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Neonatal Unit: 01782 672400

Health Visiting Service

Stoke Hub: 0808 178 3374

Staffordshire Hub: 0808 178 0611

Midwifery Team:

Central Team: 01782 233582

North: 01782 231152

County: 01785 230839

Newcastle: 0300 1230904

South: 01782 231822

NCOT Team: 01782 672723

General Community Midwife Hub

01782 672 181

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National Breastfeeding Helpline: 0300 100 0212

NCT Infant Feeding Line: 0300 330 0700

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Copy of Generic BF support poster Stoke (Poster (Portrait)) (7)

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Birth Afterthoughts is a listening and debriefing service available to any woman who has given birth to their baby. It is a confidential service that provides an opportunity to discuss and understand what happened during labour and birth.
Speak with your Midwife or Health Visitor to be referred.

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In this video, a breastfeeding counsellor helps a mother with her positioning and attachment whilst breastfeeding.

Key to achieving the Baby Friendly standards is a workforce able to support mothers to breastfeed effectively. This video provides some guidance on this.

You can see more of the 'From Bump to Breastfeeding' DVD on the Best Beginnings website.

Video not working? Contact us

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Positioning and attachment video - Baby Friendly Initiativ

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In this video, a breastfeeding counsellor helps a mother with her positioning and attachment whilst breastfeeding. Watch to learn more.

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This video guides mothers on how to hand express and talks about the times when hand expression might be useful.

See the Breastfeeding Network website for FAQs and a leaflet all about expressing and storing breastmilk.

Problems viewing this video? Contact us.

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Hand expression video - Baby Friendly Initiative

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This video guides you through how to hand express, and talks about the times when hand expression might be useful for you.

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https://www.tommys.org/pregnancy-information/premature-birth/feeding-your-premature-baby-in-the-hospital

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Any breastfeeding is valuable

Exclusive breastfeeding for the first six months ensures the best outcomes for babies. Right from birth, it's important to ensure mothers and babies are supported to get breastfeeding off to the best possible start.
However, there are some mothers who cannot or choose not to breastfeed exclusively. In these circumstances, any breastfeeding is valuable: babies benefit from receiving the maximum amount of breastmilk possible.

Managing supplementation rates

Evidence suggests that early supplementation is associated with an increased risk of stopping breastfeeding. This should therefore be avoided whilst feeding is being established. Ongoing sensitive support to ensure mothers can effectively attach their baby at their breast and know how to hand express if baby is reluctant to feed, will reduce the need for supplementation.

Should a baby require supplementation for clinical reasons, this should be kept to a minimum safe level and mothers should be encouraged to maintain their milk supply with a view to returning to full breastfeeding. Disruption to breastfeeding can also be minimised by choosing an alternative method of feeding which best supports the return to full breastfeeding when possible.

Local supplementation rates should be monitored and action taken if they appear to be increasing. There should be steady progress to reduce supplementation rates, especially for supplements given without medical indication or fully informed choice.

If a mother has decided to introduce formula milk for non-clinical reasons, ensure that she is aware that this may impact on her milk supply. It is important to adopt a gentle, non-judgmental approach when discussing this sensitive issue (see our guidance on conversations with mothers and our video on communication in pregnancy for tips). If she has made a fully informed decision to introduce formula milk, she can be supported to continue to provide breastmilk for her baby. You can work together on a plan to help her maximise her breastfeeding, thereby supporting her to see herself as a breastfeeding mother.

Some mothers may want to return to full breastfeeding. Providing practical support around gradually decreasing the amount of formula she gives, whilst increasing her own milk supply, will help her make the transition as safely as possible.

It's about taking it one day at a time, not going "Oh I need to think about three months...". You need to think about now. This feed.

To meet this standard

In maternity services - help mothers and babies get breastfeeding off to a good start with uninterrupted skin-to-skin contact and support with positioning, attachment and hand expressing

Where possible avoid supplementation whilst breastfeeding is being established

If supplements are given for clinical indication or as a result of fully informed maternal decision, keep the amount of formula to a minimum (whilst ensuring safety of the baby) and support mother and baby to return to full breastfeeding as soon as possible

Monitor supplementation rates with a view to reducing the rates for non-clinical reasons

If a mother has decided to combine breast and formula milk, ensure that she has information and support to continue to maximise the amount of breastmilk and breastfeeding her baby receives

Revisit her goals as she may want to return to full breastfeeding after the initial challenges faced in the difficult early weeks. Work with her to develop a plan to increase her milk production and gradually decrease the amount of formula used

Remember to praise mothers: however much breastfeeding they are doing they remain breastfeeding mothers.

Further resources

The health visitor says "Well done" and you feel so proud!

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Maximising breastmilk - Baby Friendly Initiative

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Exclusive breastfeeding for the first six months ensures the best outcomes for babies. Right from birth, it's important to ensure mothers and babies are supported to get breastfeeding off to the best possible start. However, there are some mothers who cannot or choose not to breastfeed exclusively.

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You may be reading this because you have a preterm baby, or because you are expecting to deliver your baby before full term and you want to be prepared. Perhaps you're supporting someone who has recently had a preterm baby. Whatever your situation then we hope this information will help to get breastfeeding off to a successful start.

Before your baby arrives
Your premature newborn
Establishing breastfeeding
Looking after your own health and wellbeing
Taking your breastfed baby home

Before your baby arrives

If you know your baby will be arriving soon, you may wish to try antenatal expression of colostrum. This is where you hand express some of the thick, creamy first milk into a sterile container such as a syringe. This can be given to your baby immediately after birth reducing the possibility of them needing to have early formula feeds. Hypoglycaemia (low blood sugar) can cause serious long term health problems if left untreated, and preterm babies are at higher risk of low blood sugar than babies born at term. Having some colostrum ready means that this is available instead of formula (or donor milk if available).

If you are at risk of early labour and taking precautions to avoid it, then consult with your healthcare professionals about your individual case before starting antenatal expression as it may be considered to increase your risk of going into labour.
You can read more about antenatal expression here.

If there is time before your baby arrives, someone from the paediatric team on the neonatal unit where your baby will be cared for should come and talk to you about how you plan to feed your baby. You can supply them with any expressed colostrum you have in a labelled container, and discuss how you wish your baby to be fed while you are establishing your milk supply.

Some neonatal units will have access to donor breastmilk, and will be able to tell you if your baby will be eligible to receive this - as supply is limited, this is likely to be restricted to the babies who need it the most. They will discuss and get your consent if formula may need to be given while you are building your milk supply. This may also be the time to talk about how you want supplementary feeds to be given to your baby.

Smaller or weaker babies will be given a nasogastric tube, to allow milk (your own, donor or formula) to be fed down the tube. Bigger and stronger babies may be given bottles. You may wish to discuss paced bottle feeding (the art of giving bottle feeds in a way that supports breastfeeding) or cup feeding.

If you wish to express breastmilk for your baby, then your hospital should be able to provide you with a breastpump - asking for this before your baby is born means that you have it ready as early as possible. In the early days you need to be stimulating milk production in your breasts between eight and twelve times in twenty four hours, including at least once at night - this might be by your baby feeding effectively at the breast, or pumping sessions.

To read more about successfully expressing breastmilk, click here.

Your premature newborn

When you baby arrives there is likely to be a sudden rush of activity as your baby is checked and stabilised. They may be rushed off to the neonatal unit leaving you feeling stranded in the delivery unit. Be kind to yourself. You may feel that starting to express milk is a practical way that you can be involved in their care even when you are apart from each other. There is evidence to show that if you start expressing within the first hour after birth it can have a long term positive effect on your milk supply.

Establishing breastfeeding

You may be expressing on your ward (if you are still an inpatient) or on the neonatal unit. Many mothers find that being close to their babies while they are expressing can help to increase the amount that they are able to express. If you are separated, looking at photos of your baby can help or smelling something that has been close them.

If you are expressing on the unit, you may wish to be close to your baby as you do so. Some mothers use screens for privacy. You can ask for these to be provided. You don't have to use screens if you prefer not to - using scarves or nothing at all is a completely acceptable choice. Do what you feel comfortable with and helps your milk to flow easily. Listening to music may help you to relax and increase your milk production.

You are the person most known and familiar to your baby. Being with you is the safest and most secure they can possibly feel. If your baby is very fragile they may not be able to come out of their incubator at first. Ask the staff how you can be involved in their care and to show you how to hold and comfort them through the vents in the incubator. Once your baby is able to come out of the incubator, then kangaroo care can become an important part of your time together. This is where your baby is placed skin to skin on your chest for as long as possible and a blanket put over both of you. Your baby is able to enjoy the sensations of your closeness and the deep relaxation and comfort they feel helps them to regulate their breathing, temperature and other health indicators. It also helps your breast to become a familiar environment and allows them to practise feeding directly from the breast easily.

It used to be thought that babies under a certain gestation didn't have the ability to suck and swallow, or that directly breastfeeding was tiring to them. Happily, more recent studies have disproved these concerns. Once babies are well enough to breathe unaided (off ventilation and continuous positive airway pressure - CPAP), they can be brought to the breast. Smaller and younger babies will still need to have some of their milk given to them via tube feeds, but this allows you and your baby to learn to breastfeed together without a feeling of pressure.

Smaller babies have smaller mouths and lower muscle tone. This may mean you need extra support to get breastfeeding established. Seek skilled help early and often. Keep asking until you find someone who is able to support you effectively.

Premature babies often find it easier to feed in laid back breastfeeding positions. This is where you are supported in a reclined position with your baby tummy down on top of you. This helps gravity to 'stick' your baby to you and stops them slipping off. If you need to sit in a more upright position, then supporting the whole length of your baby's body close to yours with a hand behind their shoulders means they don't have to support their weight and stops them from curling in on themselves. Read more about laid back breastfeeding here.

You may find that your baby quickly falls asleep when breastfeeding. This isn't a sign that you are exhausting them, but that they are small and being soothed. You can help them to stay awake for longer by washing their face with cool water, gently blowing on them or tickling their feet. You may find that breast compressions - gently smoothing down your breast towards the nipple - helps your baby to stay alert and interested in feeding as this makes the milk flow more quickly and easily for them.

All new babies need to feed frequently - and premature babies are no different. The volume of milk that their stomachs can take at each feed is very small, and breastmilk is easily digested. It is normal for babies to feed between 8-12 times in a 24 hour period, including at least once at night.

Neonatal unit staff need to be able to ensure that all the babies in their care are receiving the right amount of milk for them to grow. Premature or sick babies may be less able to communicate their need for milk. These two things combined mean that units often use feeding schedules, with feeds timetabled every two, three, or even four hours.

When you agree how often your baby is to be offered supplemental feeds (any milk not directly from the breast) it may be helpful to remember that four hourly is less frequently than you would expect a healthy, full term newborn to feed. You may also choose to consider these as 'backup' feeds - any time spent feeding directly from the breast doesn't reset the clock, but is bonus extra calories. Keep writing down how often you are breastfeeding in your baby's notes, as this may help you and the staff to feel confident about the transition from scheduled, measured feeds, to baby led, responsive feeding.

One of the things the unit staff will look for in a baby coming close to going home is that your baby is able to rouse themselves to feed. If your baby is waking for feeds more often than their feeding 'schedule' (and you are spotting signs of effective feeding), this may be a sign that they are becoming better able to manage their own need for milk. You will probably need to keep offering more frequently than they ask for milk - this is true for many babies. Remember, you can't feed too often, and your baby can always say no if they don't want milk right now!

Breastmilk is an incredibly responsive food, made specially for each baby. The milk that you are making for your premature baby will be even more densely nutritious than the milk of a full term mother. Every drop of milk that you can supply for your baby is like medicine - strengthening and building their immune system and providing the calories they need to grow. Some mothers feel that providing milk for their babies is a unique way that they can care for their babies. It can be an important part of bonding with a new and fragile baby. While your baby will continue to benefit from your milk for as long as you provide it, you aren't tied to expressing for longer than you want to do so. If you decide it's time to stop, then gradually reducing your pumping sessions will slow and stop your milk production without causing problems for you.

Looking after your own heath and wellbeing

You will be recovering from pregnancy and birth, and may be experiencing additional health problems. It is important to remember to look after yourself - the more smoothly your recovery goes, the more strength and energy you will have to become more and more involved in your baby's care. If you have older children at home, you may be struggling to balance meeting their needs with being present with your newborn. Many mothers have to leave hospital long before their baby is ready to come home and have to travel back and forwards to be with their baby. This is a time to say yes to as many offers of help as you possibly can. If someone can provide a lift, deliver a meal, entertain an older child or do a load of washing - or just sit with you to talk things over in the hospital cafe - these may make life a little easier for you and help you to keep going at a difficult time.

You may be taking medications yourself and be concerned about them passing through your milk. Discuss your concerns with your and your baby's medical teams. They may be able to reassure you or find suitable alternatives. For specialist information about whether a drug is compatible with breastfeeding, you can contact your local LLL Leader who has access to resources and professional support.

It may feel impossibly painful to keep leaving your baby. Remember that by looking after yourself - eating, sleeping and taking the medication you need to get well - you are making sure that you carry on being able to be there to look after your baby.

Taking your breastfed baby home

Separately to any health issues your baby may be facing, your neonatal unit will want to know that you are able to make sure your baby is getting enough milk to continue growing. Being aware of your baby's early hunger cues is important so that you can feed responsively and before baby gets too upset. You may have a very sleepy baby who still needs your help to wake themselves up to feed beyond their due date. Setting an alarm for the middle of the night can help you to make sure they don't go for longer than a four hour stretch without feeding at night.

Read more about recognising early hunger cues and about waking a sleepy baby here.

Read more about how to tell if your baby is getting enough milk here.

Many breastfeeding mothers and babies enjoy safe cosleeping. Premature babies are at greater risk of Sudden Infant Death Syndrome or Sudden Unexplained Death in Infancy (SIDS/SUDI). While they will benefit from sleeping close to their mother, premature babies should sleep on a separate, firm surface such as a sidecar cot.

It can be scary to make the transition from caring for your baby in hospital with a team of staff around you, to being at home. Your healthcare professionals are likely to make extra visits to support you and to keep an eye on your baby's weight gain. You may find that being home together, able to stay together all the time, and in a comfortable environment, you rapidly get to know and understand your baby more easily and become more confident in your mothering skills.
Photo credits: Olivia Brown and other mothers
Other resources

You can read a mother's story about mothering her premature baby through special care

This video looks at breastfeeding in the first hour after birth

The drugs in breastmilk service, while not an LLL resource, gives quick access to information from a qualified pharmacist

The Small Wonders films follow families through their experiences of having a baby on a neonatal unit

Global Health Media have a series of videos about various aspects of life with a small baby

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Successfully breastfeeding your premature baby - La Leche League GB

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You may be reading this because you have a preterm baby, or because you are expecting to deliver your baby before full term and you want to be prepared. Perhaps you're supporting someone who has recently had a preterm baby. Whatever your situation then we hope this information will help to get breastfeeding off to [...]

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Transitioning a premature baby onto the breast 

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Transitioning a premature baby onto the breast 

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When a baby or babies have arrived early, it is common to feel stressed and helpless. One of the few things lactating parents can do is to provide colostrum and milk for their babies. Preterm human milk is different to that of a someone who delivers at term. It has higher levels of energy, fats, protein, vitamins and minerals, and most importantly it has higher levels of immune factors. It is highly valued in the neonatal unit and parents are usually supported to hand express colostrum within the first 6 hours after birth, and then move onto the pump to provide breast milk for tube feeds. The hospital should be able to advise on renting a hospital grade double pump to be used when the parent is discharged home. It is important to pump frequently; we recommend 8-12 times in 24 hours making sure at least one is between 2-5am when hormone levels are at their highest. A more detailed blog on establishing milk supply is available here.

But what next? How do we go about actually breastfeeding? Is it possible to move to exclusively breastfeeding when you have had such a traumatic entrance to the world? The answer is yes, but it will take time.

Once premature babies hit around 32-33 weeks gestation they often begin to start developing a suck, swallow, breathe pattern in short bursts and may start rooting for the breast. Hopefully you will have already been given the chance to have lots of kangaroo care with your babies before now, but at this point it can really help transition the baby from tube feeds onto breastfeeding.

Learning to breastfeed when you are a premature baby is a long, slow, tiring process and it requires everybody to have lots of patience. To start with babies can have skin to skin time, or kangaroo care, be encouraged to lick the nipple and if they are ready to possibly have a few sucks. A baby can begin with non-nutritive sucking at a recently pumped breast to provide a gentle experience without an overwhelming flow of milk. Then a fuller breast can be introduced. But at this early stage the majority of any feed will still be expressed milk through the feeding tube. The staff will encourage you to try each baby at the breast once or twice a day so as not to tire them out too much. Once they become stronger and start to suck and swallow more effectively its a good time to move to more frequent feeds. It can be a good plan to try baby at the breast during their tube feed as they will begin to associate the act of breastfeeding with the feeling of having a nice full tummy. A nipple shield can help the smaller baby to latch onto the breast, especially if they have been given bottles. There is evidence that suggests shields can increase milk intake in preterm infants in the early days, so this can be worth considering, especially if you are struggling with pumping. Remember ask for lots of support from the hospital staff during this time. This is actually one of the benefits of having babies in special care.

When the babies appear to be feeding better and getting much more milk we can move on to the next stage. This can be at different ages for different babies. For some it can be around the 36-37 week gestation mark, others need to get to near full term. The hospital staff will help give confidence that it is time to move to the next stage. Whilst some babies will be able to move straight on to exclusive breastfeeding from tube feeding, this new enthusiasm for feeding can be a bit misleading as the suck can still be uncoordinated and inefficient and the babies can still tire easily. If we move on to exclusive breastfeeding too quickly, it can cause problems with babies not taking enough milk, becoming too tired and then starting to reduce their weight gain. So for many babies its advisable to continue to top up with expressed for a little while. A lot of parents choose to top up by a different method than tube so the babies can get home, although some hospitals will discharge a baby still tube feeding. Hospital staff may use a tool like the Breastfeeding Assessment Score below to calculate how much top up to give baby. They will calculate to work out exactly how much milk depending on baby's weight, gestation, growth about how much a full feed is.

For twins and triplets it is important to remember that they are individuals. One baby may be much better at feeding than the other. It can be hard not to compare and be worried and frustrated if one baby is not managing to feed as well. But, with time, it is very likely that they will catch up and both will feed well from the breast when ready.

Generally hospitals prefer to use bottles to feed babies their top ups, or during the night when the parent is not there. They are easier, there's less waste and staff are pushed for time so go for the easier option. So to minimise the impact on breastfeeding of using a bottle, it is important to use a paced bottle feeding technique. Paced bottle feeding means letting the baby take control of the speed of the feed and when to take breaks and when to finish. Sit baby in an upright position and keep the bottle as horizontal as possible whilst still filling the teat with milk to avoid intake of air. Baby should be encouraged to latch on to the bottle like the breast, so touching the top lip to encourage baby to route and bring baby onto the bottle chin first, teat into the roof of the mouth. Start with an empty teat to encourage them to wait for the let-down when breastfeeding, they do not swallow air if teat is totally empty. Stop frequently and make sure you do not force baby to have a certain amount. With this slower feeding technique, the baby will be able to tell it is full and finish the feed when satisfied. And baby will be more able to transfer between bottle and the slower flow of the breast.

The chance to 'room in' for a night or two before you are discharged home will hopefully be available. During this time it's often encouraged to move on to responsive feeding as opposed to hospital routine based feeding. But babies can still be sleepy and not wake for feeds at this stage so its important to make sure that they feed at least every 3 hours as a minimum, measured from the start of each feed.

For a lot of preemie parents, their first experience of being at home with their early baby is to be in an intense breastfeed, top up, express routine, every 3 hours or more, day and night. This is called triple feeding and is utterly exhausting and overwhelming and it is often difficult to see past this stage. However with good feeding support from health visitors and breastfeeding specialists and the discharge team from NICU, exclusive breastfeeding is generally eventually possible. Babies are individuals and it is often somewhere between 36 weeks and 42 weeks gestation where they begin to feed efficiently enough to fully breastfeed.

Whilst the baby still needs top ups it is imperative that there should be somebody to look after the breastfeeding parent. This routine is so full on that there is not much time for anything else, especially sleep! Somebody to do the top up whilst pumping saves time. Breastfeeding makes you hungry and it's important for energy levels that you eat properly, so having someone to feed you whilst you feed the babies can make all the difference. Every single breastfeed given and every single drop of expressed milk should be valued and encouraged. Emotional support is vital and reminding that soon it will become much easier can keep everyone going through this incredibly tough time.

Support can be invaluable at this time but a lot of parents feel unsure about taking their preterm baby out to groups due to risk of infections. This is where home visits from well informed health care professionals and good online support can step in. Online support especially can be great, as long as it is properly moderated, as parents can make contact with others who have been in the same position or are going through it at the same time. Peer to peer support is incredibly important. There is also often somebody around at 3am during the night feeds to sympathise!

So how do we know when a baby is feeding well enough to fully? Their suck becomes more coordinated and they can remove more milk from the breast. You can watch for the full term feeding pattern of sucking fast for a minute to stimulate the let down, and then move on to deep slower jaw movements with pauses in between. You may be able to hear swallowing. Breast compressions can help to get a bit more milk into the baby if they are still seeming a little inefficent or sleepy at the breast. They often have a big feeding frenzy at around 40week due date and sometimes want to cluster feed at this time. This can be very unnerving for a preterm parent who is used to having a sleepy baby who needs to be woken for feeds. Cluster feeding should be encouraged and explaining that it is completely normal behaviour and will help baby get lots of milk helps understanding. However it does not necessarily translate in to weight gain immediately. It can be very discouraging when baby has been feeding all night and only put on a small amount the next day. However you often find a day or two later and it pays off.

It is a good plan to get some support with tandem feeding. Tandem feeding maximizes the time spent feeding as there's less waiting time for babies and it is a more efficient use of time. It helps synchronize the babies' feeding times and more importantly sleeping times! A strong feeder can help a weak feeder by stimulating the let down and getting the milk flowing. It also increases milk supply and the milk has a higher fat content.

Dropping or reducing the top ups gradually can make it a bit less stressful. For more detailed info in reducing top ups see our other blog here

But here's an overview: Parents can reduce the volume of top ups and put babies back on to the breast if not settled. Babies are often more settled during certain times of day or night and these can be the first feeds to just breastfeed. Encourage the babies to have a second or third go on the breast if they do not settle after the first feed. Twins or triplets can be put back on the same breast, they will trigger another let down of milk. Nappy output and weight gain should be kept a close eye on during this process.

Sometimes when babies move on to more direct breastfeeding, their weight gain can flatten off a little bit. This can be really discouraging but it can take a bit more energy to fully breastfeed and they can tire themselves out and burn more calories. As long as they are still gaining this is usually ok and they will set off following their curve again given a bit of time. This may be a good time to get some reassurance from a breastfeeding specialist.

Breastfeeding is so important for babies, but even more so for premature babies. But establishing breastfeeding in the neonatal unit is like a marathon, not a sprint. It is a slow process taking every ounce of patience and determination. But it is worth every bit of stress.

Kathryn Stagg ABM BFC, Updated May 2021

References

Breastfeeding and Human Lactation, enhanced 5th edition, Wambach & Riordan, 2016

The Breastfeeding Atlas, 6th edition, Wilson-Clay and Hoover, 2017

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Transitioning a premature baby onto the breast - a step by step guide for parents | Breastfeeding Twins and Triplets

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When a baby or babies have arrived early, it is common to feel stressed and helpless. One of the few things lactating parents can do is to provide colostrum and milk for their babies. Preterm human milk is different to that of a someone who delivers at term.

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Your breast milk is important to your baby at any age. Giving your premature baby your breast milk benefits their health as well as yours.
Breast milk:

helps protect your baby from infections, particularly of their gut - premature babies are more likely to get infections

contains hormones, nutrients and growth factors that help your baby to grow and develop

is easier for your baby to digest than formula milk, because it's human milk specially designed by your body for your baby

See other benefits of breastfeeding.

If your baby is very small or sick, they may not be able to breastfeed from your breast at first. But, you can start regularly collecting your breast milk (called expressing) as soon as possible after your baby's born. This will help get your milk supply going and the milk you express can be frozen so you can give it to your baby later. Then you can start breastfeeding from the breast once you and your baby are ready.

Even if you were not planning to breastfeed, you could express your breast milk for a while to help boost your baby's immune system in the early weeks after birth.

Spending lots of time close together with your baby can help boost your breast milk supply and establish breastfeeding.

Skin-to-skin contact with your premature baby

If your baby is well enough, you'll usually be encouraged to spend time holding them against your skin as soon as possible. This is sometimes called kangaroo care.

Your baby will usually be dressed just in a nappy, hat and socks and then placed inside your top, under a blanket, or in a soft sling so they can be held securely against your skin. If it's cold outside you can also put them in a sleeveless vest with an open neck.

This skin-to-skin contact helps you feel close to your baby. Your partner can enjoy this kind of contact as well.

For your premature baby, skin-to-skin contact:

reduces stress and/or pain

promotes healthy weight gain

helps to establish breastfeeding

helps them sleep better

helps to regulate and support their heart rate and breathing

For mums, skin-to-skin contact:

helps reduce your chance of developing postnatal depression

increases your confidence as a new parent

can help make breastfeeding easier and increase the amount of milk you make

For dads and partners, holding your baby skin to skin:

helps you bond with your baby - babies can hear both parents' voices in the womb and will be calmed by the sound of your voice as well as their mum's

helps you feel more confident as a parent

Expressing milk if your baby is premature

It's recommended you express often, ideally at least 8 times a day to begin with - including at least once at night - to keep your milk supply up.

In the early days, it's often easier to express your milk by hand. Your midwife or a breastfeeding supporter can show you how.

You'll probably only express a few drops to begin with but, if you hand express often, this will increase. Even if you are only expressing a small amount it will still help your baby.

In the early days you can collect your breast milk in a small, sterile cup and store it in a syringe.

Once you are producing more milk, you could try using a breast pump. If your baby is in a neonatal unit, the hospital will usually be able to lend you an electric breast pump for expressing your milk. If they cannot lend you one, you can hire one.

Read more about breastfeeding help and support to find out about hiring a pump, or phone the National Breastfeeding Helpline on 0300 100 0212.

The staff, your midwife or a breastfeeding supporter can give you advice about how to increase your milk supply. They can also show you how to encourage your milk to flow and how to use a breast pump.

Always ask for help early if you have any worries or questions.

Tube feeding your baby

Babies do not normally learn to co-ordinate the sucking, swallowing and breathing needed for feeding until about 34 to 36 weeks of pregnancy.

If your baby is born before this time, they may need to have breast milk via a feeding tube to begin with. This goes through their nose or mouth into their stomach. The staff in the neonatal unit can show you how to feed your baby this way.

Babies who are very premature or sick may need to be fed via an intravenous (IV) line to begin with. A fluid containing nutrients is fed straight into your baby's vein.

Visit the Bliss website to read more about tube feeding.

Using donor breast milk

Some hospitals can provide donated breast milk for your baby to have until your own supply is established.

See the United Kingdom Association for Milk Banking (UKAMB) website for more about donor breast milk.

If donor breast milk is not available, your baby can have formula milk until you're producing enough breast milk.

It's recommended you do not buy donor milk over the internet. This is because the source cannot be confirmed and you cannot be sure whether the donor or the milk has been screened for infections.

Moving on to breastfeeding your premature baby

While holding your baby, you may notice them try to move towards your breast. Gradually, as they develop and get stronger, they will be able to breastfeed directly.

The first time you try it, the hospital staff may ask you to express first, then put your baby to your breast. This is so your baby is not overwhelmed when your milk lets down.

At first, your baby may only lick the breast, then next time take a few sucks until they gradually become happy and confident feeders.

You can combine tube feeding with breastfeeding until your baby is getting everything they need from the breast only.

Using a lactation aid (supplementer)

You could also consider using a lactation aid. This is a way of supplementing your baby's breastfeeds with either expressed breast milk or formula.

A tiny tube is taped next to your nipple so your baby can get milk via the tube as well as from your breast while attached to your breast. This helps to support your baby as they get used to attaching to the breast.

Visit healthtalk.org to see mums talking about feeding their sick or premature babies.

Got a breastfeeding question?

Sign into Facebook, or use an Amazon Alexa or Google Home and use the Start4Life Breastfeeding Friend chatbot for fast, friendly, trusted NHS advice anytime, day or night.

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Your breast milk is important to your baby at any age. Giving your premature baby your breast milk benefits their health as well as yours.

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You and your baby: Supporting love and nurture

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You and your baby: Supporting love and nurture

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How can health professionals support my family to get involved?

The nurses, doctors and other health professionals on a neonatal unit can support you to feel more confident in caring for your baby.

They can help by talking through anything that might be stopping you being more involved.

You might like to ask a nurse of other health professional on the unit to support you by:

Showing you how to do your baby's daily cares, like changing nappies, washing them, and dressing them

Giving you clear information about your baby's care, in a way that you understand

Understanding your emotional needs and how staff can support you

Making sure you understand and agree to the treatment your baby needs - this is called consent

Giving you practical information about how the unit works and the policies they have

Giving you any financial help that's available for car parking, hospital food, or other expenses

Showing you where to find further financial support if needed

Showing you where to find support if you are having to travel a long way from home to see your baby

Supporting you to help them, by letting you be a part of life on the unit. For example, many units let parents be there for the health professionals' ward rounds

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Getting involved in your baby's care | Bliss

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Find out how you can be involved in caring for your baby during their stay on a neonatal unit.

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Positive touch is a way of communicating your love and reassurance to your baby and hearing your baby's needs in return. Babies do communicate, and by watching and listening to your baby you can learn what kind of touch to use and when it is appropriate, safe and pleasurable for your baby.

It's harder for your baby to communicate when exposed to too much noise, too much light, too much cool air, or an uncomfortable lying position. See whether the environment can be calmed down first. In time, you will get to know your baby's individual ways and you may find your baby responding more often and for longer.

Comfort holding

Comfort holding is one of many ways for you and your baby to get to know each other. Your baby may be more comfortable lying in the incubator than being held. In this case, the staff may suggest that you try comfort holding if they think your baby is well enough. Comfort holding is 'still touch'. Cradling your baby with still, resting hands can be more comforting than stroking or massage, which are more stimulating.

Comfort holding can:

soothe your baby during uncomfortable procedures.

settle a restless baby.

help your baby to get back to sleep after feeds and care.

encourage your baby to be quietly awake and responsive.

Comfort holding is a way to experience loving touch when your baby is not ready to be held.

Talk to your baby's nurse about comfort holding. Together you can watch for signs from your baby that will guide you as to when and how to do it.

Be careful to:

Remove watches and jewellery, pull your sleeves up to the elbows, and wash your hands and lower arms. This reduces the risk of infection inside the incubator.

Always make sure that your hands are warm before touching your baby.

If your baby has difficulty keeping warm, make sure there is a layer of fabric (a hat, vest or blanket) between you.

Speak to your baby before touching, so that they are aware of your presence before you start.

Cradle one or both hands around your baby's feet, head or body, and keep them still. Your baby may also like to grasp one of your fingers.

Wait and watch for signs that tell you that your baby is relaxed.

You can continue for as long as you are both comfortable. When you finish comfort holding, move your hands away from your baby very slowly.

Kangaroo Care

Kangaroo Care is skin-to-skin contact when a baby is placed against the parent's chest. Benefits include improvements with lactation and with establishing breastfeeding, and better weight gain for the baby. In the longer term, it helps parents to feel closer to their babies and more confident in caring for them. Kangaroo Care can be used with babies with high medical needs, but this will require careful planning and collaboration with the neonatal staff.

Talk to staff and plan a good time and comfortable place for you to try Kangaroo Care.

While Kangaroo Care is based on direct skin-to-skin contact, removing your baby's clothes is not vital if this is upsetting for him or her. A hat and a blanket for extra warmth might be necessary for very small babies.

Hold your baby chest-to-chest tucked inside your clothes, enclosing him/her to keep his/her temperature stable. Check that the head is well supported and if you can't see your baby easily, try using a hand mirror.

Explore what you both like to enjoy together. Some babies like to have their eyes shielded, others like to be sung to softly or while having a tube feed. Allow time for your baby to settle and get the full benefit.

If you baby is happy, you can cuddle for as long as you are both comfortable. Lie back, relax and enjoy.

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Premature and sick babies undergo many medical procedures that can cause them some discomfort. As your baby's parents, you are the best people to balance this with a positive, reassuring touch.

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UKAMB

Welcome to UKAMB

Donated breastmilk from the country's network of milk banks helps to save the lives of premature and sick babies.

UKAMB is a registered charity that supports human milk banking in the UK and was set up in 1997. Our motto is 'Every Drop Counts' and we believe that the provision of safe and screened donor breastmilk makes an important contribution to the care of the premature and sick infants who receive it. Our goal is to ensure access to donor milk to every child who would benefit from its use.

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UK Human Milk Bank - Breast Milk Donation, BreastMilk Storage, UKAMB

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UKAMB, a registered organization supports human milk banking to save the lives of premature and sick babies. Connect with our network today!

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Support for women with birth trauma/PTSD after birth.

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The Birth Trauma Association (BTA) supports all women who have had a traumatic birth experience. It is estimated that, in the UK alone, this may result in 10,000 women a year developing Post Traumatic Stress Disorder (PTSD)

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Expressing & Storing Breastmilk for your baby

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Expressing & Storing Breastmilk for your baby

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

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https://www.breastfeedingnetwork.org.uk/drugs-factsheets/

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Drugs in Breastmilk factsheets - The Breastfeeding Network

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These factsheets have been compiled by our Drugs in Breastmilk information service team of pharmacists. If you are unable to find the information you are looking for below, or you still have questions, you can contact the team by sending a private message via our Facebook page or via email. Please provide as much information as possible (age […]

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

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

Breastfeeding guidance: English (for reference)

Bottle feeding guidance: English (for reference)

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Foreign language resources - Baby Friendly Initiative

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

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বুকের দুধ পান েরান োরননকদেনিো (Bengali)

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বুকের দুধ পান েরান োরননকদেনিো (Bengali)

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स्तनपान केलिए गाइड (Hindi)

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स्तनपान केलिए गाइड (Hindi)

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Sprijină hrănirea bebelușului tău (Romanian)

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Sprijină hrănirea bebelușului tău (Romanian)

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Підтримуйте годування дитини (Ukranian)

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Підтримуйте годування дитини (Ukranian)

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اپنے بچے کو کھانا کھلانے میں مدد کریں۔ (Urdu)

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اپنے بچے کو کھانا کھلانے میں مدد کریں۔ (Urdu)

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https://www.facebook.com/TheLotusService

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到 Facebook 查看帖子、照片和更多内容。

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patientadvice.uhnm@nhs.net
Tel:

01782 676450

You can talk to PALS who provide confidential advice and support to patients, families and their carers, and can provide information on the NHS and health related matters.

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University Hospitals of North Midlands NHS Trust

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Read this leaflet about It's ok to ask for more information
"It's OK to ask" has been designed to encourage our patients to ask the questions that matter to them, be prepared before their consultation and have the confidence to say if they do not understand the information they are being given.
We all feel concerned when we don't understand something, as things can become confusing and even frightening. We know that half of what a person is told is forgotten and half of what they remember is misunderstood. It is for this reason we want to encourage our patients to ask questions. Many people we care for need support to understand health information. This can be even more challenging when our patients have sensory difficulties or English is not their first language. Our aim is that our patients understand.
Why do we need to improve communication with our patients?
The message from our patients remains loud and clear that they want to receive more information and have more involvement in their care. This may be how to take their medication, being able to choose which treatment path to follow, making healthy food choices or finding their way around a busy hospital.

Research tells us that patients who feel involved in decisions about their care and who understand their condition have better outcomes.

We want to really make a difference by giving our patients the knowledge, understanding, skills and confidence to maintain their own well-being in the way that is best for them.

We have a responsibility to make sure that our explanations are not only heard but most importantly understood. If we get it right and encourage our patients to feel confident asking questions to help them understand: it will reduce the need for repeat appointments and hospital admissions.

We are committed to providing the best possible experience for patients and visitors.

Patient Experience and Involvement Strategy ​​​​ - read or download a copy

We know that patients who have a better experience generally have better health outcomes. There is also evidence to suggest that patient experience is improved when patients have more control over their care and make informed decisions.

As a result of listening to feedback, we recognised that we could communicate better with our patients. You told us that we don't always get it right when it comes to involving you in your care and that we don't always provide you with the information you need.

The 'It's ok to ask' initiative has therefore been introduced to encourage you to ask the questions that matter, be prepared before you see a health professional and have the confidence to say if you do not understand the information being given.

This will help us to ensure that we:

Provide timely, clear communication that our patients understand

Provide an environment where patients are confident to ask questions

Learn from patients themselves how much information they would like to receive and the way they would like to receive it.

Ask for a free bookmark when you next visit our Trust. It contains all of the information you need to get involved, suggesting three simple questions that you may want to ask when you next see a health professional:

What is my main problem?

What do I need to do?

Why is it important I do this?

Tell us if we got it right for you by completing our Friends & Family Test

Any complaints about your stay in hospital or your treatment will be listened to. These help us to identify where we are getting it right and where things can be improved for future patients.

There are a number of ways you can do this.

You may wish to raise a concern about something that could have been done better or differently to help us improve.​

It is always best to speak to the staff who are treating you first of all.

If this does not resolve your concern please contactPALS (Patient Advice and Liaison Service)​​, who will be able to support you and advise you of your options.

You may also wish to raise a formal complaint about an experience that you feel has been poor or things that you feel need to be improved or changed.

Details on how to do this can be found within the Compliments, Concerns and Complaints Leaflet​​. Click on the link for more information or contact PALS (Patient Advice and Liaison Service)​​ ​

Please be assured your care will not be affected if you raise a concern or make a complaint. Let us know your comments as soon as possible and where necessary. We will do our best to put things right for you

If you would like support in raising a complaint, independent advocacy services are available to you. The services below will be happy to advise you:

www.asist.co.uk(advocacy service)
www.totalvoicestaffs.org ​ (advocacy service)​

The NHS constitution sets out patients' rights to accessing healthcare: NHS constitution Handbook V2 (2015)​

As a Trust, we have a legal obligation to ensure our patients and visitors have equal and inclusive access to all our services. This includes those whose characteristics are protected by the Equality Act 2010​ :

Age

Disability

Gender re-assignment

Marriage and civil partnership

Pregnancy and maternity

Race including nationality and ethnic origin

Religion or belief

Sex

Sexual orientation

We have a number of public involvement groups and forums. Please contact Angela Grocott, Head of Patient Experience and Public Involvement on 01782 675487 for more information or if you are interested in joining.

NHS England have also said that we need to make sure communication is equally accessible to all people and that we should have things in place to support our patients and visitors who have a communication support need.

We support individual communication needs on request. Examples of some of these are:

A hearing loop is available for use within wards and departments

Interpreter services are available

Large print information is available

Printed information is available in a range of different languages

Audio information can be made available

For people who are Next of Kin but may have hearing impairments which make being contacted by phone difficult, we can send you a text message asking you to contact the ward

We can also assist with access to an independent mental capacity advocate if you feel you might need support

We have aHospital Passport​ for people with hearing impairments

To support with increasingly diverse communication needs, we now have the option to send a text to the identified next of kin or emergency contact to ask them to contact the ward. No personal or confidential information can or will be sent using a text... it is simply a text to ask someone to contact the ward. If you would prefer to receive a text rather than a phone call, please speak with the nurse in charge or contact PALS- the PALS office is just off the main corridor behind Main Reception​

Like most people, we like to know if we are doing a good job. By telling us, it encourages staff and helps to build confidence in the quality of our care. If you have received good treatment or service and would like to thank the staff involved, please let us know by contactingPALS (Patient Advice and Liaison Service)​. They will ensure that your compliments are passed on to the service or individual concerned as quickly as possible.

Your UHNM Hero

You can also tell us who your UHNM Hero is! Winners of the UHNM Hero award receive a certificate and have their story published on the hospital's website and social media pages. Click here​ to find out more.

Tell us, we are listening!
As an organisation, we regularly collect patient, visitor and staff feedback through a variety of different ways.
Get involved, have your say! Complete the Friends and Family test
All feedback is valued as a really important way for us to improve the experience of our patients and visitors. Positive feedback allows us to share good practice throughout the organisation and negative feedback helps us to learn and put improvements into place.

Whether you are a patient or carer, family member or visitor, your comments are important to us. You can leave feedback about your experience of the services provided at our Trust in the following ways:​

NHS Choices
Patient Opinion

Healthwatch Staffordshire

Healthwatch Stoke on Trent ​
Are you due to use our services in the near future? Are you interested in becoming a 'Mystery Shopper' or completing a diary to describe your experience?
We welcome the opportunity to hear about what it really feels like to be a patient at UHNM. If you would like to tell your story to a member of the patient experience team, please contact Angela Grocott, Head of Patient Experience on 01782 675487 or email: angela.grocott@uhnm.nhs.uk

Contact Angela Grocott, Head of Patient Experience on 01782 675487 or email: angela.grocott@uhnm.nhs.uk for more information.

The feedback that we receive is used to provide both local and national reports.

If you would like to read some of the feedback we have received in more detail, click on the links below (Insert monthly/quarterly reports)​​

University Hospitals of North Midlands is committed to involving patients, carers and members of the public in planning, developing, delivering and monitoring the services it provides and commissions. We recognise that a big part of involving pa tients and the public is about giving people a say in how we do things at our Trust.

Involving patients and the public in decision-making is crucial to ensuring that NHS services deliver what patients want and need. We know that listening to our patients and the local community enables us to drive the improvements that matter to them; it is one of the ways in which we can deliver our objective of providing quality patient care.

This section of the website contains information on a variety of ways that you can get involved.

Volunteer at University Hospitals of North Midlands

Volunteers help to improve the quality of patient care in a range of ways. If you are interested, find out more about volunteering​ at either of our sites.​​

'In Your Shoes' events and 'Patient Story'

Have you recently been a patient in our hospital? Your experience is really important to help us to share what we do well, make improvements where we could do better and shape our new services going forward. You may wish to share your story alongside other patients/carers or prefer to meet with a member of the Patient Experience team on a one to one basis.

Hospital User Group (HUG)
Terms of reference July 2019
The aim of HUG is to:

Maintain an overview of patient and public involvement in the Trust, providing patient-focused feedback

Contribute towards the development of Trust policies and procedures that affect patients and public

Work with the Trust in seeking views from patients and the public and hard-to-reach groups by developing links with patient/public/community groups

Provide a user perspective in the development of the Trust's service plans, contributing to various focus groups on request/as able

Patient Information Ratification Group

Be part of the team that reviews and ratifies new information leaflets written for patients and carers to ensure they are fit for purpose. This can be completed at home for those volunteers who cannot spare the time to attend a monthly meeting but would like the opportunity to review leaflets and provide feedback via email.

Mystery Shopper

Use your contact as a patient in our Trust to provide structured, anonymous feedback about your experience.

Complaints Peer Review Workshops

UHNM has worked with Healthwatch to develop an independently led, Trust-wide Peer Review Programme, which will provide consistency of approach to reviewing complaints and how we investigate and respond to them. We know that it is important to​ listen carefully to what people say and to conduct investigations in a fair and objective manner. By becoming a member of our Complaints Peer Review Workshop, you will be supporting us to achieve our aim that all complainants are treated with respect, tact, compassion and concern for their well-being.

Contact

If you are interested in getting involved in any of our groups, please contact either Angela Grocott, Head of Patient Experience or Rebecca Pilling, Quality Improvement Facilitator: Patient Experience on 01782 675487 or via email to Rebecca.pilling@uhnm.nhs.uk

Welcome to the Patient Advice and Liaison Service, or 'PALS' for short. At University Hospitals, we aim to provide patients with the best possible care and environment during their hospital stay. PALS was introduced to assist and support patients throughout their care. We an impartial, welcoming, open and confidential service for people who would like information or advice, or would like to comment about any aspect of the services provided by University Hospitals. We can:

Provide the opportunity for patients, relatives and carers to raise, in conf idence, any problems concerns or comments they may have about the care and service they receive from staff

Provide patient feedback forms for patients to comment on services provided

Make ward or home visits if necessary

Provide information on how to view or receive copies of your health record

Provide you with information and refer you to independent or specialist advocacy services

Try to resolve any concerns that you may have. If the PALS officers cannot sort the problem out, they will try to find someone who can

Give information about the Trust's complaints procedure and help to find support

Provide a welcoming environment for you to discuss your concerns or make a suggestion or comment

Treat your information in strict confidence and only pass to others with your direct consent

Return your call as soon as possible if we cannot speak to you personally when you telephone

Collect patient comments from feedback boxes weekly, and acknowledge comments within two working days of receiving them if a name and telephone number is provided

Acknowledge any email received as soon as possible

Seek your permission if issues need to be taken forward

Where are we?

The PALS office at Royal Stoke is situated inside Main Building, to the right of reception in the main entrance. The office is open 9.00am to 4.00pm, Monday to Friday (not including bank holidays).

The PALS office at County Hospital is located in the main entrance, to the right before the main reception desk. The office is open 9.00am to 5.00pm, Monday to Friday (not including bank holidays).

or telephone: 01782 676450.

If the PALS officers are not available when you call, there is a answerphone service where you can leave a private message which is only available outside of normal working hours (after 4pm and on weekends and Bank Holidays). We will normally call you back the same or next working day.

Are you hard of hearing?

You can text PALS on 07432 169045.

If, after talking to PALS, you are not satisfied and wish to pursue a complaint, please contact the complaints department by emailing: complaints.department@nhs.net ​ or telephoning 01782676453.

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Patient Experience and PALS | University Hospitals of North Midlands NHS Trust

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Read this leaflet about It's ok to ask for more information "It's OK to ask" has been designed to encourage our patients to ask the questions that matter to them, be prepared before their consultation and have the confidence to say if they do not understand the information they are being given.

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Maternity and Neonatal Voices Partnership (MNVP) - Staffordshire and Stoke-on-Trent, Integrated Care Board (icb.nhs.uk)

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MNVP long logo STAFFORDSHIRE & STOKE-ON-TRENT

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https://www.combined.nhs.uk/our-services/adult-community/parent-and-baby-service/

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Service name

Parent and Baby Day Service

Main contact number

0300 123 1769

Service based at

The Bennett Centre

Richmond Terrace
Stoke-on-Trent
Staffordshire
ST1 4ND

Service hours

8.30am- 4.30pm - Monday to Sunday

About the service

The Parent and Baby Day Service is a specialist perinatal secondary mental health service. The service is interested in the prevention, detection and management of perinatal problems that complicate pregnancy and the postpartum year. These problems can include new difficulties, recurrences of previous difficulties, and those women who have existing mental health problems. The team at the Parent and Baby Day Service provides a comprehensive service of high intensity with customised treatments for parents with psychological disorders associated with pregnancy and childbirth.

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Parent and Baby Day Service 0300 123 1769 The Bennett Centre Richmond Terrace Stoke-on-Trent Staffordshire ST1 4ND 8.30am- 4.30pm - Monday to Sunday The Parent and Baby Day Service is a specialist perinatal secondary mental health service. The service is interested in the prevention, detection and management of perinatal problems that complicate pregnancy and the postpartum year.

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The Lotus Service - MPFT. 268 likes. The Lotus service is a Maternal Mental Health Service that provides specific support for local families who are coping with birth trauma, fear of childbirth,…