and the breast will drop and slip out of their mouth. Breastfeeding pillows can get in the way too because they lift a baby up too high and prevent you tucking them in against your tummy. See where your breasts naturally rest and hold your baby accordingly. If you need them, tuck pillows in after they are well attached.

Bring baby to breast, not breast to baby. Since breasts are attached to you and you baby is moveable it makes much more sense to bring your baby to the breast, not the other way round! And it works better too. With their body tucked firmly against you (or laid on top of your body), your baby will feel more stable and have better head control, and you'll feel a lot more comfortable too.

It's easier to latch onto a softer breast. It's much easier to get a deep mouthful if the breast is soft so breastfeed frequently to avoid engorgement. When your baby bobs their head and licks the nipple, it naturally makes it easier to latch on. If your breast is full and hard, you can use reverse pressure softening to move fluids away from the nipple area so your baby can latch on well. Apply gentle steady pressure with your fingertips on the areola around your nipple for about a minute. You can also press with the sides of your thumbs or fingers. Denting the breast at the edge of the areola with a finger and placing your baby's chin in the dent may also help. Gently hand express a little milk too if needed.

Your baby needs to choose his own timing. Your baby will probably do best if they pick the moment to latch on. You can help by supporting them in a position that lets them do this when they are ready. To encourage your baby to gape hold them close against you, close enough to the breast so they know the nipple is there, but where they can't quite reach it. Be prepared for your baby to lick and nuzzle for several minutes before they are ready to open wide.

The natural or laid-back breastfeeding positions shown in the following videos can be a great help in encouraging your baby to latch on well, as well as being comfortable for you. You can recline comfortably with your baby on top of you with their whole front against you and their body completely supported by yours.

Best Beginnings' video demonstrates clearly how to make sure your baby is attaching well to the breast, you can view it here.

This video demonstrates how to enable your baby to latch deeply on to your breast so that breastfeeding is comfortable for you and means your baby get enough milk:

This video shows how to attach your baby well, and shows a variety of comfortable breastfeeding positions:
http://m.raisingchildren.net.au/articles/breastfeeding_attachment_video.html

Using different breastfeeding positions

The cradle hold

Although the cradle hold is one of the most common nursing positions it can be a challenge for new mothers to learn. You need to hold your baby's body firmly against you to give them stability because their weight is supported mainly by your arms. Shifting so you are sitting on your tailbone, rather than upright can help stability and reduce the strain on your arms (see picture right). It can be difficult to control a baby's head and to keep them high enough and close enough to your breast. A small baby may tend to curl up in a ball in this position if not pulled in closely enough against your body. It may not be the best choice at first if you're experiencing any problems with latch-on, milk transfer or if you have sore nipples. Once you're more confident with breastfeeding, you may find you use a version of the cradle hold much of the time, especially when out and about.

Your baby's whole front is against your tummy, their hip resting on or near your thigh, tucked around you like a comma. Their chest will be snuggled into the breast and your nipple near their nose.

Their head is resting on your forearm and/ or wrist (not the crook of the elbow).

As your baby opens their mouth to take the breast, pull their body in firmly against you.

Once your baby is attached, settle back a little for your own comfort and so that more of their weight is taken by your body.

Laid back breastfeeding

Remember that Biological Nurturing™ positions aren't just for the first week or two. They can be really useful later on when you want to relax, and especially if you are breastfeeding more than one baby or if your baby is fussy or unwell.

The cross-cradle hold

The cross-cradle position can be useful in the early days because it gives you more control in guiding your baby to the breast. It can be uncomfortable to maintain without good support under your arms, especially with larger babies, so once your baby is attached, switch arms as shown in the picture below. After the first few weeks and as your baby grows longer and heavier, you may prefer to use other comfortable holds. Avoid touching the top or back of your baby's head because it often causes a baby to pull back from the breast. Forcing a baby onto the breast by firmly holding the back of the head usually has the opposite effect and can put a baby off breastfeeding.

Cross cradle

Tuck their whole front against your tummy, their hip near or resting on your thigh.

Your hand supports their neck (not the back of the head) with your palm between their shoulder blades.

Your other hand is free to shape or stabilise your breast if needed.

Make sure your baby isn't too far round the front-line them up so their eyes and nose are near the nipple.

As your baby opens their mouth, give a little push with the palm of your hand to bring their chest in close against you.

This will help their head tip back and let them plant their chin deeply against your breast.

Once your baby is attached you can bring your other arm round to support your baby's body and settle back a little for your own comfort and so that more of his weight is taken by your body. Hold your baby with the arm opposite to the breast he's going to latch onto.

The underarm (clutch or rugby) hold

The underarm hold is useful if you have had a caesarean birth. It helps keep the weight of your baby off your incision. It is also a good position for mothers with flat or inverted nipples and for babies with latch-on or sucking problems because it offers you a good view of baby and breast and control of your baby's head. You can also feed two babies at once in this position. For larger, longer babies you may need extra cushions behind your back to bring you further forward and allow space for your baby's length.

Your baby's front is close against your side, with your hand under their shoulders and neck.

Your elbow keeps them tucked closely against your body.

Your baby approaches your breast from below. This can work well if you have large breasts. If you have smaller breasts you may need to bring your baby into a semi-sitting position.

Make sure your baby isn't too far round the front. You may need a cushion between your back and the chair back to allow room for your baby's length and prevent them pushing themselves forward with his feet.

Side lying

This side-lying position is helpful if you are recovering from a caesarean birth or an episiotomy and invaluable for nursing in bed during the night.
It can take a while to get the knack but it's well worth persisting because it can make night feeds so much easier.
Some mothers decide to sleep with their baby alongside them. Others choose to move their baby back onto a separate sleep surface.
Safe Sleep and the Breastfed Baby will help you decide on the safest sleep arrangements for your family, based on your own individual circumstances.

* Lie on your side, with your knees bent up and a pillow under your head.
* Place your baby on their side facing you so that their body and your body form a V-shape, meeting at your hips, with your nipple level with their nose or eyes.
* You can put your arm under your baby's head as shown, or up by the pillow with your baby lying on the bed.
* As your baby latches, give a little push between their shoulder blades to bring their chest in closer and help their head to tip back and their mouth to
open wide.
* You may find it helpful to tuck a small pillow or rolled blanket behind the small of your back and/or between your knees.

Standing up

At some feeds babies just do better if you stand up. You can sway or bounce gently to help calm your baby, and the lack of a lap can be helpful. As always keep your baby nice and stable and let them lead the way. Try angling their legs down instead of holding them horizontal, and see what happens. Or try starting with them against your shoulder, supporting them as he moves down to the breast. Even when using other positions, sometimes just standing up and sitting down again straight away helps everything settle into a comfortable position.

As time goes by

Whether you choose to breastfeed sitting up, reclining or lying on your side, you will need to adjust how you support your baby as he grows in length and weight. Use the principles shown here as you experiment with different positions. Sometimes there are physical or medical causes for pain or discomfort such as tongue tie or a thrush infection. If you are still finding it difficult to get comfortable, do persist with seeking further and continued support. There is almost always a breastfeeding solution to breastfeeding problems. You can contact an LLL Leader by calling our Helpline. You can also find support and encouragement from breastfeeding mothers in your local LLL group.

Written by Sue Upstone, Karen Butler and mothers of LLLGB

Further Reading

The Womanly Art of Breastfeeding. LLLI. London: Pinter & Martin, 2010.

Mastitis
Beginning Breastfeeding
Breastfeeding Your Baby - easy read
Caesarean Birth & Breastfeeding
Comfortable Breastfeeding - easy read
Skin-to-Skin
Engorged Breasts - Avoiding & Treating
Hand Expression of Breastmilk
Inverted Nipples
My Baby Needs More Milk
My Baby Won't Breastfeed
Nipple Confusion?
Nipple Pain
Nipple Shields
Nursing Supplementers
Safe Sleep & the Breastfed Baby
Sleepy Baby - Why & What To Do
Tongue Tie
Too Much Milk & Oversupply

LLLI Resources
Position to breastfeed

Other resources
How to do Biological Nurturing: www.biologicalnurturing.com/video/bn3clip.html
Best Beginnings videos to watch online: www.bestbeginnings.org.uk/watch-fbtb

References
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, TX: Hale Publishing, 2010.
Biological Nurturing: Laid-back breastfeeding for mothers (DVD). Colson, S. et al. 2012.
An Introduction to Biological Nurturing; New angles on breastfeeding, Colson S. Amarillo, TX: Hale Publishing, 2010.
Supporting Sucking Skills, Watson Genna, C. Burlington, MA: Jones & Bartlett, 2012.

This information is available to buy in printed form form the LLLGB Shop.
It is also available in kindle edition.

Information, references and links on this page are taken from La Leche League resources, unless stated otherwise. Please note that LLLGB does not endorse information from outside sources, extra information is provided for you to consider. Information supplied is not intended as advice, and you are in the best position to make a decision as to how the information offered will affect you and your baby.

Copyright LLLGB 2016

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Positioning & Attachment - La Leche League GB

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Good positioning and attachment is important for maintaining milk production. A baby who attaches deeply at the breast is able to remove milk effectively.

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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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