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UNICEF leaflet

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Updated in 2022 with important new messaging on sleep safety, this leaflet offers helpful, practical advice to parents on looking after their sleeping baby both during the day and at night.

Caring for Your Baby at Night and When Sleeping 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 Baby Sleep Info Source (BASIS), the Royal College of Midwives (RCM) and the Institute of Health Visiting (iHV).

Printed copies are available for £15 per pack (1-9 packs) or £11 per pack (10 or more packs). There are 50 leaflets per pack and this price includes P&P within UK. Order using the Baby Friendly Resources order form, which you can download from our Resources page.
Please note: Orders for UK delivery only, and include postage and packaging costs. Orders may take up to 7 working days to process. The Baby Friendly Initiative reserve the right to re-print items at any time. If you are looking to order audit tools or e-learning please use our digital resources order form.

Caring for your Baby at Night and when Sleeping

A Guide for Parents

Download now

Caring For Your Baby at Night and When Sleeping: A guide for health professionals

Our accompanying guide supports health professionals who will be using Caring for Your Baby at Night and When Sleeping with new parents. It looks at the evidence underpinning the recommendations in the leaflet and offers guidance on discussing these issues.
An updated version of the health professional's guide will be made available soon.

Further resources

The Baby Sleep Information Source (Basis) is an informational source for parents who wish to make informed choices about their infant's sleep and night time care, and is the result of a collaboration between the Durham University Parent-Infant Sleep Lab, La Leche League, NCT, and the UNICEF UK Baby Friendly Initiative.

We have also collaborated with The Lullaby Trust, Public Health England, and Basis to create a range of resources for parents and health professionals, with accessible guidance on safer sleep practices. The following are available to download and buy on The Lullaby Trust website.

Safer Sleep for Babies: A Guide for Parents

Safer Sleep for Babies: Saving Babies' Lives - A Guide for Professionals

Safer Sleep for Babies: Quick Reference Card

Public Health Wales have produced a version of the Caring for your baby at night leaflet in Welsh, which is free to download.

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Caring for your baby at night leaflet - Baby Friendly Initiative

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This leaflet, endorsed by BASIS, the RCM and The Lullaby Trust, offers practical advice for parents on caring for their sleeping baby.

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If you have any problems with breastfeeding, it's important to ask for help from your midwife, health visitor or a breastfeeding specialist as soon as possible.
That way issues like sore nipples or breast engorgement can be sorted out early.

Here are some of the problems breastfeeding mums sometimes have, plus tips on how to tackle them.

Sore or cracked nipples

Sore nipples usually happens because your baby is not well positioned and attached at the breast.

Putting up with it could make pain or discomfort worse, so it's important to get help from your midwife, health visitor or breastfeeding specialist as soon as you can.

See more advice on sore nipples.

Not enough breast milk

When you first start breastfeeding, you may worry that your baby is not getting enough milk. It can take a little while before you feel confident that your baby is getting what they need.

Learn the signs that your baby is getting enough milk.

Offering your baby both breasts at each feed and alternating which breast you start with will help to stimulate your milk supply. So will keeping your baby close and holding them skin to skin.

See more ways to boost your breast milk supply.

Breast engorgement

Breast engorgement is when your breasts get too full of milk. They may feel hard, tight and painful.

Engorgement can happen in the early days when you and your baby are still getting used to breastfeeding. It can take a few days for your milk supply to match your baby's needs.

Engorgement can also happen when your baby is older and not feeding so frequently, perhaps when they start having solid foods.

See how to manage breast engorgement.

Baby is not latching on properly

Breastfeeding is a skill that you and your baby need to learn together. It may take you both a while to get the hang of it.

If you are finding breastfeeding painful or your baby does not seem to be satisfied after feeds, they may not be latching onto the breast properly.

Find out how to latch your baby on.

Learn the signs that your baby is well attached.

Too much breast milk

Occasionally women make too much breast milk and their babies struggle to cope.

It's best to get your midwife, health visitor or breastfeeding specialist to watch a feed to see if they can spot why this is happening. They can also show you different positions to help your baby cope with large amounts of milk.

Read more on how to tackle too much breast milk.

Breastfeeding and thrush

Thrush infections can sometimes happen when your nipples become cracked or damaged. This means the candida fungus that causes thrush can get into your nipple or breast.

If you suspect you or your baby has a thrush infection, see your health visitor or GP.

See how to spot the signs of thrush while breastfeeding.

Blocked milk duct

If breast engorgement continues, it can lead to a blocked milk duct. You may feel a small, tender lump in your breast.

Frequent feeding from the affected breast may help. If possible, position your baby with their chin pointing towards the lump so they can feed from that part of the breast.

See more help for blocked milk ducts.

Mastitis

Mastitis (inflammation of the breast) happens when a blocked milk duct is not relieved. It makes the breast feel hot and painful, and can make you feel very unwell with flu-like symptoms.

It's important to carry on breastfeeding. Starting feeds with the tender breast may help.

See more self-help tips for mastitis.

If you are no better within 12-24 hours, or if you feel worse, contact your GP or out-of-hours service as you may need antibiotics.

Breast abscess

If mastitis is not treated, or if it does not respond to treatment, it can lead to a breast abscess, which may need an operation to drain it.

Read more about breast abscesses.

Breastfeeding and tongue tie

In about 1 in 10 of babies, the strip of skin that attaches the tongue to the floor of the mouth (frenulum) is shorter than usual. This is known as tongue tie.

Some babies who have a tongue tie do not seem to be bothered by it. In others, it can stop the tongue moving freely, which can make it harder for them to breastfeed.

The good news is that tongue tie easily treated.

See the signs of tongue tie in breastfed babies.

Got a breastfeeding question?

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

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If you have any problems with breastfeeding, it's important to ask for help from your midwife, health visitor or a breastfeeding specialist as soon as possible. That way issues like sore nipples or breast engorgement can be sorted out early. Here are some of the problems breastfeeding mums sometimes have, plus tips on how to tackle them.

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UNICEF first week with a newborn baby

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The first week with a newborn can be a wonderful and exciting time, but adjusting to a new life can also be overwhelming, especially when parents aren't sure what to expect. In this guest blog, lactation consultant Emma Pickett explores what's "normal" in the first few days, and encourages mums to trust their baby and their own instincts of love, affection and responsive feeding.
I've been taking calls from new parents on the National Breastfeeding Helpline since it opened in 2008. Calls often begin with a mum in tears and she's sounding desperate. Breastfeeding really matters to her and she wants it to work. She's overwhelmed and confused. The first voice we hear might sometimes be the partner's and a mum is too upset to even come to the phone.

Hundreds of these calls end with a contented calm voice saying, "Thank you. It's such a relief to know that's normal. I feel so much better now". As it happened, breastfeeding was actually going OK; what was interpreted as a breastfeeding 'problem' was actually a new baby's normal and natural response to their new environment. The family just didn't know how babies were 'supposed to behave'.

If I had a magic wand, I would download into all parents the knowledge of what is normal in a newborn. Think The Matrix film - but instead of the ability to pilot helicopters or practise high level martial arts, you'd know about cluster feeding and a newborn's desire for closeness, nappies and normal fussiness. The National Breastfeeding Helpline would be quieter overnight but we'd all feel a lot more relaxed and able to enjoy these teeny new people in our lives.

But actually ... you've already had that download. You just may not have realised it. It's deep in there after millions of years of evolution, facilitated by hormones and natural instincts. It may not mean you know the exact details of the colour of baby poo on day three, or how to correct a baby's latch without help, but there's so much you do know. You may not have grown up surrounded by breastfeeding, and for some aspects you will need support and information, but there's a ton you do know about your baby: things that just feel right and things that don't. And your baby had the download too. Sometimes it gets fuzzied with a birth that didn't go to plan but their instincts are in there too.

Two things that are normal:

1.Babies want to be close to you.

Imagine a news story about a baby gorilla just born in London zoo: "ZSL London are delighted to announce the birth of new baby Fumbi. Mother and baby are in good health" but days later it's reported that staff are concerned. Fumbi's mother (despite being surrounded by other older female gorillas and having observed newborn care) keeps trying to put Fumbi down. She places her in the hay and walks off repeatedly and appears to be trying to avoid holding her for long periods. Fumbi is agitated. Her heart rate and respiratory rate shows signs of distress. She's losing heat (because teeny newborn gorillas have a large surface area and need to be held to regulate their temperature). Fumbi isn't feeding as often a newborn usually does because of the periods of separation. The mother appears to be missing out on some of the oxytocin- (the hormone that promotes feelings of love) induced bonding that helps the formation of their early relationship. Fumbi is at risk.

Oh dear. Something seems to have happened to Fumbi's mother. We'd be worried.

However, this is exactly what is happening in human homes across the UK today (though not in many other countries and cultures). We are primates just as gorillas are. We're designed to be close to our babies. We can see that by looking at the constituents of our breastmilk. Other mammals have much higher fat milk so babies can be left while mum fishes or grabs a rabbit for lunch. Our babies are born immature because of our pelvis shape from being upright and our large brains, and they are designed to have milk regularly for a relatively long time. We are supposed to hold our babies. Some people call us 'carry mammals'.

But instead we get the message that babies can be 'spoilt'. We are supposed to encourage them to be independent and sleep apart from us. If we can't put them down, if they want to sleep touching us, if we hold them when they sleep - we've apparently failed some test. Though it's not quite clear who the examiner is.

There are popular books that even use terms like 'accidental parenting' just to load on the value judgments. Parenting experts such as Truby King in the 1910s told parents to avoid cuddling and unnecessary attention and the spectrum of 'advice' has been flip-flopping backwards and forwards ever since. Today one book will tell you to wear your baby in a sling as much as possible and another will tell you to arrange a baby's sleep by the clock and leave a baby only a few weeks old to cry if necessary.
What does your baby want?
They don't want to be put down and eaten by a sabre toothed tiger (less of a problem these days). They don't want to waste energy keeping warm and crying when they don't need to. They want to keep those calories to lay down fat and develop their brain. They want to use your breathing rate to regulate their own respiratory rate. They want you to notice when they start to show early feeding cues. They want your familiar smell and taste. You are home to them.

"My baby won't go down in its Moses basket". Yes, it's frustrating when you thought that was what they were 'supposed to do'. But would it feel easier if you knew that wasn't likely to be their first choice and there are good biological and evolutionary reasons for that?

"But I'm not going to get any sleep". According to the Baby Sleep Information Source, "70-80% of breastfed babies sleep with their mother or parents some of the time in the early months, and many studies have found that mothers and babies who bed-share breastfeed for much longer than those who sleep apart." Research shows that these mums breastfeeding through the night (and mostly bed sharing) will also be getting better quality sleep and be more rested than other parents. Good sleep is possible if we stop battling nature.

The book "Sweet Sleep: night time and naptime strategies for the breastfeeding family" is a great place to start. It talks to you about creating a safe space where everyone gets a better night's sleep.

A lot of your baby's urges are eminently sensible. If they don't want to sleep in a separate pile of hay, trust them. They are here today because those urges have kept them safe over the generations.

Don't expect to be up and making a moussaka on day five. The feeling that you 'shouldn't' be holding your baby is exacerbated when we live in a society which tries not to let new parenthood change our lives. Our bodies aren't supposed to change. Our commitment to work isn't supposed to change. Our ability to engage with political life and housework and social media isn't supposed to change. Actually, throughout much of human history, mum isn't going to do much of anything for a good 40 days. Someone else is making the moussaka, just as you would have once made the moussaka for them. We are supposed to be doing nothing else other than eating the food made by others (really doesn't have to be moussaka), sleeping and being with our new baby.

2.They come to the breast for lots of different reasons and they usually have a good reason for doing so.

Just as parents feel they've failed if their baby doesn't sleep in the separate pile of hay (aka fancy Moses basket that cost £75 and granny knitted a blanket for), they feel a failure if baby is at the breast 'too much'. I have written elsewhere on the dangerous obsession of the infant feeding interval. It's dangerous for both babies and mothers. But we need to remember breastfeeding isn't just about feeding and it never has been.

Babies have jobs to do. They are helping you to form new breast tissue in the first few weeks. They are elevating your prolactin levels (the hormone that governs milk supply). They are stimulating oxytocin (which is the key hormone in relationship-building and creating a sense of calm and well-being). They are increasing milk volume and altering fat content. They are reducing levels of the stress hormone, cortisol. They are facilitating digestion and the passing of stools. They are hydrating, regulating their temperature, feeling emotionally secure, growing brain connections and trying to get to sleep (which is one of the purposes of breastfeeding.)

To think breastfeeding is just about food and calories (and "quick, measure the gap between breastfeeds!") is to do nature a huge disservice. Measuring all the different reasons a baby comes to the breast is like trying to measure fairy dust. Do you count all the times your partner cuddles you, strokes your arm, kisses you, smiles at you affectionately, communicates with you, has a drink of water, eats a snack or has a meal? You wouldn't find an app for that.

Stop thinking about minutes. No one can tell you a baby should feed for X number of minutes because we all have different physiology and our babies do too. Create your world around you so you can meet your baby's needs in the way they are asking you to. Don't try and mould your baby to fit into a world that has become obsessed with counting and measuring. If you know you are a routine person and you are struggling with a feeling of 'losing control', give yourself a few weeks and see how it feels to trust your baby. Once your milk supply has maximised, you'll have some options. Try and 'control' too early and you'll find things go out of your influence in ways you can't come back from easily.

Get help if things feel wrong - if breastfeeding hurts, if you're not sure about weight gain or nappies, if you can't work out how to meet your own needs for food and sleep. There are lots of people who will help out and we're at the end of a phone or a Twitter account or Facebook page. But don't confuse your baby behaving unexpectedly for something going 'wrong'. Maybe no one told you what normal would be.
If we let normal happen it will make all of our lives easier in the long term. You're creating a little person who enters this world with their needs being met.
This blog was originally featured on the Growing Families conference website.

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Guest blog: "Is this normal?" The first week with a breastfeeding newborn - Baby Friendly Initiative

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In this guest blog, lactation consultant Emma Pickett explores what's "normal" in the first week with a newborn, and encourages mums to trust their baby and their own instincts.

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UNICEF video

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Home > Meeting baby for the first time video > meeting-baby-for-first-time-video

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Unicef video

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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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BFN (Breastfeeding Network) leaflet

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ABM (Association of Breastfeeding Mothers) leaflet

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Antenatal Expression of breastmilk ABM leaflet

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Further information

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Many parents are concerned that their baby may be tongue-tied. Many breastfeeding problems are blamed on tongue-tie. Almost everyone has a lingual frenulum, or bit of tissue under the tongue that helps connect the tongue to the floor of the mouth. The most important thing is that the tongue can move properly.

Most breastfeeding problems are caused by misunderstanding what babies need. Help with positioning and latch is the first step to improving breastfeeding. LLL meetings, LC consultations, breastfeeding or baby cafs are all good resources for getting individualized help.

Some tongue-tied babies can make breastfeeding work. Even if your baby has an obvious tongue-tie, first get help from a lactation professional.

Most professionals agree that a tight frenulum that attaches to the tip of the tongue can make it more difficult for babies to feed. These tongue-ties can be easy to treat in a doctor or dentists office. Figure 3 shows a very tight frenulum that experts agree needs treatment.

There is more controversy about babies who do not have good tongue mobility but do not have a tight frenulum at the front of the tongue. New anatomy research suggests that tight fascia (the soft tissue that joins body structures) may be responsible. Depending on the cause of the tightness, therapy may be the best option. Physical therapy is best studied for neck muscle imbalances caused by the babys position during pregnancy, other body work may be helpful as well.

Heres how you can look at your own babys tongue movements:

The first thing to assess is whether your baby can stick out his or her tongue. If you touch your baby's lips, he will probably open his mouth. You can then touch the front of his lower gum with your fingertip. This makes him stick the tongue out. We want to see the tongue come out flat over the lip without denting or dimpling.

Next, we want to see if your baby can lift her tongue way up to the roof of the mouth. All the way up is perfect, half way is enough for most babies to be able to breastfeed. Again, her mouth should be open when you check if the tongue can lift up.

Tongue-ties:

This baby (figure 3) has an obvious tongue-tie. You can see the membrane right at the front of the tongue, and you can see how it makes it hard for him to lift his tongue up.

figure 3: obvious tongue-tie

Babies with a tight frenulum may have a notch in the tip of the tongue when they try to move the tongue (figure 4). This is also called a "heart-shaped" tongue. Some babies have a notch but can still lift the tongue normally. Remember we want to look at the whole baby and not just one feature.

Babies with a tongue-tie will often raise the sides of the tongue while the front of the tongue pulls downward toward the floor of the mouth. Professionals call this a "low tongue posture". See (figure 5)

figure 5: low tongue posture

Babies with restricted or weak tongue movements will have a high, narrow roof of the mouth (figure 6). This is an important "double check" or confirmation that the tongue is not moving well. There are other reasons to have a high or narrow palate too, such as being in a position during development that prevented the baby's head from expanding side to side.

Having a shorter lower jaw than average can affect tongue strength. This baby (figure 7) does NOT have a tongue-tie. Dividing the frenulum when the real reason for sucking problems is a short jaw or muscle tightness in the face or neck will not help and can often make the problem worse.

Again, if your baby does seem to be tongue-tied, please get lactation help first. Some tongue-tied babies are able to breastfeed without treatment with some special help latching on. An IBCLC should also be able to help determine whether a breastfeeding problem is from a tongue tie or is from poor latch or positioning, a short jaw or tight muscles and communicate these findings with your baby's primary health care provider.

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Many parents are concerned that their baby may be tongue-tied. Many breastfeeding problems are blamed on tongue-tie. Almost everyone has a lingual frenulum, or bit of tissue under the tongue that helps connect the tongue to the floor of the mouth. The most important thing is that the tongue can move properly.

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NHS & UNICEF Baby Friendly Initiative leaflet

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NHS & UNICEF Baby Friendly Initiative leaflet

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Key Breastfeeding information including hand expressing, storage of expressed milk & how to know baby getting enough milk

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Gloucestershire Breastfeeding Supporters' Network - Friendly and free breastfeeding support groups run weekly

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The Gloucestershire Breastfeeding Supporters' Network (GBSN) is a charity "owned" and run by peer supporters. We provide information, encouragement and support to families at any stage of their breastfeeding journey, from pregnancy through any challenges, to weaning from the breast and beyond. Every week we run seven groups across the county.

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Video illustrating how positioning & attachment works

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Good attachment will help a baby get more milk and make breastfeeding more comfortable. This video shows why good attachment is so important to breastfeeding success and what a mother can do to deeply attach her baby to her breast.