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Factsheets Knowing your rights and the law in pregnancy and childbirth is important. Our factsheets provide you with the latest information on your rights, where they come from in law, and how they are backed up in guidance. Each link below goes to a new page where you can read the information or download a ... Read more

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challenging inequality : promoting wellbeing

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Twins Trust - We support twins, triplets and more...

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Lots of useful information, helpline, online forums, and courses.

Join as a member to support their work and access a range of discounts and receive a quarterly magazine.

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Twins Trust - We support twins, triplets and more...

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Supporting you through every milestone of your journey with twins, triplets or more. From being pregnant with twins, triplets or quads through to parenting twins, triplets or quads, we are here for you.

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BRAIN tool: helping you make decisions in your maternity care

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Best Beginnings - creators of Baby Buddy

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BRAIN tool: helping you make decisions in your maternity care

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My top five 'absolute must haves' for new parents- with links!

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My top five 'absolute must haves' for new parents- with links!

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So many options, but what are the real 'must haves'?

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Didcot hand me on baby, toddler and maternity items Facebook group

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Didcot hand me on baby, toddler and maternity items Facebook group

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Didcot hand me on baby, toddler and maternity items | Facebook

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A group for passing on baby, toddler and maternity items in the Didcot area. All items are to be exchanged for free. Let’s try to reduce the waste by sharing within our community.

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Oxford University Hospital Trust Maternity Team online Parent Education Workshops

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Oxford University Hospital Trust Maternity Team online Parent Education Workshops

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Free workshops covering late pregnancy, labour, birth, postnatal care and infant feeding.

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the maternity team at oxford university hospitals

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the maternity team at oxford university hospitals tickets

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The Maternity Team at Oxford University Hospitals

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The Maternity Team at Oxford University Hospitals is using Eventbrite to organize 4 upcoming events. Check out The Maternity Team at Oxford University Hospitals's events, learn more, or contact this organizer.

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Information on birthplace options and maternity services

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This site is best viewed with a modern browser. You appear to be using an old version of Internet Explorer.

Announcement
Wantage Maternity Unit and Cotswold Birth Centre temporarily closed for births
About us

Over 7,500 babies are born in Oxfordshire every year. Our vision for every family is to experience excellent personalised care from the right professionals, through pregnancy, birth and beyond. We strive to deliver real choice and continuity of carer.

We are also a regional referral unit for complex pregnancies, and our Newborn Care Unit provides special care for babies in Oxfordshire and across the South East.

We encourage those with low-risk pregnancies to have their babies at home or in one of our five midwifery-led units; however, it is your choice where to give birth, and your choices include the Delivery Suite at the John Radcliffe Hospital.

No matter where you chose to birth, our excellent midwives and doctors work with you and your family to support the decisions you make about your pregnancy and beyond.

What families say about us

"Good and safe care... consistently saw the same midwife when possible, who was brilliant and made me feel safe and secure. The care I received during labour, I will be forever grateful to those brilliant women"

"Well supported home birth, good follow up care, had one excellent pre-natal appointment regarding my mental health where I felt well listened to"

To provide feedback on our services you can visit patient feedback or complete our MVP survey

How to find us

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Copyright (c) 2022 Oxford University Hospitals NHS Trust

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This site is best viewed with a modern browser. You appear to be using an old version of Internet Explorer. Wantage Maternity Unit and Cotswold Birth Centre temporarily closed for births Over 7,500 babies are born in Oxfordshire every year. Our vision for every family is to experience excellent personalised care from the right professionals, through pregnancy, birth and beyond.

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Wallingford Maternity and Birthing Centre

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Wallingford Maternity and Birthing Centre

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Wallingford Maternity and Birthing Centre - Maternity - Oxford University Hospitals

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Maternity at Oxford University Hospitals. Labour and birth. Places to give birth. Wallingford Maternity and Birthing Centre.

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Labour Pains - Information on pain relief choices during labour

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Information for expectant parents and healthcare professionals on pain relief choices during labour

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The final moment - how does birth feel? Induction - what you need to know Zheela's VBAC story - Leena's birth I made very different decisions the first time around. Back then, I trusted others more than I trusted myself.

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Mental health problems are common during pregnancy and/or after the birth of a baby.

It is important to tell your GP, midwife or health visitor about your thoughts and feelings early, to ensure you get the help you need earlier, rather then waiting until things get worse.

Perinatal mental health

The perinatal period includes your pregnancy, labour, birth and the postnatal period up until your baby reaches one year of age.

Mental illness can affect anybody regardless of previous history. Some will experience a mental health problem for the first time during their pregnancy, or after the birth of their baby.

Others will have had ongoing mental health problems, and then become pregnant, or will have had past mental health problems.

Getting pregnant and having a baby will be very exciting for most people; however it can come with new challenges and demands. Even if you have not experienced mental health problems in the past, the physical and emotional changes pregnancy and childbirth brings can sometimes trigger a mental illness.

The most common mental health problems in pregnancy and after the birth of a baby are depression and anxiety. This figure increases during the first year following childbirth.

Frequently asked questions

What happens if I've had mental health problems in the past, but I am currently well?

If you have suffered from a mental health problem in the past, which was treated and you are now well, then it is still really important that you share this information with your community midwife as soon as possible.

The severity of your previous condition will depend on the management of your care. For some, pregnancy and childbirth can cause them to become unwell again due to the physical and emotional changes that having a baby can bring.

Should I stop my medication?

You may worry about taking medication in pregnancy. You need to think carefully about what the risks and benefits of medication are for you and your baby. It may be safer to take medication in pregnancy than to stop. This is more likely if you have had a more severe illness.

If you are worried, or want to get pregnant and have questions surrounding your medication, then discuss this first with your psychiatrist or GP. They can give you up-to-date information about medications in pregnancy. They can also help you to decide what is best for you and your baby.

It is very important that you don't stop your medication or reduce the dose suddenly. You are more likely to become unwell again if you do this without advice.

For further information regarding medication in pregnancy and while breastfeeding your baby, please visit:
Best use of medicines in pregnancy
What can I expect from my pregnancy?

Mental wellbeing is as important as physical health for the whole family. When we first see you (your 'booking' appointment) we will ask you about your past medical history, including your mental health and wellbeing and that of your family, and any medication taken. Various medical professionals will ask routine questions about your thoughts and feelings throughout your pregnancy.

At booking, and at 28 weeks, we will give you questionnaires about anxiety and depression to fill in: this is to encourage you to share any concerns, so we can offer you the best advice and support. Research shows early identification and support can reduce distress caused by mental health problems.

Where can I get help if I am worried?

Pregnancy can be a very emotional experience, and it can sometimes be difficult to know whether your feelings are manageable, or a sign of something more serious.

Trust yourself. You are the best judge of whether your feelings are normal for you. There are no rules about how worried you must be before talking to your midwife or GP about how you feel. You can talk to a healthcare professional at any time if you have concerns during your pregnancy. The sooner you ask for help, the sooner you can get the right support, if you need it.

We can give you printed copies of this leaflet, available on this website:
Antenatal and postnatal depression and other emotional difficulties during pregnancy and after birth (pdf)
Tips

Pregnancy and the postnatal period can be a stressful and challenging time. Here are some tips to help you relax.

10 tips to relax in pregnancy - Tommy's

Antenatal Mindfulness

Online Antenatal Mindful Birth Course

Four-week course run by midwives and teachers trained in Mindfulness Based Childbirth and Parenting (MBCP).

£20 per person / £40 couple

Concessions available for anyone in receipt of benefits.

For more information or to register please email:
mindful.birth@ouh.nhs.uk
Links

Services within Oxford

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Copyright (c) 2023 Oxford University Hospitals NHS Trust

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Mental health problems are common during pregnancy and/or after the birth of a baby. It is important to tell your GP, midwife or health visitor about your thoughts and feelings early, to ensure you get the help you need earlier, rather then waiting until things get worse.

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Word-thought for the day: replacing risk with chance - Dr Sara Wickham

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Risk and chance: which word is less likely to evoke a stress response?

Almost any time we use the word risk in relation to childbirth, we could choose to use the word chance instead. The meaning stays the same but it is no longer cloaked in fear. - Sara Wickham.

This is one of my favourite things to say and share.

I originally posted something on this a few years ago after talking to midwives and medical students about statistics and the language that we use when we talk to women about evidence and decision-making.

I am concerned that, whether by accident or design, the language that is used tends to over-emphasise the potential downsides of certain courses of action (or inaction) in ways that range from unhelpful to downright misleading.

I could say lots more about this, and have discussed it in almost every book that I have written.

But today I want to focus on just the one word: risk.

Because almost any time we use the word risk in relation to childbirth, we could choose to use the word chance instead. The meaning stays the same but it is no longer cloaked in fear.

We also need different ways of saying 'low risk' and 'high risk.' Those are also inaccurate and misleading terms, and I've written more on this in several of my books as well.

We could say that there are some women who are healthy and have an average chance of having a problem (previously known as 'low risk') and other women who may be healthy or may have one or more challenges (though they may still be healthy overall) and who have a slightly elevated chance of a problem. Those women are sometimes referred to as 'high risk' but, when we look at the statistics, we often see that the chance of a problem is often only slightly higher in absolute terms. And the overall chance is still very low.

It is common, for instance, for a woman to be told that she has two or four times the risk of having a particular unwanted outcome if she doesn't agree to an intervention that is being offered. But it's often the case that, when we look at the statistics that relate to this outcome, we find that even a women with every risk factor still has more than a 99 per cent chance of not having a problem, regardless of whether or not she agrees to the intervention.

So it's very unhelpful to use relative risk, as we are often dealing with rare events which then end up sounding more common than they really are. And no matter how we categorise or label people (and I have serious concerns about doing both), problems are never inevitable. In the vast majority of situations, things will go well. More on that here.

The problem is that many people don't have the time, will, energy and/or understanding to say all of that and explain the nuances.

It's great that some things can be expressed in a picture and a sentence or two.

But so many things can't, and we have to account for those too.

If you're bothered by the way in which the notion of risk is used in maternity care, and would like to read about a different viewpoint, or find a resource to recommend to clients, then have a look at my book, What's Right For Me? Making decisions in pregnancy and childbirth.

It was written specifically to help women and families to find their way through the information maze and work out which is the right path for them. You can find out more about it here.

Books to help you become informed and make the decisions that are right for you...

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Word-thought for the day: replacing risk with chance - Dr Sara Wickham

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Almost any time we use the word risk in relation to childbirth, we could choose to use the word chance instead, says Sara Wickham.

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Choosing and using slings and baby carriers

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Choosing and using slings and baby carriers

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A Guide to Slings, all you need to know to get started with slings

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Do you have lots of questions about using a carrier with your child? Here is our guide to slings, which will tell you all you need to get started!

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Birthing for Blokes | The Complete 14-Part Video Training for Fathers

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Birth isn’t just something that happens to your partner—your presence has a direct impact on the safety and speed of the room. In this 6-module, 14-video mas…

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Honest, impartial and most importantly DETAILED reviews of slings and carriers of all types.

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What's the difference between a One-way and a Two-way Stretchy Wrap?

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“2-way” stretchy wraps are easier to use - this includes a list of brands to look out for 

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“2-way” stretchy wraps are easier to use - this includes a list of brands to look out for 

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2 way brands - Calin Bleu, Izmi Baby and Breeze, Hana, Boba Bamboo, Lifft, Joy and Joe Bamboo, Coracor.

Can usually be picked up on a second hand selling site from £5-20.

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While all stretchy wrap are long pieces of stretchy material, individual brands can be quite different to one another. And one of the most striking differences can be in HOW these wraps stretch. In particular there are two main flavours - One-way and Two-way stretchy wrap. But what does this mean? What is the difference?

Simply put, a one-way stretchy wrap is one that stretches in ONE direction only (or stretches much much more in one direction than the other). Generally these wraps stretch only in the vertical direction (along the width of the wrap). While a two-way stretchy wrap stretches in two directions - both along the width and the length of the wrap.

You can see this for yourself here;
So what are the pros and cons of each type?
Two-way stretchy wraps are easier to pre-tie and then pop your baby in because they are stretchier and because they stretch evenly, which means they stretch in a way that feels more intuitive - easier for your brain to understand and predict. So it's very easy to put the sling on and get it tight enough that it will support baby once they are in but still have enough space to stretch it out to put baby in easily. Conversely, One-way stretchy wraps are much harder to pre-tie because they don't stretch evenly. That uneven stretch means it is often quite hard to tie them tight enough that they will support baby once in and still have space to get them in easily. The window between too tight and too loose is just much smaller. Consequently, I often think of pre-tying a one way stretchy wrap as being a bit like finding the right setting on a tempermental old toaster where there is just about 2mm between still bread and completely burnt. The window on a two way stretchy wrap is simply much wider and so it is much easier for a new sleep deprived parent to learn.

It is worth noting that you can tie using methods other than the pre-tie method, and this can work a lot better for one-ways. But often the manuals only show the pre-tied method so parents don't realise this is possible and often the whole reason they bought a stretchy wrap in the first place was because they wanted the convenience and ease of being able to pre-tie first and then pop baby in and out as needed.

On the flip side in general one way stretchy wraps are more supportive of bigger babies. The reason for this simply being because they are less stretchy they don't get stretched out as much as baby grows, while a more stretchy two way will definitely start to feel more "bouncy" and less supportive as baby gets heavier between 4-6 months. But often parents are moving on around this point anyway as babies tend to grow out of either type stretchy wrap developmentally rather than physically as they go through the huge developmental leap that happens somewhere between 3 and 4 months. So being less supportive isn't a huge con, but it is worth noting if you have reason to believe your more likely to be using a stretchy wrap for longer (i.e. developmental delay or other special consideration).
Which brands are one-ways or two-ways?
Well known one-way stretchy brands include; Moby, Ama, Liberty, Funki Flamingo, Free-Rider, Manduca, ByKay and most the cheap stretchy wrap brands found on Amazon

Well known two way stretchy brands include; Izmi Baby, Hana Baby, Calin Bleu, Boba, JPMBB Original and Basic, Lifft, and Joy and Joe
For more ways in which stretchy wraps differ and a huge table comparing 16 different brands please do check out this article.
-Madeleine

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What's the difference between a One-way and a Two-way Stretchy Wrap?

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While all stretchy wrap are long pieces of stretchy material, individual brands can be quite different to one another. And one of the most striking differences can be in HOW these wraps stretch. In particular there are two main flavours - One-way and Two-way stretchy wrap. But what does this mean?

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Can't recommend this new series from the BBC enough - balanced, evidence-based, fascinating 15 minute nuggets of loveliness.

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Catch up on your favourite BBC radio show from your favourite DJ right here, whenever you like. Listen without limits with BBC Sounds.

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Badger Notes - Access your healthcare records

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About Badger Notes

Badger Notes allows you real time access to your maternity, child or neonatal records.

The information that appears is generated in real-time from your hospital based system using details entered by your midwife or other health professionals involved in your care.

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Badger Notes - Access your healthcare records

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About Badger Notes Badger Notes allows you real time access to your maternity, child or neonatal records. The information that appears is generated in real-time from your hospital based system using details entered by your midwife or other health professionals involved in your care.

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Beyond the Mountain: preparing for the postnatal period

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This is why, in my work as a doula, I always suggest my clients and I spend at least one antenatal session talking about their postnatal preferences. When I first bring up the concept, people often look at me oddly. Their understanding of the postnatal period tends to be that they'll recover from birth and get to know their baby. And of course, to some extent, this is absolutely true. But that's not all there is to life past the mountain. So, what kinds of things should expectant parents consider when it comes to postnatal preferences?

First of all, you need to think about what you want your setting - your postpartum cocoon - to be like. Do you want to spend the initial days or weeks in your own home? Or would you prefer to stay with a relative or friend who you know will lovingly care for you? Where would you feel safest? And how can you make that location feel cosy? Are there lights or images that you'd like to have around you? Do you expect to spend a lot of time in a bed, supported by piles of pillows? Or do you plan to make your nest on a sofa?

Once you know where you will most likely be, consider how many rooms your cocoon will have, or whether it will be across different floors. You might decide you need multiple changing and feeding stations dotted around, complete with nappies, wipes, cloths, breast pads, reusable water bottles, reading material, and so on. People underestimate how often a baby might fall asleep on them, leaving them stuck on a couch, and it's essential that you have access to plenty of drinks, snacks and books, wherever you are. Hopefully, you'll have people around you who will rush to your side with a nappy or a granola bar, but there may be times when you're on your own and you don't want to disturb your settled baby just to plug in your phone or put the kettle on.

Speaking of people, who are you allowing into your cocoon? Just as you might carefully curate your list of who you want with you while you give birth, you should ponder this same issue in regard to your postnatal period. Some new parents feel overwhelmed by relatives descending on them, eager to meet the baby. There are folks who simply don't want to play pass the parcel with their newborn, while there are others who long for company and would be glad to have people there to help them. Some aren't sure, and no matter how you feel, you have the right to change your mind. So, how social do you think you'll be feeling after you've been through the marathon that is birth? Are there people who would bring joy to your life if they visited? Are there some who you know would be helpful and would put on a load of laundry or cook you a meal? Are there people you feel you need to put off seeing for as long as possible? It's your baby and it's your new family; it's acceptable and necessary for you to put boundaries around who is allowed into your cocoon.

Stuff to buy or prepare

When you're pregnant, people often start telling you about things you absolutely 'must' have. Guess what? You probably don't need most of them. Humans have successfully been raising babies for a very long time without the fanciest pushchair or a wardrobe full of adorable outfits. If you want those things and can afford them, go ahead. But also consider a few items that would be useful - potentially even necessary - in the postnatal period.

It's not terribly exciting, but maternity pads for your lochia, breast or chest pads for your milk, laxatives, pain relief, and a small jug for pouring warm water on your genitals as you pee might all come in handy in those immediate weeks. If you think you might want to express milk, a pump can be a good purchase, but try to give yourself some time to get the hang of breastfeeding or chestfeeding before you stress about adding in pumping sessions.

If you, your partner, or anyone else, can prepare meals for you in advance, that can be a real time-saver when you have a new baby. Another option is to purchase a lot of ready-toeat meals, or easy-to-cook items such as rice, pasta, tinned vegetables, beans and so forth. If there's anything you would love to have, get it in the house in advance. It may be a celebratory bottle of beer or some of that cheese your tastebuds decided should be off-limits during pregnancy. Some people have particular foods linked to their ethnic or religious background that are considered important to have in the postpartum weeks. If that's you, think about whether this is something you can cook or whether you need to arrange for someone else to make it for you.

And don't forget to treat yourself to a good pile of books or magazines, bought or borrowed, as you will probably be spending a lot of time resting and feeding. Your thumbs might get tired of scrolling on your phone so prepare a list of reading material, TV shows, films, audiobooks or podcasts that you'd like to enjoy while holding your lovely new baby.

Things to do

By 'things to do', I certainly don't mean you should be making plans for running errands, getting out on the football field or attending stand-up comedy shows - unless that's what you want to be doing. Rather, I mean thinking about how you might like to structure your parental leave and that of your partner, if you have one. Consider how much time you'll have off and what sorts of activities you will want or need to do in that time. Of course, you'll have some required appointments - officially naming your baby, for example, or seeing the GP or midwife. But mostly, you'll have a lot of unstructured time, which can be challenging for some people.

There may be cultural or religious traditions that you want to partake in: a baby's christening or head-shaving, for example. You may also want to have some 'keeping in touch days' at work. (Then again, you might not.) You might feel you need some solo time, whether that's a walk on your own or a massage. All these things will have to be scheduled.

In addition, many regions have lots of baby-centred activities. Find out what's on offer near you and what you might want to do. Do you like the sound of baby massage, postnatal yoga, baby cinema, baby swimming, bounce-and-rhyme sessions at the library, breastfeeding cafes, sensory sessions, or something else? If you did an antenatal course, do you think you might want to hang out with other new parents from that group? Don't push yourself to leave the house too soon, but do consider whether you might feel isolated if you stay in too much. Be cautious about planning too many activities; think about what might work for you and your baby.

Support Finally, who will help you if you need it? Keep a handy list of friends who might be able to get your older children to school, or who could take a restless toddler to the playground for an hour, or who might be willing to walk your dog or water your plants.

Look into grocery delivery and, if it's within your means, cleaning or cooking services. Anything you can do to make your life easier tends to be well worth it. You don't want to be recovering from birth and stressing about the thick layer of dust in your living room; if you're the type of person who can't overlook a mess, consider a short period of hiring someone else to do some tasks for you. If you think you'll need help taking care of the baby and transitioning into your new role as a parent, look into a postnatal doula, who is there to support you as an individual, and you, the baby and your partner (if you have one) as a family.

Meanwhile, don't forget your own wellbeing. You will have a GP check-up, but it is often rather perfunctory. Make sure you know where to turn if you need physiotherapy or other physical support, especially if you have had a tear or a c-section. And as for your mental and emotional health, see if there are any therapists, charities or others who might be of help, should you find you need to talk to someone once you've had the baby.

There are many brilliant charities and helplines in the UK (and in other countries), dedicated to everything from breastfeeding to baby loss. Think about the issues that may currently affect your life, such as eating disorders or depression, and how they might change as you become a parent. Line up support before it becomes too hard for you to reach out for it.

Giving birth is an exciting and transformational event, but there's a lot beyond that mountain to think about as well. Make your preparations for the postnatal period while you're pregnant, so your parental leave is as easy and pleasant as possible.

____

B.J. Woodstein is a doula, lactation consultant, writer, translator and associate professor in literature. Her most recent books include We're Here! A Practical Guide to Becoming an LGBTQ+ Parent and The Portrayal of Breastfeeding in Literature. She lives in Norwich with her wife and their two daughters. bjwoodstein.com

Photography by Nicole Hamic. nicolehamic.com and on Instagram @nicole_hamic.

____
Published in issue 82 of JUNO. Accurate at the time this issue went to print.

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Beyond the Mountain: preparing for the postnatal period

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For many people, the experience of being in labour and giving birth feels like a mountain they have to climb. Often, when you're pregnant, you can't see beyond that mountain.

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When breastfeeding is going well and if you don’t plan on being parted from your baby, a breast pump is not an essential purchase. Sometimes it is helpful to remove breast milk from a breast, however a breast pump is not the only way as hand expressing can be very effective. This article looks at situations when a breast pump might be useful and answers frequently asked questions. It is a companion article to How to Increase Milk Supply When Pumping.

Do I need a pump if I am exclusively breastfeeding?

Most mothers won’t need a breast pump if they are exclusively breastfeeding. If situations arise when it might be useful to remove additional breast milk manually (see below) then a mother can hand express or a pump can be purchased as and when needed.

What is hand expressing?

A breast pump is not the only way to remove milk from a breast. Breast milk can be removed by using ones fingers to rhythmically compress the breast behind the nipple. For much more information including useful videos see Hand Expressing Breast Milk. Hand expressing techniques are very useful for removing milk from an engorged breast to resume comfort levels, or for expressing enough milk for a feed if a mother is due to be separated from her baby.

When might a breast pump be useful?

It can be helpful to express breast milk by pump in the following situations:

If a baby is not able to breastfeed—removing breast milk from the breasts frequently will stimulate your milk supply and provide a supplement to keep your baby well fed until he is able to breastfeed. Pumping eight to ten times a day is often suggested as a useful guide if a newborn is not breastfeeding directly at the breast. Using a breast pump can be more efficient and less tiring than hand expression if milk needs to removed very regularly. Hiring a hospital grade pump for a month or two may be a good option if a pump is not needed long term.

If a baby is not getting enough breast milk—pumping after breastfeeds can help to increase a milk supply by thoroughly draining the breasts and stimulating more milk production. As in the point above hand expressing could serve this purpose but for regular use a breast pump can be more efficient and less tiring on the hands.

If breasts are engorged—pumping or hand expressing to remove enough breast milk from the breast to resume comfort levels will relieve engorgement and avoid mastitis (inflammation of the breast).

If you will be separated from your baby regularly or are returning to work you will need to pump enough breast milk to feed your baby while you are away from him. Pumping breast milk can be very effective when larger volumes are needed.

If you have flat, inverted or dimpled nipples a breast pump can help to evert your nipples before a breastfeed which may make it easier for your baby to latch (attach to the breast) when he is learning to nurse.

A manual or hand operated breast pump

What about expressing so my partner can help with night feeds?

Some mothers may be interested in expressing milk in advance for night feeds so they won’t have to get up at night to feed the baby and might get a full night’s sleep. However although this may work for some families occasionally, this could compromise a new mother’s milk supply. Babies expect to breastfeed during the night and your breasts expect to breastfeed too. One of the hormones of lactation, prolactin, is especially high at night. By sleeping all night instead of breastfeeding on demand, your breasts may become engorged with milk. Engorgement can be painful, will cause your milk production to slow down and can put you at risk of getting blocked ducts or mastitis. The chances are, you will wake at night anyway with uncomfortable, full breasts and need to pump to make yourself comfortable again. Waking to pump defeats the objective of a full nights sleep and, in most cases, you may as well breastfeed your baby while you’re awake. For more reading see Baby Waking Up at Night and Bed-Sharing With Baby.

A single electric pump ⓒEmily Walker

Are there any disadvantages to using a breast pump?

Cost. There are many different types of breast pump such as manual (hand operated), electric (single or double) or hospital grade (expensive multi-user pumps used in hospitals) and some can be very expensive to buy. Checking reviews and considering why you need a breast pump can help a mother choose one that is cost effective for her needs.

Cleaning time. Pump parts will need to be cleaned very carefully which can be time consuming.

Hygiene concerns over time. Unless the pump has a closed system and includes safeguards for several users such as hospital grade pumps, it is unhygienic to use second hand equipment. Doing so will usually invalidate a warranty. Infections can be associated with using a breast pump. Mould and pathogens have been found inside used breast pumps e.g. within the tubing. ¹

Overstimulation causing oversupply. Too much unnecessary pumping can increase milk supply to problematic levels.

Reducing milk supply. Exclusively pumping mothers may find their milk supply begins to drop over time due to the differences with direct breastfeeding.

Nipple preference. Once breast milk has been removed from the breast it has to be fed back to baby. Feeding methods include cup, bottle, or by a feeding tube on a finger. Each has their own advantages and disadvantages. Some types of bottle have more potential to affect a baby’s latch at the breast than others (nipple confusion) or for baby to prefer a bottle over a breast (nipple preference). For more information to reduce nipple confusion see Best Bottle for a Breastfed Baby? and Tips to Bottle Feed a Breastfed Baby.

Breakdowns. Pumps can break or may not work properly. The Womanly Art of Breastfeeding explains:

…consumer-grade pumps aren’t built to last much more than a year or so, the average length of time that a mother might be pumping for one baby. When they start to wear out, they don’t just suddenly stop working. The suction and cycling mechanisms veeerrry slowly break down, and eventually you realise you aren’t pumping as much milk and the suction doesn’t feel as strong (or is too strong). Consumer-grade pumps aren’t closed system like rental-grade pumps, so milk and moisture may have entered the mechanical parts, where bacteria, mould, and viruses can grow.

Some single pumps can be converted to a double pump at a later date

What is the best type of breast pump?

One type of breast pump isn’t necessarily better than another as different pumps suit different mothers and some mothers may even find hand expressing works better than pumping for them. Options include:

Manual pump—works by manually squeezing a lever with the hand to draw milk from the breast by suction. Usually one of the cheapest types of pump.

Silicone pump—a single piece silicone pump with no moving parts which works by suction generating a gentle vacuum pressure on the milk making tissue of one breast while you feed your baby on the opposite breast to create a let down. For more information see This Year’s Big Thing… which describes the Haakaa pump by Shel Banks.

Single electric breast pump—an electric or battery operated pump that allows pumping each breast separately.

Double electric breast pump—an electric or battery operated pump with two collection sets to allow pumping both breasts at the same time. Newcomers to the pump market in recent years include a range of hands free portable pumps with a rechargeable battery (brands include Elvie, Freemie or Willow) which can be slipped unobtrusively into a nursing bra.

Hospital grade double electric breast pump—a pump that is suitable for more than one user and has a greater reliability and efficiency. Expensive to buy, these pumps can be hired from pump manufacturers or hospitals.

For specific brand recommendations there is a useful section on p 193/4 of Making More Milk The Breastfeeding Guide to Increasing Your Milk Production 2020 by Lisa Marasco and Diana West or visit their website at lowmilksupply.org for a summary of their favourite pumps and their individual features.

Our sister article How to Increase Milk Supply When Pumping has more tips for choosing a breast pump:

Look for a pump with multiple settings for speed and suction to give you more comfort and control and to mimic a baby’s sucking pattern. Some breast pumps can generate unsafe vacuum levels or maintain a vacuum for too long. Pumping should not hurt and pumping with a suction that is too high can inhibit milk release (Mohrbacher, 2020 p 490)

Consider whether you want a single pump or a double pump. A double pump allows you to pump both breasts simultaneously which can save time (see above).

Look for a choice of flange size. The part of the pump that is held to the breast has various names with different pump manufacturers such as breast shield (Medela), breast shell (Ardo), funnel (Ameda) or flange. Look for a pump with different sized flanges because nipples and breasts are not all the same size and the right fit is important for your comfort levels (pumping should not hurt!)—see “Breast pump flange fit” below.

Availability of replacement parts. Consider whether a battery back up option would be useful in addition to mains operated.

Check reviews online from other women who have tried them before buying a pump.

Hospital grade pumps may be available to borrow from your maternity hospital or for short-term hire from major pump manufacturers in your country e.g. contact Ardo, or Medela in the UK.

Second hand pumps may not work efficiently and may have hygiene concerns.

Using a breast pump

If you do decide you need a breast pump and want tips to maximise the amount of milk expressed see How to Increase Milk Supply When Pumping for help with:

How often to pump

How long to pump in each session

What sort of volume of milk to aim for

How to choose and use a breast pump.

A hospital grade pump has a greater reliability and efficiency

Summary

There is no need for every pregnant woman who wants to breastfeed to buy a breast pump just in case they need one. In most cases when breastfeeding is going well you will not need to pump your breast milk. If you do need to express milk occasionally due to engorgement or because you need to leave some milk for your baby while you’re apart; hand expression can work very well. If you have a newborn baby who can’t breastfeed yet, hiring a hospital grade pump for a month or two may be all that is needed. While a breast pump can be very useful in a number of situations, mothers can decide whether they need one based on their own circumstances. For much more information on using a pump see How to Increase Milk Supply When Pumping.

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When breastfeeding is going well and if you don’t plan on being parted from your baby, a breast pump is

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How to make a Postnatal Recovery Plan | Positive Birth Movement

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There’s a template to make your own in the goodie bag 🙂

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How to make a Postnatal Recovery Plan | Positive Birth Movement

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Every culture in the world has, or used to have, a tradition of nurturing new mothers, a period of about a month when relatives or members of the community (usually women) rally round to support the new mother. They take care of household tasks, feed the mother specific nourishing foods, take care o…

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What is the fourth trimester? | Baby & toddler articles & support | NCT

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Kathryn Kelly, NCT antenatal teacher, explains: 'The Fourth Trimester is a way of describing the period after birth when both parents and baby are adjusting to their new lives.

'We think of other trimesters as being three months long, and we can think in terms of roughly another three months after the birth to make the adjustments to being a new family.'

What's the fourth trimester like for babies?

Having been in your warm womb for nine months, your baby has now got to get used to a sensory overload of sights, sounds and smells, as well as a frequently colder environment where they're not constantly supported by your protective amniotic fluid.

Kathryn says: 'Babies have been used to being fed continuously, sleeping when they want to, and being rocked in the cosy embrace of their mum's tummy. When babies are born we introduce gaps between feeds, and put them in a different place to sleep. It's no wonder that they can find this scary, and it's natural that they cry to express their fears.'

Understandably, babies are likely to cry more in this three-month period than any other time in their life. But however logical it might be, it doesn't make this period any easier for new parents. Knowing that other parents are going through the same experience, and thinking of this period as the fourth trimester, might help.

'Parents describe it as a very useful concept, which reminds them that it is OK to find the early days with a baby hard. It is a period of transition, where women become mums, men become dads, and babies adjust to life outside the womb,' Kathryn says.

What can you do to help your baby in the fourth trimester?

Fundamentally, the closer your baby feels to you, the happier they will be. According to Kathryn: 'Anything that mum, dad or other carers can do to replicate the womb-like world will help their baby feel safe. And when we feel safe, we thrive. For your baby, this means holding them close, perhaps in a sling, so they feel the warmth of your body, hear your heartbeat, and are gently rocked as you go about your day (or night).

'Feeding for babies, just like for adults, is about more than just nutrition, it's also social - a way of sharing and being with those we care for. Feeding your baby whenever they they want to will support their emotional development, as well as their physical and intellectual development.

'Your baby will sleep when they're tired, and you will both feel safer if they're close to you. Many parents tell me that in the early days their baby won't sleep in their Moses basket or crib, but only when they're held by a parent. This is perfectly normal and understandable when you think about the baby's point of view. It's important that parents find out about the safer sleep guidelines, and work out a way of sleeping that suits them as a family.'

Can you 'spoil' your baby in the fourth trimester?

No. Despite some people saying that babies need to 'learn' that you won't rush to pick them up every time they cry, in this crucial Fourth Trimester period you can't care for them too much. In fact, the more you look after them when they're upset, the more reassured and confident they'll be.

How might you be feeling?

Even if you're not an international tennis champion, parents who have gone from living busy, independent lives, can find the sudden change to around-the-clock care for a completely dependable infant hard.

Add to that the need to recover from a traumatic or difficult birth, and you can understandably feel like you're the one in need of a little TLC. Kathryn says: 'With the emotional changes in a woman's body, plus the realisation of the enormous responsibility of having a baby, new mums can feel overwhelmed and tearful at times.

'Partners can be dealing with their own response to the birth, their changing identity, and strong feelings about protecting and providing for the family. All of these feelings can also be affected by the way both mum and her partner were parented themselves.'

As with all stages of early parenthood, it's worth remembering that this stage will pass. In what seems no time at all, you might be looking back at the period with fondness at how tiny and attached to you your baby was when they were first born.

However, that is not to downplay how challenging the Fourth Trimester can be for parents. When you're in it, it's all-consuming. You can feel like you don't know what you're doing and you're constantly one step behind.

So, what should I do?

If you think in terms of the first three months of your baby's life being a Fourth Trimester, it can be easier to take the pressure off getting back to 'normal'. You wouldn't have been trying to rush around tidying the house and welcoming endless visitors when you were heavily pregnant, so don't put pressure on yourself to do it now.

'When women are discharged from healthcare some people might think that means they should be able to return to normal life, but there is a long period of adjustment and care needed at home,' says Kathryn. 'Friends and family can support new parents with food, help around the house, and reassurance that they are doing a great job of looking after their baby.'

This is especially important for mums who are raising their baby alone, in which case asking for help from friends and family in advance can help ensure you get the support you need.

Kathryn adds: 'Having very modest aims in the early days - getting outside most days (perhaps a short walk around the block), eating well, resting as much as possible - will change over time to meeting up with friends regularly, getting some exercise every day, and doing the most necessary housework.'

When will the crying settle down?

'As babies grow and change, things that seemed easy one day might feel very difficult another,' Kathryn says. 'A baby's crying tends to peak at around week six, which can mean that parents feel they must be doing something wrong, or that there is a problem with their baby. However, this is normal, and has usually reduced by three months.

'Parents report the excitement and happiness that comes when they see their baby is starting to interact with them, including smiling for the first time.'

Where can I get more help?

'Part of the challenge of this early period is the feeling that there is so much to learn, and to worry about,' explains Kathryn. 'Using safe sources when looking for information about caring for yourself or your baby will reduce anxiety.

'Reputable sources such as NCT practitioners and the website, or NHS health professionals and are a good place to start. Avoid sources of information (including people or media) who make you feel bad about your parenting, and stick with people who you trust and who support you.

'Although things can feel like they're getting harder in the early weeks, most people are feeling much better by around three months after the birth, and some will feel fine before that. If parents are still finding life a real struggle at that point they might consider talking to a health professional, or seeking more support from friends and family, to help them until they are feeling more in control.'

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby. To find out when an NCT nearly new sale is happening near you, search here.

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

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What is the fourth trimester? | Baby & toddler articles & support | NCT

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Everyone knows that pregnancies last three trimesters - so what exactly is the Fourth Trimester? We explain what this crucial stage is, and what it means for you and baby

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How our biology and early brain development explain our babies' behaviour, sleep and feeding.

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Human Evolution: Why Babies Sleep As They Do -

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Human infants are uniquely helpless compared to other primates — a result of our evolutionary history. Learn how this shapes infant sleep, night waking, and the need for close parental care in this evidence-based overview.

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Follow the OMVP Facebook page for updates on maternity services and ‘Ask the Midwife’ Facebook live Q&As.

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Oxfordshire Maternity Voices Partnership is on Facebook. Join Facebook to connect with Oxfordshire Maternity Voices Partnership and others you may know. Facebook gives people the power to share and…

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Feeding your baby can feel quite overwhelming at first - whether you are breastfeeding, bottle feeding or a combination of both.

We have lots of guidance to support you, along with hints and tips from other parents.

There is a lot of evidence to show how beneficial it is to breastfeed your baby, especially in the early weeks. However, it can take time to get the hang of, and there may be reasons why you cannot breastfeed.

If you have any feeding worries or concerns, the best thing to do is speak to your midwife or health visitor.

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Feeding your baby - Best Start in Life - NHS

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Whether you are breastfeeding, bottle feeding or a combination of both, we have lots of guidance to support you, along with hints and tips from other parents.

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Expecting a baby? - Find out how your milk making Superpower works! Check out our fab new video explaining all about how lactation works.

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9 Things to Expect When You're Breastfeeding by Professor Amy Brown

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Professor Amy Brown is based in the Department of Public Health, Policy and Social Sciences at Swansea University in the UK where she leads the MSc in Child Public Health. With a background in psychology, she first became interested in the many barriers women face when breastfeeding after having her first baby. Three babies and a PhD later she has spent the last twelve years exploring psychological, cultural and societal barriers to breastfeeding, with an emphasis on understanding how we can better support women to breastfeed and subsequently raise breastfeeding rates.

It's a pleasure to welcome Professor Amy Brown to the blog with her breastfeeding advice.

However you feed: breastfeeding or bottle feeding, the most important thing is a fed and happy baby and a happy mum.

Over to Amy......

Breastfeeding your baby is one of the most natural things in the world, right? Well yes, but natural doesn't necessarily mean easy. Lots of things that are natural take practice- none of us learn to walk without a few bumps - and breastfeeding is no different.

Getting good information and good support is really important. Unfortunately,not everything you read will be accurate or have your best interests at heart. So here are nine truthful things to expect when breastfeeding...

Latching your baby on might look different to what you imagined

Babies don't feed by just sucking on the nipple. Instead, they take a large mouthful of your nipple and areola (the darker skin around your nipple) and draw your nipple right towards the back of their mouth, whilst massaging the underside with their tongue.

This isn't as uncomfortable as it sounds - nipples are remarkably stretchy. But it is important to get it right and that can take practice. A good latch helps them get lots of milk, and stops you getting sore. Ask your midwife for support, check out these great videos for a visualisation of what you're aiming for ( https://bit.ly/2j1Ics6) and don't be afraid to keep on asking until you've got the hang of it.

Breastfed babies feed lots, and I mean LOTS

If you listen to great aunty Mable she might tell you babies should be fed every four hours on the dot. Indeed, in the 1950s babies were brought from the nursery to their mother every four hours for a feed. You'll still find books telling you this is how babies should feed. However, this advice, quite simply, is nonsense.

We now know that feeding your baby responsively e.g. whenever they ask to be fed, day or night, helps build a good milk supply. Trying to stretch out feeds has the opposite effect. Babies can feed at least every 2 - 3 hours, as breast milk is easily digested. This is rarely at set times, as they can't read clocks, but do you eat and drink in a set routine?

Night feeds are very normal

...and what you feed them has no impact on sleep despite what people might suggest. Babies have tiny tummies so need frequent feeds, and just because the sun has gone down, doesn't mean their other needs have disappeared. Babies have short sleep cycles and wake for many reasons other than hunger. What you feed them won't help them if they wake because they are cold, need a nappy change or just want a cuddle. And breastfeeding mothers actually get more sleep as it's quicker to breastfeed at night rather than prepare a bottle.

You'll become fascinated with the content of their nappies

Yes really. One of the best ways to tell whether milk is going in, is to look at what is coming out. As your baby takes in more milk in the first days their nappies will change from a black sticky colour to mustard-y yellow. By day 6, they should be having at least 6 wet and 2 dirty nappies a day (after 6 weeks some babies have fewer dirty nappies).

You can estimate what a wet nappy feels like by putting 2 - 4 tablespoons of water into a nappy and feeling its weight. A poo counts as a poo if its roughly bigger than a £2 coin. Yup, you'll never look at £2 coins in the same way again.

Complete strangers will have an opinion on how you feed your baby

This one actually isn't specific to breastfeeding. Some strangers just like to tell all mothers they're doing it wrong. Breastfeeding? Wrong! Bottle feeding? Wrong! Baby sleeping? Wrong! Not sleeping? Wrong! The key is to realise there is no right answer and it's about them, not you. Just smile and nod or ask, 'Why do you want to know?' Or breastfeed in front of them - that'll make them go away.

The same goes for people who tell you exaggerated horror stories. This is a tough one as most likely they themselves were given bad advice or didn't get the right support and in their own way, are trying to help. But their story does not have to be your story.

It's normal to find some days tough

You might really want to breastfeed. But that doesn't mean it will always be wonderful. You will have tough days and may tell everyone you've had enough. But that's OK. There is no prerequisite that you have to love breastfeeding every day, or even at all. After all, you might love your job or your partner but that doesn't mean you don't sometimes feel frustrated or fed up with them.

Saying that, it's easy to blame breastfeeding when things are tough when actually it may just be the responsibility of caring for your tiny person. Stopping breastfeeding won't stop them needing to be fed, changed, or continually jiggled. Motherhood itself is tough. And you know what? It's also fine to say that.

You'll fall in love with your partner in whole new ways

A friend told me how she never felt more in love than when her partner was massaging a blocked duct on her breast at 4 am. Another burst into happy tears when her partner stood up to an uptight relative who told her she shouldn't be feeding in public. Another bonded over the shared joy of a full nappy. OK, maybe she was a bit sleep deprived, but you get the gist...

You'll feed anywhere if your baby is hungry

Before your baby was here, the thought of breastfeeding in public made you a bit anxious. Fast forward a few months and anything goes. Up a mountain, in the supermarket queue, during the vows at a very serious wedding (yes, the bride) ...

When you have a breastfed baby, you quickly learn that your nipples will solve almost everything. Breastfeeding has all sorts of health benefits but the ability to soothe a crying baby within 15 seconds is top of many women's reasons for breastfeeding.

One day, it will all just click

Sometime, probably when they're around eight weeks old, you'll realise it all suddenly got that bit easier. You've got your latch sorted. You're leaving the house without thinking too much. You've fed in so many places that you no longer think twice. Your postman has quite possibly seen your boobs, both of them, and neither of you care.

Keep going, it's worth it.

Follow Amy on Twitter: @Prof_AmyBrown
Website: www.breastfeedinguncovered.co.uk

The Positive Breastfeeding Book by Amy Brown is published by Pinter & Martin £14.99

Buy my bestselling book in paperback or audio

My debut book is my guide to surviving and thriving at work and at home and offers insight into how to create a digital business or return to work with confidence.
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9 Things to Expect When You're Breastfeeding by Professor Amy Brown

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Professor Amy Brown is based in the Department of Public Health, Policy and Social Sciences at Swansea University in the UK where she leads the MSc in Child Public Health. With a background in psychology, she first became interested in the many barriers women face when breastfeeding after having her first baby.

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What should I expect in the first 40 days of breastfeeding?

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What should I expect in the first 40 days of breastfeeding?

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Here's Why You Should Ignore Those Breastfeeding Horror Stories

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We all like a good birth and baby horror story, don't we? There's nothing like scaring new parents about rare or even impossible eventualities that probably didn't even happen in the first place.

' My birth lasted 27 days ' claims Auntie Pat.

' That's nothing,' says Linda. ' My baby swallowed my nipple whole. Both of them '.

' Pah! You're BOTH pathetic,' says Colin. ' My wife had to feed our baby 24 hours a day. One day I came home and there was just her shoes and this giant, ravenous baby in her place. She had literally had all life sucked out of her '.

Try not to pay too much attention to breastfeeding horror stories. People like to share stories - it makes them feel better - without thinking about the consequences for you. A few months down the line, once you know more about breastfeeding, you'll see that many of these stories arise from women being utterly let down.

Maybe they weren't supported, or maybe they were given bad advice. In countries such as Sweden, where breastfeeding rates are higher (and support is much better), horror stories are much less common. That's not because Swedish breasts are magical, but because their society is very supportive of breastfeeding and therefore very breastfeeding friendly.

Unfortunately, in many countries, although things are gradually improving, we have a long history of not being very supportive of breastfeeding and breastfeeding mothers at all. Only a couple of generations ago, formula milk was marketed as being scientifically best for babies, and the idea that babies should only feed every four hours was really common.

This meant that many of our mothers and grandmothers would have formula-fed, and knowledge about how to breastfeed (and the importance of responsive feeding) was lost, while formula milk came to be regarded as normal and acceptable. Fast forward 60 years and we are still picking up the pieces: bad advice, coupled with a lack of understanding and support, means many women are set up to fail.

One of the key parts of getting breastfeeding off to a good start is being armed with knowledge about how it works, what to expect (including what might be challenging, or signs you may not be able to produce enough milk) and where to get support if you need it - both practical and emotional.

Who will you go to if you're not sure what you're doing?

Do you know how to tell if something's not quite right?

Who will offer a shoulder to cry on if you're feeling exhausted, rather than a bottle of formula?

Thinking about all these things in advance can help stop bigger problems occurring. We talk about breastfeeding being natural, and this leads to many people thinking breastfeeding is natural like breathing, which most people can do automatically, without effort or thought. But it's not. Breastfeeding is natural like walking. Something we can almost all do (although some will have a physiological issue that makes it not possible), but a skill we need to master, something we need help and guidance with.

And just like with walking, in the early days it can take a while to find your feet, and there will be times you fall on your bum. But that doesn't mean you can't breastfeed, any more than falling over means you can't walk. It just means you need to reach out and get the right help and support to get you back on your feet, and before you know it, it will be second nature.

I am not going to lie and say that breastfeeding is the easiest, most natural thing you will ever do and your entire experience will be absolutely blissful. You will likely have times when you are uncomfortable, worrying about whether it's all going right, or just feel fed up.

Is there anything in life - particularly if it's worth doing - that is really easy all of the time? You might absolutely love your partner, but I bet there are times when you want to throttle them. You might love your job, but you still have days when Bob from finance has driven you to drink. You might love cake, but apparently some people even find there is a limit to that.

So breastfeeding can be a challenge, yes. But when they look back, few people regret doing it. Most people who have regrets over breastfeeding have regrets that they had to stop before they were ready - usually because they were not supported or given the information needed - rather than regretting breastfeeding itself.

Difficulties can arise, and sometimes you can be utterly exhausted and wishing someone else would just latch the baby on for an hour or so. But it's absolutely fine to dislike breastfeeding, but still really want to carry on. You might want to do it for you and your baby, but loving it or even enjoying it is not a prerequisite. It's ok to have a moan and expect someone to listen, not tell you to stop - they wouldn't immediately tell you to quit your job if you were having a bad day!

But also remember like many challenges, the start of it - the earliest weeks - often feel the toughest. When you get past them, it often gets much easier. Many mothers say that once they crack the early weeks, it all become so much easier and most definitely worthwhile.

Also, bottle feeding isn't necessarily an easier solution. In fact, it takes more time overall, there is more stuff to buy and remember to take out, and babies, despite what you might be told, do not miraculously start sleeping better. Turns out it's really just caring for a baby that can be tough, whichever way you do it -and for that mothers need and deserve to be cared for in return.

The following post is based on an extract from the Positive Breastfeeding book, published by Pinter and Martin publishers.

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Here's Why You Should Ignore Those Breastfeeding Horror Stories

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We all like a good birth and baby horror story, don't we? There's nothing like scaring new parents about rare or even impossible eventualities that probably didn't even happen in the first place. ' My birth lasted 27 days ' claims Auntie Pat. ' That's nothing,' says Linda.

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For many mothers breastfeeding is easy-baby is born, attaches to the breast on his own, milk flows and baby grows. However it is not so straightforward for some mothers. Problems can include baby not wanting to breastfeed, low milk supply, painful breastfeeding and more. Most problems can be prevented or overcome with a little prior knowledge and some skilled support. This article discusses how to get a good start to breastfeeding and is a companion article to Breastfeeding Tips for Newborns.

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#1 Find out what to expect

Find out as much about breastfeeding as you can before your baby arrives so you know what to expect. Knowing the answers to common questions can help avoid any problems. How do I position my baby to breastfeed? What if breastfeeding hurts? Do babies have one breast or two per feed? How often do babies breastfeed? How do I know if my baby has had enough milk? Do I need a breast pump or any other equipment? Why did I have difficulties breastfeeding my first baby? For answers to these questions and more:

#2 Birth matters

Birth practices can promote or undermine breastfeeding . Where possible, having an unmedicated, active birth can help to get a good start to breastfeeding because:

Pain killing drugs and epidural drugs can and do find their way to the baby to make him drowsy and less interested in breastfeeding, sometimes for several days.

Instrumental deliveries such as forceps or ventouse can leave a baby feeling bruised and uncomfortable.

Having intravenous (IV) fluids (a drip) can also interfere with latching (the way baby attaches to the breast) if extra fluids enter your breast tissue (see Engorged Breasts).

Some birth practices can delay milk coming in see No Breast Milk After Delivery.

If a baby is sleepy, stressed or in pain they may not be able to tap into their natural instincts to breastfeed-they may not want to breastfeed at all at first. Not breastfeeding as soon as possible (in the first hour after birth is ideal!) could delay getting breastfeeding established and could interfere with your milk supply later (see #3 and #6 below). For more information see Birth and Breastfeeding by LLLGB and When Baby Won't Breastfeed.

#3 The power of skin-to-skin

Your baby wants and expects to be held close in skin-to-skin contact after birth. The first hour after birth is particularly important for your baby to rest undisturbed in skin-to-skin contact and have their first breastfeed. When your baby is in the right place next to his food source (the breast), a baby can use his senses of touch, smell, sight and taste to find the nipple himself-just as other mammal babies find their mother's teat on their own after birth. Skin-to-skin contact helps your baby latch, promotes the hormones needed for milk production, regulates your baby's heartbeat, temperature and breathing and makes him feel safe. Skin-to-skin contact includes letting a baby use their hands-take off any scratch mittens and see Why Skin-to-Skin? for more benefits of skin-to-skin contact.

Breastfeed in the first hour after birth

Jane Morton of Stanford University explains the benefits of breastfeeding in the first hour after birth (sometimes called the golden hour) in Successful Breastfeeding Begins Right at Birth. Benefits include:

Strong feeding instincts. All baby mammals' instincts and feeding reflexes are primed to help them find their mother's teat straight after birth

Birth hormones (e.g. oxytocin) help to push milk forward and make breastfeeding or hand expression easiest during the first hour

Sends a strong signal to the milk factory to start milk production.

#4 Comfortable breastfeeding-position and latch

The way a baby attaches to the breast is often called their attachment or latch. The way a baby is held to the breast (their positioning) also affects how they can latch on. Getting a comfortable latch where baby has a big mouthful of breast tissue as well as the nipple is important so they can get plenty of breast milk when they suckle. The more breast milk your baby takes away from the breast at each feed the more milk will be made to replace it. See "How to Breastfeed" in Breastfeeding Tips for Newborns for more information on getting started or see Breastfeeding Positions for Newborns, Latching Tips and Breastfeeding Videos.

#5 Frequent feeds

Babies have small tummies and breast milk is digested quickly. Newborns therefore need to feed very often day and night, at least 8-12 times per 24 hours can be expected. How often milk is removed from the breasts is important both for a baby's next feed and for your milk volume later because:

Milk is made on demand, the more milk that is taken by a baby (or pump) the more will be made to replace it

Frequent breastfeeds in the early weeks helps calibrate milk production later as baby grows

See How Often Should a Newborn Feed? and Breastfeeding Tips for Newborns for more reading.

#6 If baby won't breastfeed

Be prepared that if your baby doesn't latch straight away it isn't because he doesn't like breastfeeding, it's because he can't... yet. Plenty of skin-to-skin contact (#3) and good breastfeeding support (#10) can help with this. If your baby isn't latching:

Hand express

Start hand expressing your colostrum (the first breast milk) straight away after the birth. The sooner you can start this the better for your milk supply. Starting in the first hour after birth is ideal and is discussed in Stanford University's video Successful Breastfeeding Begins at Birth. Your midwife can also help you if needed and see Hand Expressing Breast Milk. Colostrum can be collected in a small spoon or syringe (it will just be small volumes at first) and fed to your baby. Hand expressing as often as your baby would be breastfeeding-at least every two hours-will stimulate your milk supply and keep your baby well fed.

Pump

Once the volume you can express increases as your milk comes in, you can use a breast pump. Using an electric pump every couple of hours during the day and every four hours at night will protect your milk supply until your baby can latch.

Frequent feeds-keep your baby well fed

Feed your baby all your expressed breast milk by syringe, cup, small spoon or bottle until baby is ready to latch. Avoid letting your baby sleep for long periods-feed your baby at least every two hours at first. A baby might be having 30ml breast milk per feed by day three, 30‑60ml per feed by day four, 60‑90ml per feed in the second and third weeks of life and 90‑150ml per feed in months one to six. Your health professional or IBCLC lactation consultant may recommend specific volumes of milk for your baby based on their weight.

Provide opportunities to latch

Hold your baby in skin-to-skin contact as much as possible to give them an opportunity to latch using their natural reflexes. There can be lots of reasons why a baby doesn't latch straight away; lactation consultant Diane Wiessinger gives examples in My Baby Just Doesn't Get It. For one to one help contact a breastfeeding specialist to help you and see When Baby Won't Breastfeed and How to Get Baby Back to Breast.

Don't panic if you can't get your baby to latch on. Babies have a strong instinct to latch for many months, there is plenty of time yet to work on attachment with your breastfeeding specialist. Do pump though! It is very important to protect your milk supply if your baby can't latch by removing any breast milk from the breasts. By frequently removing colostrum (the first milk) and breast milk by hand expression and pumping, your milk supply will be protected and you will have a supplement to keep your baby well fed.

#7 Avoid artificial teats

A baby needs to use a different sucking technique at the breast to that used with an artificial teat. Some babies can get confused between the two techniques (nipple confusion) or begin to prefer the bottle teat over the breast (nipple preference). Avoiding dummies and bottle teats can help to get a good start to breastfeeding by avoiding nipple preference or confusion. Avoiding formula, unless it is medically indicated, will mean all your baby's sucking is at the breast to stimulate your milk supply. If needed, alternative ways to give small volumes of milk to your baby include using a spoon, syringe or cup feeding. For larger volumes you could consider supplementing at the breast with a supplemental nursing system. If you do need to use a bottle, there are ways to make bottle-feeding more like breastfeeding to help avoid nipple confusion. For more reading see:

#8 Special situations

Certain situations may need individualised support to achieve a good start to breastfeeding. Perhaps your baby has been born earlier than expected, or you have inverted nipples, perhaps you have had breast reduction surgery, breast implants or have a medical condition that could affect milk supply. Perhaps you found breastfeeding a previous baby didn't work out and wonder if it will happen again. If you have any concerns it's a good idea to chat with a breastfeeding specialist before your baby is born, or as early as possible afterwards, so that you know exactly how to get breastfeeding off to the best start for your situation. Some parents may be interested to find out more about expressing colostrum antenatally which can be helpful in several situations.

#9 Know when help is needed

Getting help at the earliest sign of breastfeeding difficulty from a breastfeeding specialist is important. The longer problems are left, the more difficult they can be to put right. Painful nipples, lack of poop, jaundice, poor weight gain and prolonged engorgement are all potential red flags that breastfeeding is not going as well as it could be.

Pain

Does breastfeeding hurt? Painful, sore nipples are a sign that something is wrong. Breastfeeding should not hurt, even in the first few days. Breastfed babies feed very often as their tummies are small and breast milk is quickly digested. They might feed every couple of hours or more often. With such frequent feeds, a mother could quickly become sore and have cracked or damaged nipples if the latch is painful. Not only this, if a baby is latched to the nipples without a big mouthful of breast, it will be harder for them to get enough milk. For more reading see Why Does Breastfeeding Hurt? and Causes of Sore Nipples.

Dirty nappies

Is baby having plenty of dirty nappies? A lack of dirty nappies in the first few weeks could be a sign that baby isn't getting enough breast milk. When a baby is getting enough milk in the first week, there will usually be a clear sequence of colour changes of their poo. The colour of poop will gradually change from black to mustard in the first five days and will increase in volume. After the first five days, at least three to four dirty nappies with yellow or mustard poop every day are a good sign that feeding is going well. The number of wet nappies will also increase. See Breastfed Baby Poop for further information.

Jaundice

Is your baby jaundiced? Increasing yellowing of the skin (jaundice) may be an indicator of poor transfer of breast milk in the early days after birth. A certain amount of jaundice is normal, and is caused by a breakdown of excess red blood cells which makes yellow bilirubin that leaves the body through baby's poop. If your baby isn't feeding well and consequently isn't doing plenty of poops to excrete the bilirubin, jaundice will take longer to clear. Check with your heath professionals and see Jaundice in Breastfeeding Babies for further information.

Poor weight gain

Is your baby gaining weight? After the initial weight loss in the first few days of life, your breastfed baby will start to gain 30-40g per day if breastfeeding is going well. See Is My Baby Getting Enough Milk? and Understanding Your Baby's Weight Chart for more information about normal weight gain. If your baby is not gaining much or any weight, don't wait, get good breastfeeding help as soon as possible to get back on track. There is no advantage to waiting around hoping weight gain might get better on its own. For more reading see:

Engorgement

Are your breasts very full and swollen? A little engorgement when your milk comes in on the second or third day is to be expected but if breastfeeding is going well this engorgement will normally resolve quite quickly. Prolonged or unexpected engorgement could reduce your milk supply, see Engorged Breasts for information on relieving engorgement.

#10 Know who to call

Just one piece of bad advice can sabotage a breastfeeding relationship so it is important to know who is helping you and whether you can trust what they say. The training your helper may have had and hence the quality of breastfeeding help they might give can vary a great deal. Your doctor, health visitor or midwife may have had very little training. They may not know the answers to basic breastfeeding management questions.

Breastfeeding peer supporters may have only had 12 hours of training in basic breastfeeding management. They may not have breastfed their own babies.

Breastfeeding counsellors with one of the breastfeeding charities such as La Leche League, Association of Breastfeeding Mothers or National Childbirth Trust will usually have had 12 months training and will have personal experience breastfeeding.

IBCLC lactation consultants have the highest skilled professional qualification in breastfeeding. They have demonstrated at least 1000 contact hours helping mothers with breastfeeding, at least 90 hours intensive lactation study and passed a rigorous international exam. They have to stay up-to-date by recertifying every five years and taking an exam every ten years. See Why Hire an IBCLC?

Summary

There are several ways to help breastfeeding get off to a good start. Knowing how breastfeeding works and what to expect, understanding the role of skin-to-skin, and avoiding the early use of artificial teats can all be helpful for successful breastfeeding. At the first sign of any problems, it is important to find the right skilled help to get breastfeeding back on track. Sore nipples, lack of poop, jaundice and poor weight gain are all potential red flags that breastfeeding may not be going as well as it could be. An IBCLC lactation consultant or breastfeeding specialist can help to get breastfeeding running smoothly.

Footnotes & References

1. Marasco and West, Making More Milk: The Breastfeeding Guide to Increasing Your Milk Production, Second Edition, 2020

2. Mohrbacher, Breastfeeding Answers Made Simple, 2010, p237

3. Mohrbacher and Kendall-Tackett, Breastfeeding Made Simple, 2010, p 80

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For many mothers breastfeeding is easy-baby is born, attaches to the breast on his own, milk flows and baby grows. However it is not so straightforward for some mothers. Problems can include baby not wanting to breastfeed, low milk supply, painful breastfeeding and more.

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Small volumes of colostrum (the first breast milk) are usually enough for most newborn babies until their mothers’ milk arrives

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Not all women wear bras and a special breastfeeding or nursing bra is not essential for a breastfeeding mother. This article answers twelve frequently asked questions about nursing bras.

#1 Do I need to wear a bra for breastfeeding?

Whether or not to wear a bra is personal choice; some women prefer to wear a bra for breast support and/or to keep breast pads in place if they tend to leak milk in the early weeks. Women with larger breasts may feel more comfortable wearing a bra with some support.

Are there any official recommendations?

The Academy of Breastfeeding Medicine (ABM) Protocol #36 advocates for wearing a well fitted supportive bra. Their rationale is that during lactation, breasts are fluid filled and will require support to avoid lymphoedema as well as progressive back and neck pain. Lymphoedema is a condition where the body's tissue fluid drainage system (lymphatic system) is overloaded causing fluid retention and swelling. The ABM recommendation to wear a supportive bra is based on consensus or opinion (level 3 evidence; strength of recommendation C) rather than higher quality research. An alternative opinion is offered by breastfeeding author, lactation consultant and doctor Pamela Douglas who notes that potential negative effects of wearing a bra during lactation include:

Increased risk of skin damage. Bras and breast pads act like a medical dressing that can prevent exchange of air and fluid. This can increase the risk of moisture associated skin damage (MASD) which could prevent a sore nipple healing quickly. If a mother has nipple pain or persistent pain, Douglas recommends going without a bra as much as possible; nighttime, for example, is a good opportunity to allow air to circulate around the breast.

Increased risk of breast inflammation. Any restrictive, poorly fitted bra or item of clothing puts physical pressure on a lactating breast could increase the risk of breast inflammation due to compression of milk ducts.

Reduced breast movement. Bras (and less active lifestyles) can reduce normal breast movement so that depending on breast shape and bra fit, some areas of the breast may not experience much, if any, movement. Gentle manual movement of breasts is one of Douglas's five principles for prevention and management of benign lactation-related breast inflammation (BLBI). According to Douglas, gentle upper limb stretches or lifting and gently moving the breasts in various directions such as via circular movements with the hand or palm laid gently over the breast (sometimes coined "breast gymnastics") may help to prevent breast inflammation. Note: formal breast massage including therapeutic breast massage of lactation or manual lymphatic drainage is not recommended as this could traumatise breast tissue (Douglas, Vol 18: 1-20 2022).

#2 What is a nursing bra? Can I wear an ordinary bra?

A nursing bra has adaptations to easily access one or both breasts to feed your baby; for example drop down cups released by clips or zips, or soft cups that can be pulled down and tucked under the breast. It is possible to use a regular bra for breastfeeding or even adapt it into a nursing bra with cups that drop down-you can search online for a number of ways to do this. You can also turn a nursing bra back to a regular bra.

Whether you are choosing a nursing bra or considering using a normal support bra for breastfeeding it is important to:

Make sure the bra is flexible and soft enough so that pulling down or lifting the cup to breastfeed does not put any pressure on your breasts because this could be a risk factor for blocked ducts or mastitis. See #3 below for more fitting tips.

Avoid underwires (#4) and chose cotton rich material where possible (see #5 below).

Make sure the bra has enough room for breast pads (see #8) if you wear them

Check the bra cups will be large enough for when your breasts are at their fullest before a feed.

Zips or clips?

When choosing a nursing bra, it's a good idea to experiment with opening and closing different styles of bra cup. A drop cup can usually be hooked back in position with one hand which can be important when you are holding your baby at the same time. Zips may require two hands to avoid catching your skin in the zip. Look for a cup that exposes each breast fully so that there is no pressure to the breast from material during a feed. Pumping bras with small front openings meant for pumps (see #10 below) are unlikely to expose enough skin for your baby to get a deep latch (the way a baby attaches to the breast) and can put pressure on the breast which may cause inflammation.

#3 How can I check if a bra is a good fit?

Many bra departments of clothing stores or maternity stores will offer a bra fitting service to help you find the ideal fit. A well fitted bra will:

Support the breasts without cutting into breast tissue and without breasts "spilling" out of the top of the cup-any pressure on the breasts can increase the risk of mastitis or blocked ducts

Have side seams that are well behind the breast under the arm pit

Have bra straps that support the breasts without digging into the shoulders

Have an adjustable band across your back that sits horizontally and is not riding up your back

Be sufficiently flexible to allow for breasts changing size as they fill and empty with milk and with room for breast pads.

Finding your bra size and cup size

Bra companies measure bra size (US: band width) and cup size in a variety of different ways. As all bra styles differ, a good fitter may find the right fit for you without a measuring tape, just by trial and error. If buying online, check the measuring or fitting information for the company you are interested in buying from, many have videos to help you.

#4 Can a nursing bra be underwired?

Underwired bras are probably best avoided especially in the early months of breastfeeding as they could press on milk-making tissue, prevent sufficient drainage of milk and increase the risk of blocked ducts and mastitis. Milk making tissue extends under the arm pit and back to your rib cage . The Australian Breastfeeding Association advises that certain makes of underwired nursing bra may cause less problems:

there are now nursing bras available that have a flexible low-gauge wire support, designed to flex and change position with your changing shape. These are less likely to cause problems.

#5 Is cotton best for nursing bras?

Some mothers can be sensitive to synthetic fibres in pregnancy or while breastfeeding which could cause skin irritation or promote sweating. Authors Lauwers and Swisher recommend cotton rich bras (cotton or a cotton-polyester blend) and Ask Dr Sears explains the importance of fabrics being "breathable" i.e. allowing air flow so that any moisture is released quickly.

Cups should be made of a breathable fabric. This is usually 100 percent cotton, although some of the newer synthetics also allow the skin to breathe. Other synthetics trap moisture next to the nipples and encourage bacterial growth and soreness. Don't buy a bra with a plastic lining.

#6 When should I buy a breastfeeding bra?

During pregnancy breasts generally get bigger as they prepare for breastfeeding and some women may need one or more new bras during this time. Nursing bras that are bought during the early months of pregnancy may not still fit when you are first breastfeeding, however they will probably fit at some point in your breastfeeding relationship and will often be more comfortable than a regular bra.

Fit from 28 weeks

Most nursing bras fitted in the last trimester of pregnancy (from 28 weeks gestation) will also fit during breastfeeding but some mothers may find they need a bigger cup size for the first few months after birth. Lauwers and Swisher explain:

The last trimester of pregnancy is generally the earliest time for selecting a nursing bra. Some women wait until after delivery, when full milk production occurs.

How many nursing bras do I need?

Two or three nursing bras allow for washing and wearing. Start with the minimum number you can manage incase your size changes after your baby is born when your milk comes in. You can add more bras as needed when your milk supply settles down and when you're happy your chosen bra is a good style and fit. Alternatively you may decide you prefer not to wear a bra at all.

#7 Will a nursing bra stop my breasts changing shape or sagging?

A nursing bra won't stop your breasts changing shape as it is thought that pregnancy hormones are the main factor affecting breast shape regardless of the intention to breastfeed or the bra you wear. Wearing a supportive bra may reduce stretching of tissues that could contribute to sagging but even if you always wear a supportive bra-pregnancy, skin ageing, smoking, being over weight or losing weight quickly and even genetics are also likely to affect breast shape.

Will breastfeeding make my breasts sag?

As above, the hormones of pregnancy can cause permanent changes to breast shape irrespective of breastfeeding. However, if breasts increase several sizes during pregnancy or lactation, this may cause cause stretch marks and a new breast shape after breastfeeding ends, just as some mothers' tummies change shape after being stretched during pregnancy.

#8 What are breast pads and do I need them?

A breast pad is a circular pad of absorbent material that is worn inside the bra over the nipples to absorb any leaked breast milk. Some mothers leak breast milk between breastfeeds for example if their breasts are full, or if they hear their baby cry and have a let-down (milk ejection reflex). Some mothers may leak a little milk from the opposite breast while they are breastfeeding, especially in the early weeks. If you need them, breast pads can be washable (better for the environment) or disposable.

It is important to change damp or soggy breast pads frequently to avoid sore nipples. Authors Wambach and Spencer recommend choosing a breast pad that is comfortable and non irritating, be replaced whenever wet and does not leave a residue that could be swallowed by your baby. They also offer tips to prevent leaking such as feeding baby on cue around the clock (not scheduling feeds), or applying direct pressure to the leaking breast across the nipple eg by crossing your arms can help stop leaking temporarily.

#9 Do I need a sleep bra?

Wearing a breastfeeding or nursing bra at night is down to individual choice. If a sleep bra is used for light support at night and to keep breast pads in place, it should fit very loosely so as not to cut into any breast tissue and ideally be made of cotton. Pamela Douglas points out that nighttime can be a good time to allow breasts full access to circulating air which can help with nipple healing and prevention of soreness ( Douglas. Vol 18. 1-29 2022).

#10 Do I need a special "pumping bra"?

Most breastfeeding mothers won't need to pump regularly or at all, let alone need a special bra to use a breast pump successfully. What exactly is a pumping bra and if a mother finds she is pumping frequently or exclusively is a pumping bra desirable or unnecessary?

What is a pumping bra? A pumping bra is one with openings that will hold the breast pump flanges in place over your nipples so that both your hands are free. This could be helpful for pumping both breasts at the same time, for massaging the breasts during pumping (hands-on-pumping), to take the strain from your hands or release your hands to multitask. You can buy pumping bras or simply adapt a cheap sports bra by making holes in the cups that are just big enough to bring the pump flanges through.

Is a pumping bra desirable or unnecessary? It is not necessary to use a special bra in order to use a breast pump. Although it may be useful for some mothers, Pamela Douglas IBCLC cautions against hands-free pumping since it is more likely to lead to a phenomenon she calls "breast tissue drag" where there are uneven forces on the breast. Uneven pressure around the nipple and areola can cause persistent nipple pain and damage and is more likely when mothers are not using their hands to support the pump flange (Douglas, 2022, 1-29). Some mothers have supported pump flanges with elastic bands or ponytail elastics clipped to their existing bra however Douglas advises against this.

#11 Where can I get a good nursing bra?

Many good baby stores, bra departments in larger stores and online boutiques sell breastfeeding bras.

#12 I need a large cup, where can I find a larger bra?

Retailers for larger sized bras in UK include: Bravado Designs, Bravissimo, Ample Bosom, and Bras4mums. For breastfeeding tips with larger breasts see Breastfeeding with Large Breasts.

Summary

Nursing bras are not an essential purchase but if you do want one it is important to find one which fits well. A badly fitted bra could contribute to plugged ducts and mastitis.

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Not all women wear bras and a special breastfeeding or nursing bra is not essential for a breastfeeding mother. This article answers twelve frequently asked questions about nursing bras. Whether or not to wear a bra is personal choice; some women prefer to wear a bra for breast support and/or to keep breast pads in place if they tend to leak milk in the early weeks.

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All you really need to breastfeed is a breast (or two!) and a baby who can suckle. But advertising is big business and there are lots of products on the market aimed at breastfeeding mothers-from nursing covers, creams and bras, to pumps, pacifiers and special pillows. Are they really needed? This article looks at the commercial breastfeeding pillow and whether it is a necessary purchase.

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A breastfeeding pillow is not essential

In many cases a breastfeeding pillow can cause more problems than it solves. By placing a big firm padded cushion in your lap and then adding your baby on top it is quite likely that your baby could be positioned too high at the breast. Generally a baby is able to get a better latch (the way baby attaches to the breast) if they are slightly lower than your breast and snuggled in close to you. Mysterious cases of sore nipples and "persistent thrush"-that wasn't thrush -have been finally cured by throwing out the breastfeeding pillow.

Using a pillow

The best way to use a pillow (and one off your bed will do) is either behind your back to support yourself or, after latching your baby on, use a pillow or cushion to support your arms wherever they land.

Breastfeeding without a pillow

When your body takes your baby's weight in more reclining positions, you won't need a pillow in your lap at all. For much more help with finding a comfortable breastfeeding position without a pillow see the articles Breastfeeding Positions for Newborns, Breastfeeding Videos, and Latching Tips.

Safety Concerns?

In Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family, LLLI, 2014 the authors caution against breastfeeding pillows as both problematic and a possible suffocation risk if you're very tired:

Most breastfeeding helpers have seen breastfeeding pillows cause more breastfeeding problems than they solve. It's well worth getting breastfeeding help if you think you need one.

And here's something that might surprise you. A breastfeeding pillow can be a suffocation risk when you're really tired. Picture the exhausted mother who has her baby on the pillow in her lap. Sitting upright in her chair or even in bed, she starts to droop forward more and more, until enough of her body or breast weight is on the baby to interfere with his breathing. Without the pillow, there's more room for the baby to slide into her lap and there's lots of body contact to waken her if that happens.

But I really like my pillow!

If breastfeeding is going well and you use a pillow safely that's fine too. There will be some mothers and babies for whom a pillow works perfectly well. If you're breastfeeding twins you may find a specialist twin breastfeeding pillow is indispensable. Or maybe you need a firm pillow to lift baby to breast height in a rugby hold. So long as breastfeeding is comfortable and baby is gaining weight, a pillow doesn't have to be a problem but it is not an essential purchase.

As baby grows

If you have got into the habit of popping a breastfeeding pillow in your lap before you breastfeed and it's working, watch out for a time in a few weeks or months when your baby has grown so much that the pillow may begin to get in the way. For example if the pillow lifts baby higher than the breast, you may find you begin to have sore nipples or that your baby begins to fuss during feeds as it will affect how easily they can latch on.

Summary

A commercial breastfeeding pillow is not an essential item for breastfeeding a baby. A breastfeeding pillow might be helpful for some mothers in the early weeks but for others it can mean baby is too high at the breast. Pillows can be helpful to support a mother's back or arms after baby is latched, but existing cushions or pillows off the bed can also serve this purpose.

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Do I Need a Breastfeeding Pillow? - Breastfeeding Support

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All you really need to breastfeed is a breast (or two!) and a baby who can suckle. But advertising is big business and there are lots of products on the market aimed at breastfeeding mothers-from nursing covers, creams and bras, to pumps, pacifiers and special pillows. Are they really needed?

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Let's talk about the first year of parenting

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Let's talk about the first year of parenting

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"An essential book for anyone with a baby. Let's talk about the first year of parenting is an oxygen mask over your face: at a time when it can feel like the cabin pressure is dropping, it will make sure you are in top shape for the most demanding job on earth. It covers everything new parents need to know, with a focus on you and your needs; physical recovery, mental health, relationships, work stay-at-home dads the whole package. I have a 3-year-old and I'm a doctor and this book was still a shot in the arm. It's the help we all need: a hug in written form for parent with small ones."

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Becoming a parent is about so much more than just taking care of a baby - it involves changes in all areas of your life and it can be everything from fantastic and fulfilling to overwhelming and exhausting... sometimes all at once. It can be hard to work out what's normal and what's not, about everything from newborn baby behaviour, feeding and sleep, to your postnatal body, mental health, and relationships including who does the chores and who goes back to work and when.

In this warm, reassuring and practical book, Amy Brown talks you through the first year of parenthood, helping you navigate some of the challenges caring for a newborn can bring for both parents. She focuses on you and your needs, while recognising that each family is unique, in a broad discussion that also tackles men's mental health and dads staying home, and the experiences of single parents and same-sex couples. The central focus is on making sure you get the information and support you need, whatever your circumstances.

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Let's talk about the first year of parenting (New Parents)

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See our complete guide to being pregnant and staying healthy today, including our week-by-week guide and information around vitamins, alcohol and much more.

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A whole Padlet on breastfeeding - where to find good information and support

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A whole Padlet on breastfeeding - where to find good information and support

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Book covering breastfeeding, formula and solids

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You've Got it in You: A Positive Guide to Breast Feeding

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You may be worried about breastfeeding and worried that it might 'not work'. This is a common feeling when you live in a society where breastfeeding is often sabotaged by incorrect information, patchy support from a stretched health service and powerful messages from formula companies. But it's n...

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Let's talk about preparing for your baby's birth (antenatal course in a book for new parents)

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Buy Let's talk about preparing for your baby's birth (antenatal course in a book for new parents) 1 by Jackie Kietz (ISBN: 9781780667003) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

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The Positive Birth Book: The Guide to Pregnancy, Birth and the Early Weeks: The bestselling guide to pregnancy, birth and the early weeks

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Buy The Positive Birth Book: The Guide to Pregnancy, Birth and the Early Weeks: The bestselling guide to pregnancy, birth and the early weeks 2nd, revised and updated by Hill, Milli (ISBN: 9781780667652) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

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Free interactive pregnancy and parenting app.

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What is pregnancy sickness?

Pregnancy sickness is often called morning sickness, but it can occur at any time of the day or night. Despite sickness being an expected part of pregnancy, severity does vary from person to person. Sickness isn't always vomiting; nausea can be so debilitating that it effects your ability to eat and drink.

Sometimes symptoms go beyond the realm of 'normal' and your quality of life becomes impacted, at this point it's important to seek medical care. Reach out to us for information and support to help you cope and get the right treatment.
Read more about pregnancy sickness
What is hyperemesis gravidarum?

Hyperemesis gravidarum is a condition at the extreme end of the pregnancy sickness spectrum. It affects approximately 3% of pregnancies and is very debilitating for sufferers. HG strongly limits everyday activities; vomiting and/or nausea are severe.

It is important that you seek medical treatment if you are unable to keep any food or fluid down as you can become dehydrated very quickly. Often IV fluids are essential to become rehydrated, and medication is necessary to try and stabilise symptoms. Contact us to talk through your options and to help you advocate for yourself with your healthcare professionals.
Read more about HG

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Pregnancy Sickness Support home page - UK Charity

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Pregnancy Sickness Support UK Charity Supporting women with Morning Sickness Pregnancy Sickness and Hyperemesis Gravidarum

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The importance of the microbiome with Toni Harman

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The importance of the microbiome with Toni Harman

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New Initiative - Colour Coded Hats on Newborns - No Thanks!

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I felt a bit like I'd stepped back in time this morning, when I read the following Tweet from King's in London:

I really thought we were well and truly over the idea of "hatting up" term newborn babies? It seems not:

To be honest I'm even more confused, and the plan sounds more than a little flawed in a number of fronts: Historically hats were used as way back in the 70s as they were thought to prevent a dip in newborn body temperature.
1) Studies show no temperature benefits to infants wearing a hat if held skin to skin
2) Hats may actually HINDER important newborn behaviours
3) Questionable infection control
4) Better alternatives
Then we learnt about skin to skin:

"Skin Contact is a powerful vagal stimulant, through sensory stimuli such as touch, warmth, and odor, which among other effects releases maternal oxytocin (Uvnas-Moberg 1998; Winberg 2005). Oxytocin causes the skin temperature of the mother's breast to rise, providing warmth to the infant (Uvnas-Moberg 1996). In a study of infrared thermography of the whole body during the first hour post birth, Christidis 2003 found that SSC was as effective as radiant warmers in preventing heat loss in healthy full-term infants."

Another 2018 paper "The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor" - found separation hindered all areas and those kept close breastfed sooner, were warmer and their mothers had a more rapid third stage.

Focus shifted to " the undisturbed hour" after which babies don't need a hat. Even back in 2003 and the birth of my first, the midwives took the dinky hat I'd taken and placed it neatly back in my bag. Instead they tucked baby down my nightie and said after that, the ward was quite warm enough.

This seems logical right? If newborns needed a hat to survive those first few hours, surely they would pop out with their own built in hoodie?
But alas no - I made a few calls and it seems hats are indeed back in fashion; in fact mums are expected to have early skin to skin WITH a hat,
and the colour coded initiative may be rolled out on a wider scale.

As a mum and an IBCLC, I have to say this is horrifying to me.

The claimis the coloured hat enables them to identifying babies at risk of hypoglycemia (low blood sugars). All term babies apparently wear a hat for the first few hours to help maintain their temperature, including during skin to skin. This intervention it is proposed, reduces risks of separation of the dyad. First, the scent of her The scent also prompts mum to release oxytocin (often called the bonding hormone), which in turn causes uterine contractions, forcing an instant constriction of the blood vessels that were running to the placenta. (Odent, 2013). What's more, However a super amazing midwife, IBCLC friend of mine (thanks Marilyn!)
The reality is somewhat different.
baby's head is extremely important to mum during skin to skin and continuing into the early days for early bonding. I'm going to bet anyone who has sniffed their newly born baby's head knows exactly what I'm talking about - mothers often describe the scent as "addictive", which in turn encourages her to plant lots of kisses, colonising her with any microbes on her baby, enabling the tailor made production of antibodies, which are passed back via colostrum. Oxytocin is also important when it comes to breastfeeding, and as outlined above it generates heat for the baby - and so i t all neatly comes full circle.

Dr Kajsa Brimdyr, researcher and expert in the field, covered at the UNICEF Baby Friendly Conference 2018, how hats can impede baby's "breast-crawling" reflexes after birth.
So, you'd think that if we're going to implement an intervention that has the potential to impact on all the above, plus hello, can you imagine skin to skin, half chewing on a pom pom instead of inhaling that delicious newborn scent? There must be some stonking evidence it helps. A lot. Right?

Nup, not at all.
There's a paucity of studies on hat wearing at all, there's differences in terms of which hats are used (plastic, stockinette etc) and almost none in conjunction with skin to skin.
sent me a 2018 study, exploring the preterm baby and knits - in a rural setting where low cost interventions can be hugely beneficial:
"Thermal Effect of a Woolen Cap in Low Birth Weight Infants During Kangaroo Care."

"The use of a woolen cap was safe but provided no advantages in maintaining LBWI in the normal thermal range while being in a KMC ward."

Again these babies are low birthweight and so far more challenged in terms of maintaining their own body temperature - even for them, there was no advantage to a hat.
Going back to the cochrane review above, we can see what did make a difference to hypoglycemia? Yep, skin to skin.

"Blood glucose mg/ dL at 75 to 180 minutes post birth Thresholds for low glucose vary from 40 mgto 50 mg/ dL

The control group mean blood glucose at 75 to 180 minutes post birth was 49.8 mg/ dL

The mean blood glucose mg/ dL at 75 to 180 minutes post birth in the intervention group was 10.49 mg/ dL more (8.39 more to 12.59 more)

The mean difference (MD) of 10.49 mg/ dL is clinically significant"

When not in use the hat is kept "near the cot". 9000 babies are
Now I love the NHS, I think midwives do a sterling job in the face of ridiculous demands - with most having developed the bladder capacity of a Shire horse. But seriously, now they have to ensure colour coded hats, that are likely to be rarely atop a head, stay with the right baby too?
Even under normal circumstances the hats wouldn't be needed, but anyone who has spent any time in summer in a typical NHS ward, knows colour coded fans may have been more appropriate. The air-con sucks, the windows barely open and the thought of a chunky knit hat becomes preposterous.

Surely a large acrylic colour coded magnetic disk that sticks to the side of the cot would be a far more reliable and environmentally friendly indicator, one that doesn't interfere with mums and babies? It's important to understand, I'm not questioning the the need to identify at risk infants - I'm questioning the implementation.

The hat may in fact never even be worn - each baby gets a new hat for infection control reasons or it is burnt.
born in King's hospitals each year - imagine if all hospitals roll this out, acrylic yarn isn't sustainable nor is the production of hats via volunteers. Now hold up here.
The knitter may be sat knitting in the grottiest conditions, smoking whilst knitting, coughing or sneezing on the item - that's fine to put on a newborn head. Yet the moment the hat is officially allocated to a newborn, even if green and infection free - it must be burnt?
It also surely raises the question from vegans (or anyone else who chooses to avoid animals based products) of - is that hat real wool or acrylic? (I asked and they think mainly synthetic, but they're donated so don't really know).

An alternative option which I think is at least worthy of consideration, is colour coded This facilitates best practice kangaroo care carriers.
These are carriers designed to protect baby's airways during skin to skin (if mum falls asleep) and hold baby close when mum wants to be mobile.
and could provide a mobile visual indicator.
The other benefit of carriers is they could further protect against newborn falls.

Paediatrics 2019 published " In-hospital Neonatal Falls: An Unintended Consequence of Efforts to Improve Breastfeeding". The study claimed that in an effort to improve breastfeeding rates, rooming in rather than newborns in a nursery was putting babies at risk of falls.

Therefore surely the appropriate response is to identify and minimise risks?

When newborn nurseries were introduced, the problem of increased infection risk, mixing up babies or them being stolen, would all be higher than when babies weren't separated from their caregivers. As a result, tags and improved security systems followed. Hospitals have evaluated and adapted to visible risks based on separating babies from their primary caregivers.

"The profound impact of maternal separation on the infant. We knew that this was stressful, but the current study suggests that this is major physiologic stressor for the infant."

They didn't know then that separating mother and infants who need intensive care support and were sent to different units, forcing increased separation - resulted in increased mortality .

They didn't know then that Mother-Child Separation Causes Neurobiological Vulnerability Into Adulthood or that scores and incidence of SAD were increased among children who were cared in the NICU and both were correlated with the duration of stay in the NICU.

These risks, whilst not as visible as dropping an infant, are far more common and wider reaching.

Now hospitals know more - they need to re-evaluate and react according. Dr Nils Bergman (a prominent expert and kangaroo care proponont) has long-said mothers shouldn't be left alone.

The Paediatrics study noted:

All events were associated with mothers falling asleep while feeding their infant, and all occurred between midnight and 6 am

A UK hospital explored their fall rate even further. There they noticed:

"similarities in many of the circumstances in which the falls occurred. These were that the mother had:

Had a Caesarean section;

A low haemoglobin level [anaemic];

Restricted mobility, such as epidural or spinal anaesthesia.

The most common scenario was that the mother had restricted mobility, due to having had a Caesarean section, felt sleepy, and fell asleep with the baby in her arms. The baby then fell from her arms and onto the floor.

Simple interventions like open curtains and using bedside cots can reduce baby falls"
These strategies brought about a marked reduction of baby falls and are now being established across all the maternity units across the trust.
Bedside cots were so in demand they had to source more!

Kangaroo Carriers could reduce falls, protect airways and provided the additional colour coding re hypoglycemia. Either way - ditch the wooly pom poms and let mothers smell their babies.
Edited to add: A midwife friend raised an interesting theory this morning, that newborns (she felt) were at risk of becoming colder with a hat, particularly the babies with hair. Although wiped, their heads are still damp and a hat on a damp head can reduce temperature. Another interesting theory to throw into the mix!
Update Nov 2019 as the scheme has been rolled out nationally.
Comments from Facebook readers:
This one really made me chuckle:
" I just gave birth last week, and my baby was an amber hat--there was a picture of an amber hat stuck to the end of her cot. We never saw an actual hat 🙂"

Maybe hats themselves have secret magical properties only the NHS knows about? Why not an amber circle or square, why is hat imagery essential? 🤷‍♀️😂

" YES! Thank you The Analytical Armadillo, I've seen this shared so many times and every time I was thinking If there's a hat you can't sniff them!
The idea that a green hatted baby is of lower concern, would set alarm bells off with me, because the nurses could completely unintentionally be a little complacent.
Baffles me how this gains support within hospital walls, even ten years ago, after the birth (home) of our first, the midwives said, oooh no hat unless it's chilly out!"

" I'm not sure how I'd feel if my newborns had been made to wear red hats; marking them out as a concern? I think I'd probably feel like they were less than perfect or not as good as those in green hats in some way. This might sound a bit ridiculous but your hormones are all over the place and I was so worried about everything right at the start. It feels a bit dehumanising."

" My little guy would have been in a red hat (resuscitated, suspected neonatal sepsis, 5 days of antibiotics). It's hard enough for a mother on an extended stay in hospital with a sick newborn without the constant visual reminder."

" They're after them round us too, acrylic for 60 deg washing, sob. All that plasticky yarn on your beautiful new baby!"

" I always thought the hat ridiculous, particularly because I didn't want to take it home and then heard it would be destroyed for infection control. What waste, on so many fronts. Now that I've read this article (so well evidenced, well argued, as always), I'm even more incensed. It's a silly implementation of an otherwise sensible need - to easily identify babies in need of extra care."

" I gave birth 5 months ago in July. My daughter was 9lb4. They put a hat on her and when i took it off to breastfeed (i couldnt see to get her to latch) i was told she had to wear it for 24 hours! Like something out of the 1970s."

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New Initiative - Colour Coded Hats on Newborns - No Thanks!

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I felt a bit like I'd stepped back in time this morning, when I read the following Tweet from King's in London: I really thought we we...

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What's Right For Me?: Making decisions in pregnancy and childbirth

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What's Right For Me?: Making decisions in pregnancy and childbirth

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What's Right For Me?: Making decisions in pregnancy and childbirth : Wickham, Sara: Amazon.co.uk: Books

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Give Birth Like a Feminist: Your body. Your baby. Your choices.

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Your Baby, Your Birth: Hypnobirthing Skills For Every Birth

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Why Induction Matters (Pinter & Martin Why it Matters: 14)

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Here at Breastfeeding Twins and Triplets UK we will answer all of these questions and more. We will try to put your mind at rest whilst being honest about journey on which you are about to embark. Breastfeeding more than one baby is challenging, but it is definitely possible and a lot of mums go on to have a really enjoyable experience.

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Breastfeeding Twins and Triplets: A Guide for Professionals and Parents

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Breastfeeding Twins and Triplets: A Guide for Professionals and Parents

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Sure Start Maternity Grant is a £500 payment to help with the costs of a new baby: what you’ll get, eligibility and how to apply (claim form SF100).

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Your midwife can make a referral

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Our Aim
Our aim is to support local families, in Didcot and the surrounding villages, during a time of extreme hardship. We will help to relieve poverty in our community by providing essential baby items, free of charge, to families in need.

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What is Healthy Start?

If you're more than 10 weeks pregnant or have a child under 4, you may be entitled to get help to buy healthy food and milk.

If you're eligible, you'll be sent a Healthy Start card with money on it that you can use in some UK shops. We'll add your benefit onto this card every 4 weeks.

You can use your card to buy:

plain liquid cow's milk

fresh, frozen, and tinned fruit and vegetables

fresh, dried, and tinned pulses

infant formula milk based on cow's milk

You can also use your card to collect:

Healthy Start vitamins - these support you during pregnancy and breastfeeding

vitamin drops for babies and young children - these are suitable from birth to 4 years old

If you live in Scotland

You can get help from Best Start Foods (opens in a new tab) instead.

Advice on healthy eating

For more advice on healthy eating, visit:

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If you're more than 10 weeks pregnant or have a child under 4, you may be entitled to get help to buy healthy food and milk. If you're eligible, you'll be sent a Healthy Start card with money on it that you can use in some UK shops.

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Hi expectant twin parents! This is me, Kath, Didcot Baby Monday's Infant Feeding Counsellor, leaving hospital in 2011 with my twin girls. Always happy to chat about what life is like with twins.

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Why Caesarean Matters (Pinter & Martin Why it Matters: 12)

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Why Home Birth Matters (Pinter & Martin Why it Matters: 11)

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Why Postnatal Recovery Matters (Pinter & Martin Why it Matters: 18)

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Provider by The Motherhood Group in partnership with NCT.

Available via the Mumbrite App.

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Breastfeeding and the Fourth Trimester: A supportive, expert guide to the first three months

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Breastfeeding and the Fourth Trimester: A supportive, expert guide to the first three months

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Whatever you plan to have in the bottle, this is a useful guide.

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There is a vast selection of bottles and teats available online or in the High Street. Many of them claim to be closer

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Health: Baby formula machines not killing bacteria, study finds

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Formula-fed infants have a higher risk of gastrointestinal infections compared with breastfed infants, partly due to bacterial contamination from the powdered infant formula, which is not sold sterile.

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Health: Baby formula machines not killing bacteria, study finds

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The Swansea University study shows 85% of infant formula machines did not kill harmful bacteria.

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It’s biologically normal for babies to wake frequently, and to need to be close (often very close!) to you to feel settled enough to sleep. This is protective against SIDS. As much as we’d like our babies to sleep for longer periods and more independently so we can get more sleep, are products that encourage this before they are developmentally ready actually a good idea in terms of sleep safety?

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Choosing what items your baby might need can be overwhelming. To help with this we have put together a product guide with information on how to choose the products or items your baby needs to reduce the chance of sudden infant death syndrome (SIDS), what types of products you should avoid and what the marketing actually means.

Our evidence-based advice on choosing baby sleeping products

The number of products available can be confusing, so sticking to this simple guideline can help parents make an informed choice:
The safest place for a baby to sleep is in their own clear, flat, separate sleep space, such as a cot or Moses basket. We recommend a firm, flat, waterproof mattress.
We would not advise using products like swings and baby bouncers as sleep spaces as they are not firm and flat. If your baby falls asleep in a swing or baby bouncer, they should be taken out and put in their own clear separate sleep space, such as a cot or Moses basket.

Even if you are planning to co-sleep with your baby, we recommend that you have a cot or Moses basket for times when sharing a bed with your baby may be high risk, for example if you are ill, on medication, have drunk alcohol etc. Click here for more info on co-sleeping.

More information about products

New baby sleep products come on to the market regularly. We don't generally recommend for or against any individual brand of product. We do have some corporate partnerships with key manufacturers, but these do not influence the research that our safer sleep advice is based on.

The research that backs up our safer sleep advice has found that the safest place for a baby to sleep is in their own clear, separate sleep space, such as a cot or Moses basket that has a firm, flat surface with a waterproof cover, and that the sleeping surface is in good condition and undamaged.

Things to check

Does the item comply with British Standards? If so it should say on the product itself, its packaging, instructions or website.

If the item is something for your baby to sleep on such as a mattress is it:

* firm? (baby's head should not sink in by more than a few millimetres)
* entirely flat with no raised or cushioned areas?
* does it have a waterproof cover?

A few essentials that you need

For safer sleep you don't need to buy lots of products or spend more on expensive items. There are just a few items that we would recommend

* cot or Moses basket
* portable sleep space such as Moses basket, travel cot or carry cot
* mattress
* sleeping bag or sheets and a blanket
* room thermometer
* car seat

Products that we would advise you not to buy

There are some items that we would not recommend

* pods or nests
* pillows, duvets or thick heavy bedding
* cot bumpers
* hammocks
* sleep positioners
Download our product guide for additional information on British Safety Standards, buying second hand, safer sleep essentials, and more.
Frequently asked questions

Is this product safe?

Some products clearly do not fit within our guidelines. We don't comment on individual brands but have put together a product guide on what to look for and what to avoid when buying sleeping products for your baby.

The key things are to make sure the mattress is firm, entirely flat with no raised or cushioned areas and waterproof and the cot is kept free of bumpers, toys and loose bedding. Pillows and duvets should not be used for babies under 12 months.

This product claims no baby has ever died of SIDS whilst using it?

Our safer sleep advice is based on extensive research but the research only looks at SIDS, not individual products. As new products are launched all the time, it would not be possible for us to to test them and so we have to look at the evidence collected over many years that shows a firm and flat surface is best for sleeping babies.

As the number of babies dying of SIDS in the UK is now thankfully very low, this does not help to tell us whether or not a product is safe.

This product says it has passed safety tests - does this refer to Safer Sleep?

We encourage parents to make sure that any product they buy has a British Standard, particularly when buying a product over the internet. A British Standard does not mean that a product helps to reduce the chance of SIDS, but just guarantees a certain level of general safety (e.g. will not fall apart or set fire easily). You should also carefully follow the manufacturers' instructions for any product you buy and contact the manufacturer directly with any questions.

Still confused about a baby sleeping product?

If this advice seems confusing then it may be easier to remember our simple sleep advice. For sleep, a 'clear cot' with a firm, flat, waterproof mattress is fine.

A 'clear cot' is one that only includes the essentials a baby needs: a flat, waterproof mattress and some bedding, but nothing else. Three key questions you could ask are:
For help with choosing products, please download our product guide below.

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Choosing what items your baby might need can be overwhelming. To help with this we have put together a product guide with information on how to choose the products or items your baby needs to reduce the chance of sudden infant death syndrome (SIDS), what types of products you should avoid and what the marketing actually [...]

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Throughout history, parents have used a wide range of items which they feel (or they are told) will benefit their babies' sleep. In recent years products that are designed to 'promote infant sleep' have proliferated. Some of these products or sleep-aids have also become linked with increasing or decreasing babies' risk of SIDS, or otherwise affecting babies' health. There is no independent research evidence relating to most of these products, nor are there safety standards for most other than flammability of materials. However, sleep aids can provide much-needed rest for parents if they help to calm and settle babies. If sleep aids do help promote infant sleep and prevent night-time crying, there are positive results for both parents and babies' overall well-being..

In this section we summarise the research evidence currently available regarding some of the most commonly used and recommended sleep aids or products: dummies (or pacifiers), swaddling, baby sleep bags, slings, and bed-side cribs/cots.

Is encouraging babies to sleep more deeply or for longer a good thing?

Many 'sleep aids' marketed to parents claim to make babies sleep more deeply and for longer. Parents should be wary of any 'tips', products, or 'lifehacks' that make these claims.

Babies, especially newborns, have short sleep cycles and wake often during the night and the day. Although this can be tiring (because it is not the way that Western adults prefer to sleep!) it is good for babies' development, and frequent waking is protective against SIDS. Waking from sleep, otherwise known as arousal, is an important survival response that helps babies to regulate breathing and other processes. Things that interfere with an infant's arousability, especially during the critical period of development between 2-4 months, can increase the risk of SIDS.

Because of this, things that claim to help babies sleep deeper or longer can sometimes go against safe sleep guidance. Take time to think before using any 'tips' or 'tricks' that you might see online, and if you are not sure about something it is best to follow trusted safe sleep guidance. Avoid placing objects on your baby's body that might compromise their ability to breathe, avoid products that excessively restrict your baby's movement, and avoid using home-made replicas of fashionable products.

Product Safety

Infant sleep products often have labels that say they comply with or exceed safety standards. However, these standards are usually designed to test general safety (such as sturdiness and flammability) and cannot accurately measure a risk of SIDS.

Products that rock and 'shush' babies attempt to recreate the experience of being held and soothed by a parent. However, they are not a substitute for parental vigilance / attention and many manufacturers' instructions advise that they are used only with a caregiver present.

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Some parents opt for disposable nappies, while others choose reusable cloth nappies. Others still choose a combination of the two. Many reasons like environmental impact, convenience or costs might affect your choice of nappies.

The environment that we all depend on is an important consideration. Each year, parents throw away around three billion disposable nappies to landfill. That's about 2% to 3% of all household waste. And that's a lot considering disposable nappies take up to 500 years to decompose (Which?, 2018a; WRAP, 2018).

On the other hand, reusable nappies might be less convenient than disposable nappies. Disposable nappies can be easier and quicker for time-pressured parents to use. There's also a lower upfront cost involved for disposables.

Parents might choose a combination of reusable nappies and disposable ones depending on what's happening. They might use reusable nappies day-to-day at home and swap to disposables for a holiday where there's no access to a washing machine (The Guardian, 2015).

Here are the pros and cons of reusable and disposable nappies.

Reusable nappies

Positives

They are better for the environment because you wash and reuse cloth nappies, rather than throwing each one in the bin. Choosing reusable nappies over disposable nappies can halve the average household waste (Which?, 2018a; WRAP 2018).

Reusable nappies now come in a variety of funky designs, colours and fabrics, with soft cloth inserts and easy fastenings like Velcro or poppers (Which?, 2018a).

Some reusable nappies come with a removable inner layer that you can slip into your baby's changing bag, and so you don't have to wash the whole nappy every time (Which?, 2018a).

Cloth nappies can work out cheaper in the long run. They can be reused for future babies or sold on (Which?, 2018a). Reusable nappies save you around £200 to £500 over the 2.5 years that your baby is likely to be in nappies (WRAP, 2018).

Some parents say cloth nappies feel softer and more comfortable for their baby's bottom.

Natural cloth nappies may be less likely to cause nappy rashes because they don't use any harsh chemicals, dyes or plastics (Alberta et al, 2005; Pollution Issues, 2013; The Nappy Shed, 2018).

Negatives

Washing and drying your baby's reusable nappies takes time, energy, electricity costs and effort (Which?, 2018a).

Reusable nappies can be less absorbent than disposable nappies, so you might need to change these nappies more often (Which?, 2018a).

You may have a large upfront cost to get your baby kitted out with a set of reusable nappies (Which?, 2018a). On the other hand, you may find second-hand reusable nappies for sale at your local NCT Nearly New Sale for a fraction of the new price.

Sometimes it can be tricky to find baby clothes to fit over reusable nappies, depending on their size and design.

Using cloth nappies can be difficult to manage if you're going on a holiday as you can't just throw them away like disposable ones (The Guardian, 2015).

You need to be extra careful while cleaning them to ensure they are sanitary (Kamat and Malkani, 2003). Recommendations are that cloth nappies should be washed at 60⁰C (Environment Agency, 2008).

Disposable nappies:

Positives

Some parents prefer the convenience of disposable nappies as they don't need to be washed and dried. They are good for when you don't have access to a washing machine - for example on holiday (Which?, 2018b).

There are plenty of brands and sizes of disposable nappies to choose from to suit your budget (Which?, 2018b).

They are easily available in any supermarkets or departmental stores and are easy to transport as they are slim and light (Which?, 2018b).

Initially, disposable nappies can be cost effective.

Disposable nappies are thought to be more absorbing than cloth nappies (Kamat and Malkani, 2003).

They are considered to be more sanitary than cloth nappies because of their one-off use (Kamat and Malkani, 2003).

Negatives

Disposable nappies usually end up in landfill where they take a long time to decompose (Which? 2018a).

The choice of disposable nappies can be overwhelming. Some parents find certain brands leak or do not fit their baby well, so you might need to shop around.

The cost of disposable nappies adds up over time (WRAP, 2018).

Disposable nappies might contain harsh chemicals and an absorbent ingredient (sodium polyacrylate) that can cause nappy rashes (Which?, 2018b).

It is thought that toddlers using disposable nappies are harder to potty train as they can't feel the wetness (Which?, 2018b).

Most people don't correctly dispose of nappies, i.e. they leave the poo inside the nappy and throw them. While decomposing, the poo inside the nappy lets off methane gas that could contribute to greenhouse gases contributing to global warming (Environment Agency, 2008; Pollution Issues, 2013).

Whichever type of nappy you choose, one thing is certain: you will be changing a lot of nappies. And your little one will spend a lot of time in nappies. So whichever type you choose, make sure they suit you and your baby.
This page was last reviewed in October 2018.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

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

Some local NCT branches run their own cloth nappy library where you can try a range of cloth nappies out to see what suits your baby best. Find out more from your local NCT branch.

There is a second hand reusable nappy market. You may be able to pick up some second hand reusable nappies at your local NCT sale, for a fraction of the price of new ones.

Alberta L, Sweeney SM, Wiss K. (2005) Diaper dye dermatitis. Pediatrics. 116(3):e450-452. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16140691 [Accessed 16th October 2018]

Environment Agency. (2008) An updated lifecycle assessment study for disposable and reusable nappies. Available at: http://randd.defra.gov.uk/Document.aspx?Document=WR0705_7589_FRP.pdf [Accessed 16th October 2018]

Kamat M, Malkani R. (2003) Disposable diapers : a hygienic alternative. Indian Journal of Pediatrics. Available at: https://www.ncbi.nlm.nih.gov/pubmed/14703226 [Accessed 16th October 2018]

Pollution Issues. (2013) Landfill and nappies. Available at: http://www.pollutionissues.co.uk/landfill-nappies.html [Accessed 16th October 2018]

The Guardian. (2015) Nappies: which are best - disposables or reusables. Available at: https://www.theguardian.com/money/2015/jul/04/nappies-which-best-disposables-reusables-cost-ethics [Accessed 16th October 2018]

Which? (2018a) How to buy the best reusable nappies. Available at: https://www.which.co.uk/reviews/nappies/article/how-to-buy-the-best-reusable-nappies [Accessed 16th October 2018]

Which? (2018b) How to buy the best disposable nappies. Available at: https://www.which.co.uk/reviews/nappies/article/how-to-buy-the-best-disposable-nappies [Accessed 16th October 2018]

WRAP. (2018) Real nappies. Overview. Available at: http://www.wrap.org.uk/content/real-nappies-overview [Accessed 16th October 2018]

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Some parents opt for disposable nappies, while others choose reusable cloth nappies. Others still choose a combination of the two. Many reasons like environmental impact, convenience or costs might affect your choice of nappies. The environment that we all depend on is an important consideration.

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We cover general feeding choices in our Bump Club session, but it can be really useful to attend a more detailed class on breastfeeding too. There are a few good free options to choose from.

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BBC Radio Four Sliced Bread: Reusable Nappies

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BBC Radio Four Sliced Bread: Reusable Nappies

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BBC Radio 4 - Sliced Bread, Reusable Nappies

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Are reusable nappies cheaper and more environmentally friendly than disposable nappies?

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Free, self-paced online course from the Association of Breastfeeding Mothers.
Great for partners and other family members too.

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It doesn't just take the parent who has the breasts to make breastfeeding work, it takes a team and you can make all the difference! It's about knowing how breastfeeding happens, knowing how newborns behave, accessing qualified support when things are challenging, providing encouragement and emotional support - and practical support around the home too.

This FREE course is aimed at,

Expectant couples

grannies and grandads

sisters and the brothers

aunties and the uncles

friends and supporters

The course is broken down in to 5 sections which include articles and videos to empower you to become informed and confident.

1. The decision to breastfeed

2. How breastfeeding works

3. How newborns behave

4. What challenges can arise

5. Where to get help

At the end of each section, you'll also find a 'partner challenge' - an activity you can do with your partner. It can take a few minutes in the car on the way to the supermarket, or however long you like. You can do them at any point in the course or afterwards!

Please note this course is compatible only on Edge, Chrome and Safari Browsers.

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A free online short course to empower you to become informed and confident around the topic of breastfeeding

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Informed is best: How to spot fake news about your pregnancy, birth and baby

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Informed is best: How to spot fake news about your pregnancy, birth and baby

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Buy Informed is best: How to spot fake news about your pregnancy, birth and baby 1 by Amy Brown, Sara Wickham (ISBN: 9781780664903) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

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Monthly Tuesday lunchtime

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Monthly evening online antenatal session with the specialist infant feeding team from the JR.

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Easily create surveys and polls to collect customer feedback, measure employee satisfaction, and organize team events.

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Weekday evenings

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La Leche League Oxfordshire - Supporting families with breastfeeding & chestfeeding in Oxfordshire

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Free online antenatal breastfeeding education sessions using Zoom. We offer this session most months on a weekday evening, from 8 to 9:30 pm. Partners and other supporters welcome!
Please note we do not normally run sessions in August.
These are one-off sessions, but you are welcome to join more than one if you like. Many mothers have found attending our regular in-person meetings to watching babies of different ages breastfeeding to be great preparation.

Our next sessions will be:

Register online using the button below. We will email you a link to the meeting closer to the time.

If you would be interested in coming later in the year, we will add your name to our waiting list and contact you when the next dates are arranged. You can email us your questions or call Jayne at 07940 812964.

We will be looking at:

how to get feeding off to a great start

what to expect in the early days with your new baby

where to find help and support

Our sessions are informal and free, though donations to LLL are always welcome. Pregnant women and people are invited to bring their partner, or someone else close to them who will be supporting them after the birth.

Last updated June 2025

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Online Antenatal Sessions - La Leche League Oxfordshire

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Free online antenatal breastfeeding education sessions using Zoom. We offer this session most months on a weekday evening, from 8 to 9:30 pm. Partners and other supporters welcome! Please note we do not normally run sessions in August. These are one-off sessions, but you are welcome to join more than one if you like.

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Drop in Monday & Friday mornings at the King Alfred Drive Community Centre

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Our Services – Citizens Advice Oxfordshire South and Vale

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Another Padlet with more info for once baby is here

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Another Padlet with more info for once baby is here

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Weekend sessions

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La Leche League Collective - Breastfeeding and Chestfeeding Support

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Doula UK - The non-profit association of doulas in the UK

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Doula UK - The non-profit association of doulas in the UK

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Doulas support the whole family to have a positive experience of pregnancy, birth and the early weeks with a new baby. Find a doula near you.