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If your breastfeeding is going well you may wish to wait a few weeks until your breastfeeding is established before you start expressing, if you want to express. However, some of the information below may be useful if you do find yourself needing to express. Please don't hesitate to contact the Infant Feeding Team if you need more support.

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Research on skin to skin has shown that it can have a positive effect on the mother- baby relationship. Below is lots of information on skin to skin.

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Responding to babies’ needs for comfort and food is hugely beneficial for brain development and makes for more confident toddlers. Parents should be supported in breastfeeding responsively and keeping their babies close to help them become happy, healthy and secure children and adults.

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In this video, we look at the importance of developing close and loving relationships with babies in their early days and weeks.

Responding to babies' needs for comfort and food is hugely beneficial for brain development and makes for more confident toddlers. Parents should be supported in breastfeeding responsively and keeping their babies close to help them become happy, healthy and secure children and adults.

For more information:

Find more relationship building resources

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The Importance of relationship building video - Baby Friendly Initiative

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This video looks at the importance of developing close, loving relationships with babies in their early days and weeks.

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This video looks at both the theory and practice of relationship building and responsive breastfeeding, supporting families to get their relationship with their baby off to the best start.

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This video looks at both the theory and practice of relationship building and responsive breastfeeding, supporting families to get their relationship with their baby off to the best start.

Hear mothers and professionals give tips and advice on what it can mean to have a close and loving relationship with your new baby.

Find more relationship building resources

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Breastfeeding and relationships in the early days video - Baby Friendly Initiative

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Baby Friendly's video on breastfeeding and relationship building covers views and tips from both mothers and health professionals.

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thumbnail_Building a close and loving relationship with your baby (1)

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A good baby is a perception held by our society that babies should act in a certain way.  Some baby care books take advantage  of this by suggesting parents should encourage babies to be in a strict routine for  their feeding and sleep.

This animation by Dr Amy Brown encourages new parents to put the books down and instead be more responsive to their baby's needs.

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School of Health & Social Care, Swansea University

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

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The Lullaby Trust safer sleep advice gives simple steps for how you can sleep your baby to reduce the risk of sudden infant death syndrome (SIDS) which is commonly known as cot death. It can give you the peace of mind to enjoy this special time.

Our advice is based on strong scientific evidence and should be followed for all sleep periods, not just at night.

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The safest cot is a clear cot

The safest cot for a baby is a clear cot. That means removing anything that isn't essential. Babies need just two items in their cot:

It's important to remove anything that isn't essential because items such as toys, blankets and bumpers could cover their face and obstruct their breathing.

When preparing your baby's sleep space, remember:

No pillows or duvets

No cot bumpers

No soft toys or comforters

No weighted or bulky bedding

No products designed to keep your baby in one sleeping position, such as wedges or straps

No pods or nests, rolled up towels or anything soft placed on top of the mattress.

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Safer sleep overview - The Lullaby Trust

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An easy guide to practicing safer sleep for your baby and reducing the risk of sudden infant death syndrome (SIDS, or cot death).

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Caring For Your Baby at Night covers a range of topics, including getting some rest, night feeding, safe sleeping environments and helping baby to settle. It is endorsed by the Lullaby Trust, the Royal College of Midwives (RCM), the Institute of Health Visiting (iHV) and the Community Practitioners and Health Visitors Association (CPHVA).

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Babies should be sleep in a clear sleep space, which is easy to create in a cot or Moses basket. We know however that some families make the informed choice to bed share, and so recommend making your bed a safer place for baby whether you doze off accidentally, or choose to bed share. Lullaby Trust's advice on co-sleeping with your baby will tell you how.

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To reduce the risk of sudden infant death syndrome (SIDS) the safest place for a baby to sleep is in their own clear, flat, separate sleep space, such as a cot or Moses basket. However, we know that many parents find themselves co-sleeping whether they mean to or not. Wherever you're planning for your baby to sleep we recommend making your bed a safer place for baby. Our advice on co-sleeping with your baby will tell you how.

When not to co-sleep

Whether you choose to co-sleep or it is unplanned, there are some key risks you should avoid.
Co-sleeping with your baby is very dangerous if:
In these scenarios, it is always best to put baby in their own safe sleep space, such as a cot or Moses basket. Keeping the cot or Moses basket next to your bed might make this easier.
Never fall asleep on a sofa or armchair with your baby. The risk of SIDS is 50 times higher for babies when they sleep on a sofa or armchair with an adult. They are also at risk of accidental death as they can easily slip into a position where they are trapped and can't breathe.
Co-sleeping more safely

Keep pillows and adult bedding away from your baby or any other items that could cover their head or cause them to overheat. A high proportion of babies who die as a result of SIDS are found with their head covered by loose bedding.

Follow all The Lullaby Trust's other safer sleep advice to reduce the risk of SIDS such as sleeping baby on their back

To reduce the risk of accidents, do not bring other children or pets into bed with you.

Try to make sure or check that baby cannot be trapped, wedged or fall out of bed or get trapped between the mattress and the wall

Never leave your baby unattended in an adult bed

For more info on co-sleeping and safer sleep read our guide for parents
If you are bedsharing with your baby you should consider any risks before every sleep. It is easy for your situation to change if you are unwell or have drunk any alcohol, which means your baby will be safest in a separate sleep space such as a cot or Moses basket on that occasion.

Co-sleeping with your baby: FAQs

I am worried I might fall asleep while I breastfeed my baby at night, is this ok?

Click here to open this question

Breastfeeding reduces the chance of SIDS. If you feel you might fall asleep we would recommend you prepare the bed as described above so it is safer for baby if this happens.

Make sure you know the advice on when never to co-sleep so you know when to take particular care. It is really important that you do not accidentally fall asleep with your baby on a sofa or armchair. If you think you might fall asleep on a sofa or armchair, put the baby down in a safe place to sleep.

Should I co-sleep with my baby?

Click here to open this question

The safest place for a baby is their own separate sleep space, such as a cot or Moses basket. We would just advise you to read all the information on co-sleeping and how to reduce the risks, so you can make an informed decision for you and your baby.

However, there are some circumstances where we would strongly recommend against co-sleeping such as on a sofa or armchair, if anyone in the bed smokes or has drunk alcohol or your baby was premature or a low birth weight.

Can I co-sleep with twins or multiples?

Click here to open this question

If you choose to bedshare with twins or multiples we would advise not to bedshare with more than one baby at a time due to risk of accidents associated with bedsharing with more than one baby or child.

Is it safer to co-sleep using a nest or pod than with a baby just lying on the adult bed?

Click here to open this question

No. We do not recommend that babies sleep on soft surfaces such as pods or nests. If you choose to co-sleep with your baby the safest place is a clear space on a firm flat mattress the same as we would advise with a cot.

Why do you advise against co-sleeping in certain scenarios?

Click here to open this question

It is estimated that around half of SIDS deaths occur whilst co-sleeping, and that most of these are in high risk situations. We do not know the cause of SIDS and why these deaths happen but we do know what some of the risk factors are and that removing those risks greatly lowers the chance of SIDS occurring.

For that reason we strongly advise against co-sleeping when there are risk factors such as a baby being premature or a parent having drunk alcohol.

What bedding should I use for my baby when we co-sleep?
The Lullaby Trust has worked with Public Heath England, Unicef UK Baby Friendly and Basis on two publications to support families with safer sleep advice and advice on co-sleeping more safely. We have also collaborated on a guide for health professionals to have more open and productive discussions with families about safer sleep and co-sleeping. These can be downloaded below.

Click here to open this question

Adult bedding should be kept well away from your baby along with any belts or cords from clothing. Keep adult bedding at your waist height and add an extra layer of clothing if you are cold

A baby sleeping bag is a good way of giving your baby their own bedding when bedsharing.

Baby sleeping bags should be well fitted, so the baby can't wriggle down inside. Most sleeping bags are fitted according to a baby's weight, rather than age.

You might also be interested in reading the two Unicef Baby Friendly publications, which are both endorsed by The Lullaby Trust:

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Some parents choose to share a bed (known as co-sleeping) with their babies. Read our advice on how to co-sleep more safely.

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If you have made an informed choice to give your baby bottles it is important to learn how to do this in a safe and responsive way. Please speak to your midwife for further support. The key things you need to know are:
-Which formula milk to use: It is recommended that you use stage 1 infant formula until your baby is 1 year old.
-How to sterilise and make up bottles safely.
-How to give the bottle feeds in a safe, responsive and paced way.

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Guide to bottle feeding leaflet - Baby Friendly Initiative

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This leaflet provides families and health professionals with key information about bottle feeding and how to make up feeds safely.

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This leaflet gives further information about how to pace your bottle feeds and which formula to choose.

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This checklist may help you and your midwife assess that bottle feeding is going well.

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First Steps Nutrition Trust's website is a fantastic source of reliable, un-biased and evidence based information about infant formula.

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

Our Mission

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

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

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

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

Our Resources:

Are put together by nutrition experts and are regularly updated.

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

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

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

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

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

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

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First Steps Nutrition Trust is a charity which provides clear, evidence-based and independent information and support for good nutrition from pre-conception to five years of age.

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Published by Better Health Start for Life and the Baby Friendly Initiative and updated in 2022, this leaflet provides mothers and health professionals with key information about breastfeeding.

The leaflet is a teaching aid for health professionals when discussing the benefits and management of breastfeeding with pregnant women, and when teaching new mothers how to breastfeed. Health professionals may also find our breastfeeding assessment tools and practical skills review forms useful when talking to new mothers.
To enquire about printed copies of this leaflet, please visit the Department of Health & Social Care campaign resource centre. The UNICEF UK Baby Friendly Initiative is unable to assist with printed leaflets for this resource.

Off to the Best Start leaflet - A guide to help you start breastfeeding

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Off to the best start leaflet - Baby Friendly Initiative

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This leaflet from the Department of Health and the Baby Friendly Initiative provides key information about breastfeeding.

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Helping your baby to achieve an effective attachment to the breast should help make sure your breasts are comfortable and that your baby gets enough milk. Please ask for help from your midwife or the Infant Feeding Team if you need it. Take a look at this video...

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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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Breastfeeding and Relationships in the Early Days

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Breastfeeding and Relationships in the Early Days

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This video looks at both the theory and practice of relationship building and responsive breastfeeding, supporting families to get their relationship with their baby off to the best start.

Hear mothers and professionals give tips and advice on what it can mean to have a close and loving relationship with your new baby.

Find more relationship building resources

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Breastfeeding and relationships in the early days video - Baby Friendly Initiative

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Baby Friendly's video on breastfeeding and relationship building covers views and tips from both mothers and health professionals.

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How to recognise that your baby is getting enough milk...

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How to recognise that your baby is getting enough milk...

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It is important to know the signs to look for to know that your baby is getting enough milk, this checklist will help to guide you. If you are concerned that your baby is not getting enough milk please speak to a midwife as soon as possible (Hospital switch board 01384 456111).
The Infant Feeding Team will help support you if you have any concerns.

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Responsive Feeding: Supporting Close and Loving Relationships

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Responsive Feeding: Supporting Close and Loving Relationships

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UNICEF UK Baby Friendly Initiative: Foreign Language Resources

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UNICEF UK Baby Friendly Initiative: Foreign Language Resources

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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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Dudley Infant Feeding Team are available to support you throughout your pregnancy, right through until your baby is 6 weeks old:

- Lisa and Julia: Specialist Midwives Infant Feeding- lactation consultant and tongue-tie practitioner

- Lyndsay, Annmarie and Liz: Community Breastfeeding Support Workers- trained in breastfeeding peer support

The team are available for telephone support and home visits in the Dudley Borough.

Follow us on social media...see the info above

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Have you been signed up to Flo yet?

Flo, is a free text information service- you will receive information throughout pregnancy and until your baby is 6 weeks old, about things like skin- to-skin and what to expect in those early days and weeks with your new born baby.

If you would like to sign up to Flo or more information please email dgft.cbsw@nhs.net or ask your midwife.

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

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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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Before giving your baby breastmilk from a syringe always remove the bung.

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This page gives you some tips on how to hand express and store your breastmilk. It also answers some frequently asked questions on this topic.

You might be thinking of returning to work, or study, or planning a night out. It can also help relieve pressure from a blocked duct or mastitis. Expressing small amounts of colostrum before your baby is born can help give your baby extra milk in the first few days.

Please also refer to our downloadable leaflet on Expressing and Storing Breastmilk.

If you will be exclusively expressing (feeding only expressed breastmilk), whether for just a few days or longer, you might like to read our blog post on this.

Note: If your baby has been ill or was born prematurely please discuss this information with your health professional to check that the storage times apply. This is especially important if you are bringing your colostrum or milk into hospital for your baby.

Your breastmilk

Can be expressed by hand, by hand pump or by electric pump. Once you know how, hand expressing is easy and needs little equipment.

Contains anti-infective ingredients that limit the growth of unwanted bacteria.

Should still be handled and stored carefully to stop unwanted bacteria from getting into your milk and growing.

Stays at the highest quality when stored in a fridge, particularly when running at 4°C or below. Note: some fridges run higher at 5-10°C - if you don't know the temperature of your fridge assume it is running at this higher temperature.

Can be frozen, which affects some (but by no means all) of the nutrients and anti-infective ingredients of breastmilk.

Expressing breastmilk

When you first start to express it is common to get only a few drops of milk. As with breastfeeding, the more you practice, the easier it gets. Expressing at a different time of day may work better for you.

When might I need to express?

Before your baby is born - you may be advised that your baby might need extra milk when they are born. You can express and store your first milk (colostrum) from 36 to 37 weeks gestation. You can read more about this here.

In the first few days - if your baby is sleepy, or to help them attach and feed.

For both these stages your midwife will give you small oral syringes to collect your milk. These are usually 1ml to begin with.

Use the ideas in this leaflet to discover what works for you. Colostrum usually starts in tiny droplets and is often sticky - having help to collect these drops in the syringe can be useful.

Aim to express twice a day from 36-37 weeks for no more than 10 minutes, freezing the same day.

Once your baby is born, express as needed aiming to stimulate your breasts at least 8 times a day including once overnight through direct breastfeeding or expressing as this will increase your milk supply to meet your baby's needs and can help you feel more comfortable.

Hand Expressing

Once your milk is flowing, you will need a wide mouthed container like a sterile plastic pot or container that is well-cleaned and scalded with boiling water - a jug is ideal - so get this ready before you start.

Remember to wash your hands first.

Find somewhere comfortable to relax, then to help your milk to flow (let down) you might:

Relax with a warm drink, music or TV.

Have your baby close, or look at a photograph, clothing or toy to remind you of your baby.

Warm your breasts in a bath, shower or using warm flannels and practice expressing.

Try some ways to gently massage your whole breast, working from the outside toward your nipple.

Take care not to drag your skin:

Stroke with your fingertips

Roll using your knuckles.

Try using circular movements.

Make a 'C' shape by placing your thumb above and your fingers below your breast 2-3 centimetres back from your nipple

Gently press your thumb and fingers together, release your fingers and repeat in a rhythmic movement.

Sometimes pressing inwards back towards your chest wall as you squeeze helps. You may need to experiment with how far back from your nipple to squeeze - everyone is slightly different.

When the milk flow slows, re-position your fingers and thumb (as if moving them around a clock face), then express another area of your breast.

Try to express all areas of your breast and alternate between breasts.

See this video on hand expressing from UNICEF for more ideas.

Good hygiene is very important:

Always wash your hands before expressing and handling breastmilk and ask others giving expressed milk to do the same.

Always use a sterile container with a lid, not the collection jug, to store your breastmilk. You can buy disposable containers. Take care with plastic bags that can puncture easily.

Try to use a different storage container each time you collect milk. If necessary, newly collected milk may be cooled and added to previously stored milk on the same day only.

Label the storage containers or syringes with your name, breastmilk, time and date and put inside a clean sealed bag or box before storing. Name and date the bag too.

Store your breastmilk in the fridge or freezer as soon as possible.

Store away from meat products, eggs or any uncooked foods. Store at the back of the fridge and not in the door.

Storing expressed breastmilk

How long can I keep my breastmilk at room temperature if a fridge is not available?

If your breastmilk is freshly expressed it will keep for 6 hours without refrigeration, either at home or away from home. See 'travelling with breastmilk' section below for more details.
If your baby has been ill or was born prematurely please discuss this with your health professional to check that the same storage times apply.
How long can I store breastmilk in the fridge?

You can store your breastmilk for up to 3 days where you don't know the temperature, or it runs between 5-10°C.

Breastmilk can be stored for 5 days in a fridge running at 4°C or lower.*
*One study has shown fresh breastmilk can be used for up to 8 days when the fridge temperature is kept stable at 4°C or below.

If the fridge temperature goes above 4°C during this time, use your milk within 6 hours or throw away.

If you can't use a fridge at 4°C, try using a cool bag or box with deep frozen ice packs (changed every 24 hours). Protect your milk from direct contact with the ice packs or it may freeze - try wrapping the ice packs in kitchen towel. The bag can also be used to carry milk.

The lower the storage temperature, the longer expressed breastmilk can be stored. The storage temperatures given here include a degree of caution so that your milk remains safe for your baby.

If you wish to store your breastmilk for longer than 5 days, freeze as soon as you can after expressing.
If taking colostrum or milk into hospital follow their storage and transport times. REMEMBER: The more often the fridge door is opened, the more likely the temperature will rise. Try to check the temperature of every fridge (or cool bag) used for storing your milk each time you use it. If the fridge has no built in thermometer, use a fridge thermometer which can be bought cheaply from kitchenware stores.
How long can I store breastmilk in the freezer?

Breastmilk can be stored in a freezer at -18°C for up to six months.

You can store breastmilk in the ice compartment of a fridge for two weeks.

Safe Storage of breastmilk in the home

This table aims to provide a guide to how long you can store breastmilk for a full term baby with no additional health concerns.

Why are there variations in recommendations for storing expressed breastmilk?

More information about this can be found at the bottom of this page.

Please note that previous versions of our leaflet are still available in our shop and the information is still correct, noting the above.

Feeding baby expressed breastmilk

What happens if my baby doesn't take all of one bottle? Can I put it back in the fridge or on the side use it again?

Once the baby has drunk from a bottle of expressed milk it should be used up within an hour or thrown away. To avoid wasting your expressed breastmilk it is best to offer the baby only a little (e.g. 30ml) at a time until you know your baby's pattern. You can do this by keeping most of it in one container, in the fridge, and using it to top up the baby's bottle a little at a time.

Defrosting frozen breastmilk

How do I defrost my milk?

Ideally, defrost frozen breastmilk in the fridge. This milk should be used once fully defrosted which usually takes about 12 hours. If your breastmilk is still frozen after this time or you need to use it quickly, try defrosting under cool, then warm, running water. Dry the outside of the container with kitchen paper before use and use immediately. If you frequently find your milk is frozen after 12 hours in the fridge, try to freeze in smaller quantities.

How long can I keep defrosted breastmilk?

Defrosted breastmilk should be used straight away once it has fully defrosted. Throw away any unused milk.

Why can't I defrost breastmilk in a microwave?

Breastmilk should not be defrosted in the microwave because it heats unevenly, destroying antibodies and nutrients. There is also a risk of scalds and the milk would need to be left at room temperature before use.

Travelling with expressed breastmilk

How do I bring my milk home, which I have expressed at work or elsewhere?

Try to use a cool bag for transportation and put the milk in the fridge once you are home.

Fresh breastmilk can be transported within 24 hours provided storage temperatures are maintained using an insulated box or bag and deep frozen ice-packs, and total storage and transportation times do not exceed the recommended storage times.

Previously refrigerated breastmilk can be kept cool (10°C or below) for up to 24 hours when in a well-insulated bag with deep-frozen ice-packs. Take care not to freeze your milk by wrapping the ice-packs in kitchen paper first. Ensure this milk is used within the recommended refrigeration storage times as mentioned above.

Re-heating expressed breastmilk

How do I re-heat expressed breastmilk?

Expressed breastmilk can be used straight from the fridge. It does not need to be warmed. If you would like it warmed place the container (such as a bottle or sealed cup) in warm water to take the chill off. Take care not to over warm.

If the milk smells sour DO NOT USE.

When stored, the cream and milk may separate out. This is normal. Shake gently to mix before use.

Some babies are reluctant to take milk from a bottle, particularly at first. Try offering milk from a cup or spoon. They may be less reluctant when someone else gives it. If expressed milk is refused try not to worry - your baby will make up any missed feeds by breastfeeding more often or for longer on your return. See also info on this page about introducing a bottle.

Finding a breast pump

The two UK breast pump hire companies are:
Ardo breast pumps Medela breast pumps
Your midwife, health visitor or a local breastfeeding supporter may also be able to give you details of pump hire services near you.

Useful links
Human Milk Foundation
UKAMB (UK Milk Banks - find out about donating or receiving milk)
Milk Bank Scotland
Antenatal Expressing - more detailed information about this

References

(links checked May 2023)

Cook, P. Food Standards Agency. MCN10. 2006 Handling and storage of expressed breastmilk pp1-12 https://www.nice.org.uk/guidance/ph11/documents/mcn-consultation-expert-report-handling-and-storage-of-expressed-breast-milk2

Eglash, A, Simon, L, and The Academy of Breastfeeding Medicine, ABM Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants, BREASTFEEDING MEDICINE Volume 12, Number 7, 2017 (c) Mary Ann Liebert, Inc. pp390-395 https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/8-human-milk-storage-protocol-english.pdf See correction to freezer temp here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065517/

Forster, Della A et al. (2017) Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial. The Lancet, Volume 389, Issue 10085, 2204 - 2213 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31373-9/ppt

Hands A. (2003) Safe storage of expressed breastmilk in the home. MIDIRS Midwifery Digest, vol 13, no 3.

Royle, J. Weaver, G. (2016) Guidelines for the Preparation and Handling of Expressed and Donor Breast Milk and Special Feeds for Infants and Children in Neonatal and Paediatric Health Care Settings. 2nd Ed. Section 6, p18-32
BDA Guidelines for the Preparation and Handling of Expressed and Donor Breast Milk and Specialist Feeds for Infants and Children in Neonatal and Paediatric Health Care Settings
IMPORTANT: If you have any further questions on expressing or breastfeeding, do contact your midwife, health visitor or breastfeeding supporter for help and support. You can also call the National Breastfeeding Helpline on 0300 100 0212, open 9.30am-9.30pm every day of the year.

Page reviewed and updated November 2019

Variations in Recommendations for Storing Expressed Breast Milk

Written by Anabel Hands

In 2003, aware of the confusion for mothers resulting from the significant variations in recommendations for storing expressed breast milk, the BfN decided to collate all available information from primary research papers, and national and local guidance documents. These findings were published in the MIDIRS Midwifery Digest 1. The study found that storage temperature clearly determines storage time. Recommended storage times given in our Expressing and Storing Breast Milk leaflet were based on the primary research papers discussed in the study. You can find the link to this leaflet below for more information 2.

Our publication was sent to other breastfeeding organisations, including the Department of Health (DH), to facilitate agreement on storage recommendations using the results of primary research. The DH asked the National Institute of Clinical Excellence (NICE) to review breast milk storage guidelines, and official storage recommendations were changed from 24 hours in the fridge to up to 5 days at 4°C or lower, two weeks in the ice compartment of a fridge and up to six months in a freezer (March 2008) 3.NICE also recognised that refrigeration preserves the unique properties of breast milk more effectively than freezing. The National Health Service (NHS) adopted these guidelines, which appear in their leaflet Off to the best start (updated November 2009) which you can find a link to below 4.

Although a little different to BfN guidelines, the NICE and NHS recommendations took into account that fridge temperatures can vary and that a 5-day storage time covered most situations, including the need for milk expressed at the end of one working week to be used at the beginning of the following week. Some busy hospital neonatal units restrict the time milk is refrigerated as an added precaution; this is because their fridges are opened very frequently, which may affect the storage temperatures 5.

Other breastfeeding organisations, such as La Leche League, updated their published recommendations to distinguish between acceptable storage (8 days in the fridge) from ideal storage (72 hours in the fridge), and also recognised that refrigerated expressed breast milk was preferable to frozen breast milk (March 2012) see link below for more information. These recommendations are in line with the BfN leaflet 6.

It is important for mothers and breastfeeding supporters to note that leaflets and recommendations inconsistent with the published research are still in circulation, particularly on the Internet, and that countries outside of the UK may recommend different guidelines.

Please note that previous versions of our leaflet are still available in our shop and the information is still correct, noting the above.

References

1. HANDS A. Safe storage of expressed breast milk in the home. MIDIRS Midwifery Digest, vol 13, no 3, Sep 2003, pp 378 & 385.

2. BfN (Breastfeeding Network) leaflet. Expressing and storing breast milk. September 2004.

3. National Institute for Health and Clinical Excellence (NICE) Public health guidance 11: Maternal and child nutrition. March 2008.

4. Department of Health. Off to the best start. Crown Copyright 2007 278957 5p 200k Nov 09 (BEL) 299223.

5. MCN consultation: Expert report & Handling and storage of expressed breast milk. 05 April 2007.

6. La Leche League International. "The Breastfeeding Answer Book" Updated March 2012.

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Expressing and storing breastmilk - The Breastfeeding Network

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This page gives you some tips on how to hand express and store your breastmilk. It also answers some frequently asked questions on this topic. You might be thinking of returning to work, or study, or planning a night out. It can also help relieve pressure from a blocked duct or mastitis.

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Expressing for a baby on the neonatal unit...

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Expressing for a baby on the neonatal unit...

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For sick and preterm babies the importance of breastmilk cannot be overestimated. Breastmilk supports growth and provides protection from infection, with evidence suggesting that its use decreases the incidence and severity of the life-threatening disease necrotising entercolitis.

By providing breastmilk, a mother can be assured that she is uniquely contributing to the wellbeing and development of her baby. However, expressing breastmilk over a long period of time is extremely demanding and if a mother is to succeed she needs the support from those involved with caring for her and her baby.

Please speak to your midwife as soon as possible after birth for support to express milk for your baby. This checklist may be helpful if you are exclusively expressing your milk for your baby.

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Dudley Infant Feeding Team are available to support you throughout your pregnancy, right through until your baby is 6 weeks old:

- Lisa and Julia: Specialist Midwives Infant Feeding- are both IBCLCs (International Board Certified Lactation Consultants) and have specialist infant feeding and tongue tie knowledge.

-Lyndsay, Liz and Annmarie: Community Breastfeeding Support Workers- trained in breastfeeding peer support.

Hope : Flo Text Message Co-Ordinator - will ensure you receive the Flo text messages.

The team are available for telephone support and home visits in the Dudley Borough. We also offer a feeding clinic on Mondays at Stourbridge Hub. To make an appointment please call 01384 456111 ext 3887, Monday-Friday 09.00am-12.00pm.

Follow us on Social media... details as in the link above.

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BABIES CRY! Infant crying is normal and it will stop A baby’s cry can be upsetting and frustrating. It is designed to get your attention and you may be worried that something is wrong with your baby.
What can you do to help your baby? Comfort methods can sometimes soothe the baby and the crying will stop. Babies can cry for reasons such as if they are hungry, tired, wet/dirty or if they are unwell. Check these basic needs and try some simple calming techniques: • Talk calmly, hum or sing to your baby • Let them hear a repeating or soothing sound • Hold them close – skin to skin • Go for a walk outside with your baby • Give them a warm bath These techniques may not always work. It may take a combination or more than one attempt to soothe your baby. If you think there is something wrong with your baby or the crying won’t stop speak to your GP, Midwife or Health Visitor. If you are worried that your baby is unwell call NHS 111.
Not every baby is easy to calm but that doesn’t mean you are doing anything wrong. Don’t get angry with your baby or yourself. Instead, put your baby in a safe place and walk away so that you can calm yourself down by doing something that takes your mind off the crying. For more information please visit: ICON - Babies cry you can cope - Advice and Support | ICON (iconcope.org)

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Local peer support groups. For more information and to book. New Baby Network is commissioned by Dudley Public Health to provide peer support groups in the Dudley Borough.

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Skin to skin has lots of benefits for baby and can be done by both parents. Take a look at this great video from Unicef Baby Friendly Team.

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Skin-to-skin contact - Baby Friendly Initiative

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

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Keep your baby close to you so that you start to recognise the signals they make to tell you they are hungry or want a cuddle. Responding to these signals will make your baby feel safe. Cuddling your baby next to your skin allows them to smell you and hear your heartbeat, which will comfort and calm them. This will also help you to feel calm and relaxed and will help with breastfeeding.

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For breastfeeding support weekdays 09:00 - 17:00 contact the Dudley Infant Feeding Team on:

01384 456111, ext 3887
Julia- 07920246433

Lisa- 07929735941
dgft.spmwif@nhs.net

It is best to call between 09.00am-12.00pm if you can.

For breastfeeding support weekdays out of hours (5.00pm-09.00am) weekends and bank holidays contact maternity triage on 01384 456111 ext 3053.

National Breastfeeding helpline

24 hours a day, 365 days a year

0300 100 0212

nationalbreastfeedinghelpline.org.uk

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Have you been signed up for Flo yet? Flo is our tailor-made text messaging service. Especially built to support parents in Dudley. When you sign up for our text messages you get evidence based information direct to your phone, in real time. As we use your due date to allocate your package you will get reminders right when you need them. The best bit is it's 🌟FREE🌟 if you are in Dudley. Flo can support you from your baby's birth until your baby is 6 weeks old. You'll get information on...

💙Building Babies Brain

💙Pregnancy Milestones

💙Breastfeeding Facts

💙How to breastfeed

💙Resources in other languages

💙Skin to skin

💙Safer sleep

💙Links to further information on infant feeding

💙DadPad

💙Social media links

💙Mental health support

💙What to expect

💙How to know your baby is feeding well

💙Links to other services eg. HPSS, Health Visiting etc.

💙Things to avoid

💙ICON – You can cope.

Ask your midwife to refer you to be signed up or you can email us to sign you up dgft.cbsw@nhs.net. Our Florence text messaging service will always be FREE, even if you get a notification on your phone saying you will be charged, this is an automated message & you will not get any charges. The service is regulated by the PSA Authority http://psauthority.org.uk

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Parenting and Infant Feeding Support in Dudley

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Parenting and Infant Feeding Support in Dudley

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To book a session and to see the groups available each week visit https://newbabynetwork.co.uk/

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New Baby Network – Peer support organisation for parents

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Welcome to New Baby Network! Every parent deserves to thrive in parenthood. New Baby Network connects you together in […]

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The support of your partner, family and friends can really have a positive impact on your feeding journey.

Partners can also have lots of cuddles. Here's a practical guide so they can feel prepared bit.ly/bftogether & local videos bit.ly/ohbabybc

Search DadPad today on your App Store or Google Play. It is free in Dudley provides Dad with practical information on parenting a newborn baby bit.ly/DadPadDud

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If you live in Sandwell you can access feeding support in the community from Breastfeeding network- https://www.breastfeedingnetwork.org.uk/project/sandwell/

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Sandwell and West Birmingham Hospital's NHS Trust commission The Breastfeeding Network charity to provide free, non-judgemental, evidence-based information to all Sandwell families.

Our friendly peer support team can help with establishing and continuing breastfeeding, expressing, bottle feeding, weaning from breastfeeding and introducing solids. All Sandwell families are welcome to access our service. We will support you in your feeding choices. Whatever your question, or if you just want to chat to someone please get in touch.

Website
https://sway.office.com/AV3vLL0ZqlErecU4
Type of services available

Interactive antenatal workshops

1:1 Telephone/video support

Face-to-face sessions

Virtual drop-in groups on Zoom (please refer to drop-in locator)*

Breastfeeding support at Barnardos Baby Clubs (please refer to drop-in locator)*

Walking groups

Contact details

Social media and other links

Please be aware that emails and messages to our Facebook page will be seen by a small team of peer supporters.

Supporters / Funders

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Sandwell and West Birmingham Hospital's NHS Trust commission The Breastfeeding Network charity to provide free, non-judgemental, evidence-based information to all Sandwell families. Our friendly peer support team can help with establishing and continuing breastfeeding, expressing, bottle feeding, weaning from breastfeeding and introducing solids. All Sandwell families are welcome to access our service.