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The information and links on this page do NOT replace professional medical support. 

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The information and links on this page do NOT replace professional medical support. 

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Always speak to your Midwife, GP or Health visitor if you have any concerns about your baby

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Antenatal Expression of Colostrum - La Leche League GB

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Mothers start to produce colostrum (early milk) while pregnant. Being able to express colostrum is a useful skill to have. Saving your expressed colostrum may also be beneficial if your baby is likely to need special care after birth. Why express while pregnant? Being familiar with your breasts and…

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How you can help support a Mum who is breastfeeding

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How you can help support a Mum who is breastfeeding

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College of Human and Health Sciences, Swansea University

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How you can Help Support a Breastfeeding Mum...

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If you've recently found out you're pregnant, let us know - we want to make sure you're getting the right care EARLY PREGNANCY 0-12 weeks TELL ME MORE MID PREGNANCY 13-27 weeks TELL ME MORE LATE PREGNANCY 28 weeks onward

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Evidence based information on Infant Sleep

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Evidence based information on Infant Sleep

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https://www.basisonline.org.uk/

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https://www.nct.org.uk/life-parent/dads-and-partners

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https://www.what0-18.nhs.uk/parentscarers/worried-your-baby-unwell-under-3-months/colic-in-infants

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What's breastfeeding like for mums and dads? Find out here: Feeding stories from local parents.…….

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Breastfeeding Dorset-DHC, Bournemouth. 278 likes · 275 talking about this. We offer friendly informative guidance and support with breastfeeding and invite you contact us. We aim to answer posts as...

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https://www.tongue-tie.org.uk/

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Excellent Evidence based website.  Link for "fussy babies"

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By Kelly Bonyata, BS, IBCLC
It is very common for babies to be fussy and nurse very often in the evenings, particularly in the early months.
My daughter had a fussy time every evening for a couple of months (yes, it does go away!). I spent weeks camped out on the end of the sofa with a constantly nursing and/or fussy baby every evening from about 6 to 10 PM. With my son, we didn't have the luxury of being able to sit down. Alex was unhappy and crying unless he was upright and being walked around at this time of day (and sometimes this only helped him to be less unhappy). He would occasionally have a very fussy time during the day, too. Nursing rarely helped to calm his fussiness (unlike with my daughter), so I usually didn't have that tool to work with (though I always tried). His fussiness was such that I looked into other causes (such as food sensitivity), but we never determined any reason for it and he was all smiles the rest of the time. The fussiness gradually went away between 3 and 4 months, as is the norm, but the first few months were hard. Nowadays, the typical comment that I hear about him is "Is he always this happy?" So remember: this, too, will pass...

Cluster feeding, also called bunch feeding, is when babies space feeding closer together at certain times of the day and go longer between feedings at other times. This is very common, and often occurs in the evenings. It's often -but not always- followed by a longer sleep period than usual: baby may be "tanking up" before a long sleep. For example, your baby may nurse every hour (or even constantly) between 6 and 10 PM, then have a longish stretch of sleep at night - baby may even sleep all night.

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Cluster feeding often coincides with your baby's . Baby will nurse a few minutes, pull off, fuss/cry, nurse a few minutes, pull off, fuss/cry... on and on... for hours. This can be VERY frustrating, and mom starts wondering if baby is getting enough milk, if something she is eating is bothering baby, if EVERYTHING she is doing is bothering baby... It can really ruin your confidence, particularly if there is someone else around asking the same questions (your mother, your husband, your mother-in-law).

This behavior is NORMAL! It has nothing to do with your breastmilk or your mothering. If baby is happy the rest of the day, and baby doesn't seem to be in pain (as with colic) during the fussy time - just keep trying to soothe your baby and don't beat yourself up about the cause. Let baby nurse as long and as often as he will. Recruit dad (or another helper) to bring you food/drink and fetch things (book/remote/phone/etc.) while you are nursing and holding baby.

Does this mean that baby needs more milk than I can provide?

No. Don't give baby a bottle - supplementation will only tell your body that you need LESS milk at this time, and that will not help matters. Also, keep in mind that formula fed babies experience fussy periods in the evening, too - fussy evenings are common for all young babies, no matter how they are fed. The Academy of Breastfeeding Medicine spells this out in their supplementary feeding guidelines:

There are common clinical situations where evaluation and breastfeeding management may be necessary, but supplementation is NOT INDICATED including... The infant who is fussy at night or constantly feeding for several hours.

Why do babies fuss in the evening?

One frequently-heard explanation for baby's fussiness in the evenings is that milk volume tends to be lower in the evening due to the natural cycling of hormones throughout the day. However, Dr. Peter Hartmann, a breastfeeding researcher, has said that in the women he has studied, milk volume is not low at this time of day. Even if milk volume is lower in the evening, fat content is typically higher in the evening (particularly if baby is allowed to control this via cue feeding), so the amount of calories that baby is getting should not be significantly different. Milk flow can be slower in the evening, which may be frustrating for some babies.

Doctors often attribute evening fussiness to baby's immature nervous system (and the fussiness does end as baby gets older, usually by 3-4 months). However, Dr. Katherine Dettwyler (who does research on breastfeeding in traditional societies) states that babies in Mali, West Africa and other traditional societies don't have colic or late afternoon/evening fussiness. These babies are carried all day and usually nurse several times each hour.

So perhaps none of these explanations is a complete answer to baby's evening fussiness. For many babies, the fussy time seems to be characterized by a need to have small quantities of milk at frequent intervals, combined with lots of holding, cuddling and movement. Babies who are offered as much expressed milk or formula as they will take by bottle [note: this practice will decrease your milk supply!] often behave in exactly the same way in the evenings. Baby takes a small amount and dozes (and fusses), then a little more, and so on. Perhaps babies "remember" mom being very active during her pregnancy at these times, and want to be held, rocked, and nurtured constantly again.
Perhaps babies simply need to nurse more often at this time - rather than consume more milk.
Soothing techniques for the fussy times

Wear baby in a sling or baby carrier. This will free one or both hands for other tasks (fixing dinner, caring for other children) while you hold, soothe and nurse your baby.

Change of pace. Let dad have some "baby time" while mom takes a shower or simply gets some time to herself to relax and regroup after a long day.

Go outside. Relax baby (and mom too) with a walk, or just sit and enjoy the outdoors. Try this a little before baby's regular fussy time.

Soothe with sound. Sing, hum, talk, murmur shhhh, listen to music, or use 'white noise.' Try different types of sound, different styles of music and singers with different types of voices.

Soothe with rhythmic motion. Walk, sway, bounce, dance, swing, or even try a car ride.

Soothe with touch. Hold or bathe baby, try baby massage.

Reduce stimulation. Dim lights, reduce noise, swaddle baby.

Vary nursing positions. Try side lying, lying on your back to nurse with baby tummy to tummy, etc.

Nurse in motion (while rocking, swaying, walking, etc.).

Combine rhythmic motion with soothing sounds.

Avoid scheduling, even more so in the fussy evening hours.

More soothing techniques.

More resources for fussy babies

@ KellyMom

@ other websites

Helpful books

The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer
by Harvey Karp, MD

The Fussy Baby Book: Parenting Your High-Need Child From Birth to Age Five
by William Sears, MD and Martha Sears, RN, IBCLC

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Cluster Feeding and Fussy Evenings * KellyMom.com

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It is very common for babies to be fussy and nurse very often in the evenings, particularly in the early months. My daughter had a fussy time every evening for a couple of months (yes, it does go away!).

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https://abm.me.uk/breastfeeding-information/grandparents/

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Naturally, you want the very best for your new grandchild. You would like to pass on advice and the benefit of your wisdom to the new mum. Mum is going to breastfeed and perhaps you don't know an awful lot about it - when your children were small most mums bottle-fed. This leaflet will give you the latest information on breastfeeding so you can feel more confident in supporting mum in her decision to breastfeed your grandchild.

Lots of babies are bottle-fed and turn out OK. What's so good about breastfeeding?

It's true that artificial milk (formula) is adequate ― but it has lots of disadvantages compared with mum's breast milk.

Babies fed formula milk are at greater risk of developing eczema, asthma and other allergies, and are more likely to suffer with ear infections and diarrhoea.

Formula feeding increases baby's risk of more serious illnesses like diabetes and some cancers.

Formula-fed babies are more likely to be obese as they get older.

Formula-fed babies may have an increased risk of cot death.

Formula milk is harder to digest and gives baby foul smelling bowel movements. Baby is more likely to suffer constipation.

Bottle-feeding is expensive ― milk, bottles and teats, steriliser, bottle bag ― they all add up.

Breastfeeding requires no special equipment and costs nothing.

Advantages for baby

Breast milk has exactly the right amount of each nutrient baby needs. Research finds new nutrients in breast milk all the time, and then manufacturers try to add some of these to the artificial milks on the market.

Breast milk is produced on a demand and supply system. There is always milk ready when baby is hungry or thirsty. Breast milk, and especially the first milk, colostrum, has lots of infection-fighting agents to help baby's immune system.

Advantages for mum

Breastfeeding is free and it is convenient. No need to pack bottles or find somewhere to warm them whilst out. Breastfeeding can quickly calm a fussy or crying baby.

Breastfeeding helps mum and baby bond and is enjoyable. There is the sense of satisfaction in mum feeding baby from her own body.

Breastfeeding makes the womb return to its normal size quickly. Mum gets her figure back faster and can lose the weight she put on in pregnancy without dieting.

Breastfeeding reduces mum's risk of getting breast cancer, ovarian cancer and osteoporosis.

Breastfeeding delays the return of mum's periods. Breastfeeding is the perfect way for mum to relax. Sitting or lying down to breastfeed ensures she gets enough rest.

How long should feeds last?

Feeds don't need to be timed. Baby should be left at the breast until he comes off himself. Then he can be winded and offered the other breast (some babies want to feed on both sides at each feed, others don't).

Long feeds will not hurt mum's nipples if baby is attached properly. Baby suckles on the breast itself and breastfeeding shouldn't hurt.

Why are babies demand fed instead of being fed four-hourly?

Breast milk is easily digested so baby will need to feed quite often ― usually at least 8 to 12 times a day in the early weeks.

Less frequent feeding can decrease mum's milk supply, impact on baby's weight gain and hydration and increase mum's risk of blocked ducts and mastitis.

Baby needs to feed when he shows hunger signs (rooting, finger sucking). Crying is a last resort. The feeding action causes mum's body to make more milk. The more baby feeds, the more milk will be on tap.

Shouldn't baby be starting solids soon?

Breast milk is all the food baby needs in his first six months. Baby will be getting ready for first tastes of solid foods once he is sitting unsupported, taking food from your plate and feeding himself. This usually happens around six months or later.

Giving any solids or drinks (including formula milk) before six months is linked with later health problems. Introducing solid food early will result in breast milk being replaced by less nutritious first foods and baby gets fewer of mum's antibodies.

Can I give a bottle so mum can rest?

Baby should not be given a bottle or a dummy in the first few weeks while breastfeeding is being established. Sucking on a plastic teat is a very different action to breastfeeding. Baby could get nipple confusion and have problems breastfeeding. There are some suggestions for other ways of helping mum below.
How can I help with my grandchild?
There are lots of ways you can help with your grandchild: cuddling, winding, bathing, and taking him out for a short walk. Any offers of help with housework, making a cup of tea or a meal will probably be gratefully accepted. Perhaps ask mum what she thinks might help.

Encourage mum to be comfortable feeding her baby in your company. Don't make her sit in a bedroom or other private place for feeding ― it will make her feel left out of things. Mum will be able to breastfeed without 'exposing herself'.

One of the best ways to help is to support mum in her decision to breastfeed. If mum has a problem, help her to solve it (if necessary with help from a breastfeeding counsellor, midwife or health visitor).
Nearly all women are physically capable of breastfeeding but breastfeeding can sometimes be a struggle without accurate information and without support from close family.
Be careful not to undermine mum's decision to breastfeed by suggesting that she gives her baby a bottle. If you can support mum and help her self-confidence, she will be able to give your grandchild the love and care he needs and give him the best possible start by breastfeeding.
You might like to show your support for mum by giving her a gift subscription to the ABM. Her welcome pack will contain all our ABM breastfeeding leaflets and she'll receive our ABM magazine (published three times a year).

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Congratulations, you're going to be a grandparent - ABM

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Naturally, you want the very best for your new grandchild. You would like to pass on advice and the benefit of your wisdom to the new mum. Mum is going to breastfeed and perhaps you don't know an awful lot about it - when your children were small most mums bottle-fed.

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Cry-sis Helpline

- 08451 228 669 -

https://www.cry-sis.org.uk/coping-with-colic

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https://www.nct.org.uk/baby-toddler/crying/my-baby-wont-stop-crying-how-identify-and-deal-colic

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https://breastfeeding.support/best-bottle-breastfed-baby/?fbclid=IwAR1UTUzYPutKqzDGfIvwrdCFT9pvkVh_-18BmjnHM4iktYZVMBFwd5LEo9I

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There is a vast selection of bottles and teats available online or in the High Street. Many of them claim to be closer to breastfeeding in some way, whether it is the shape or size of the teat, the rate of flow of milk, the softness of the material or something about the sucking mechanism. Unfortunately, most of these claims are poorly researched and simply a ploy to increase sales. Although there is no single "best bottle" for breastfeeding, and we can't rely on advertising claims, there are certain bottle teat characteristics that seem to help preserve a baby's breastfeeding technique.

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This article discusses pros and cons of a selection of newborn teat shapes with respect to how they might influence breastfeeding. The information should be read alongside Tips to Bottle Feed a Breastfed Baby and try to check customer reviews from other breastfeeding mothers before you buy.

The aim of the game

When choosing a bottle teat for a breastfed baby, the goal is to try to recreate the same mouth position and tongue action with the bottle that your baby uses at the breast:

A short or medium length bottle teat with a rounded tip (not flattened on one side) and a medium-wide base can allow a baby to take most of the bottle teat in his mouth close to the screw cap. This will give him a wide open mouth around the base of the bottle teat and the tip of the teat will be deep in his mouth in the same position as the nipple during breastfeeding.

Comparing bottle teats

Expensive branded teats with fancy packaging are not necessarily any better than cheaper unbranded makes. Many lactation consultants recommend starting with a cheaper teat and see how that works before spending more money on expensive brands.

#1 The wide based bottle teat

A popular choice with manufacturers is to make a bottle teat that looks like a breast i.e. a short bottle nipple protrudes from a wide base. However when the angle between the nipple and base is very steep, it makes it more difficult for a baby to make a wide mouth on the teat because they can slip off it and be forced to make a narrow mouth on the nipple tip. If the artificial teat is also made of a relatively inflexible or rigid silicone, this will be even harder for the baby to shape and hold with their tongue and will feel very different to a breast. The particular teat photographed has multiple rings of ridges on the inside surface of the nipple base which will make it more difficult to keep clean.

#2 The long narrow nipple

Some bottle teats have a very long nipple compared to the base. If the length of the nipple is too long this might be longer than a newborn baby's mouth possibly making them gag. If the nipple is too long, it will also prevent the baby opening their mouth wide on the base of the teat. Whether this style will suit your baby will depend on the gradient between nipple and base, the size of your baby's mouth, and the height of the teat. The greater the number of parts inside the teat, the more difficult it will be to keep clean.

#3 The small based teat

When the base of the teat is smaller, the contrast between the nipple and the base of the teat will be less severe. A baby is more likely to be able to get both the nipple and base in his mouth up to the screw cap to mimic a deep latch (attachment) at the breast, however, if the base is too small, this will result in a smaller gape. Also be aware with small teats that if the total height is too short it might not reach deep enough into baby's mouth to mimic the correct position for breastfeeding and may encourage a shallow latch when baby returns to the breast. Ideally the material used for the teat will not be too soft that it collapses in baby's mouth, nor too rigid.

#4 The very soft teat

Some teats are made of very soft material. The teats in the following pictures are made of latex and have a slanted nipple tip. The softness of this type of teat has proved popular with premature babies or babies with neurological issues who are having difficulties with a regular teat. However if the teat is so soft that it collapses in baby's mouth when they feed, this can create a very closed, clenched mouth position which is not desirable for breastfeeding. Slanted or "orthodontic" bottle nipples may cause a baby to retract and hump the back of his tongue during bottle feeding which if repeated at the breast will compress the mother's nipple . A mother's nipple should not be compressed or distorted during a feed-this indicates the nipple has been rubbing in baby's mouth causing pain, soreness or vasospasm.

Latex is an allergenic material and some babies could be allergic to latex .

#5 The flattened teat

If a teat is sculptured on two opposite sides it will create a slightly flattened, angular teat. Depending how deeply a baby can take the teat in their mouth the flattened shape may prove difficult for baby to get a good seal with his lips and the edges of the sculptured areas could contribute to lip blisters. However if the silicone material is soft and the sides are not too steeply graded with a medium wide base, this style may suit some babies.

#6 The medium based teat with a medium height nipple

In theory the medium based teat with a short to medium height nipple is a shape thought to work well for a breastfed baby. Success will vary depending on the softness of the material used for the teat (not too firm, not too soft), the gradient between nipple and base, and the size of your baby's mouth.

#7 The gently sloping teat

Some bottle teats do not have a clearly defined difference between the nipple and the base, they look more like a nipple shield. Depending on the slope between nipple and base and the height of the teat, this shape could allow a baby to have a wide open mouth on the teat base to recreate the deep latch position desired in breastfeeding. According to reviews, some mothers found their breastfed babies accepted these when they refused other bottle teat shapes.

What about the bottle?

The bottle shape and size are not as important to preserving breastfeeding technique as the bottle teat. However the size of the bottle is worth considering. Some bottles have a very large capacity e.g. 260ml (9oz) or 330ml (11oz) yet a newborn breastfed baby typically does not take anything like these volumes at each feed. In the first few weeks, volumes per feed might be around 60-80ml (2-3oz) and between one month and six months of age, it is estimated that breastfed babies take an average 89-148ml (3-5oz) per feed . Smaller capacity bottles (e.g. 150ml/5oz) will give a more realistic estimate of both your baby's appetite and the volume of breast milk you might expect to pump in one go. See Tips to Bottle Feed a Breastfed Baby for ideas to help control the flow of milk to your baby to resemble what happens during breastfeeding.

Cleaning bottles and teats

Bottle feeding equipment needs to be kept scrupulously clean to avoid being an infection hazard. Ridges, crevices and internal parts in teats make them much more difficult to keep clean. See Sterilising Baby Bottles (National Health Service website, 2016) for comprehensive information on how to clean your baby's feeding equipment.

Alternatives to bottle feeding?

When introducing bottles to your breastfed baby, there is a risk that your baby could start to prefer a bottle teat over the breast (sometimes called nipple confusion or bottle preference) and this could undermine breastfeeding. Particularly if the reasons they are having bottle feeds are to do with difficulties breastfeeding or low milk supply. While the choice of teat shape and our Tips to Bottle Feed a Breastfed Baby can help to minimise problems, there are other feeding methods to consider such as Cup Feeding, or Breastfeeding With a Supplemental Nursing System. An IBCLC lactation consultant can help you decide on the best choice of feeding method for your baby's situation.

Low milk supply?

If you are struggling with low milk supply, contacting an IBCLC lactation consultant or other breastfeeding specialist for help can be invaluable, and see How to Make More Breast Milk. If you're considering using industrially made milks, Supplementing With Formula includes information on preparing formula safely and answers other frequently asked questions.

Summary

There are many different bottle teat shapes made of different materials with differing flexibility and flow rates. Manufacturers' statements that their bottles are "closer to breastfeeding" are just marketing claims designed to sell their products. Expensive brands are not necessarily better than cheap ones. Certain features of a bottle teat such as the length of teat, or width of the base can help mimic breastfeeding more closely. Babies come in different shapes and sizes with different sucking skills so one teat is not going to suit all babies making it difficult to recommend specific brands. Parents may have to try a few different styles to find the best bottle teat for their baby that doesn't seem to interfere with breastfeeding, and recreates the same open mouth position needed at the breast. The ideal shape will likely be a medium wide base with a short to medium nipple. Using bottles could undermine breastfeeding for some babies and cup feeding or supplementing at the breast are other feeding options to consider. This article should be read in conjunction with Tips to Bottle Feed a Breastfed Baby.

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Best Bottle for a Breastfed Baby? - Breastfeeding Support

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There is a vast selection of bottles and teats available online or in the High Street. Many of them claim to be closer to breastfeeding in some way, whether it is the shape or size of the teat, the rate of flow of milk, the softness of the material or something about the sucking mechanism.