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Download the free Anya App. Pregnancy, parenting & infant feeding

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Download the free Anya App. Pregnancy, parenting & infant feeding

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Anya is here 24/7 for your pregnancy parenting & breastfeeding questions. Even at 3am. Free Premium upgrade for all parents in Brent

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FREE download for St Helens parents - support with infant feeding & parenting

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FREE download for St Helens parents - support with infant feeding & parenting

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Anya is here 24/7 for your pregnancy parenting & breastfeeding questions. Even at 3am. Free Premium upgrade for all parents in Brent

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Wirral Community Health and Care NHS Foundation Trust

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Henry, Healthy Start, Bright Future - Wirral Community Health and Care NHS Foundation Trust

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This technique involves expressing colostrum in the final few weeks of pregnancy. It can also be referred to as 'colostrum harvesting' and is advocated by some NHS Trusts.

Mothers are normally advised to wait until around 36 weeks before starting antenatal expression. Mums who are having multiple births may sometimes start sooner as giving birth earlier is more likely.
Why do it?
For some mothers, it can be a useful tool that helps ensure their baby will start life without the need for formula supplementation. The importance of exclusive breastfeeding for all babies has been well-established by scientific research.

Colostrum contains vital immunological properties and helps to colonise the baby's gut with healthy bacteria that protect against allergy and disease.

It also contains the perfect balance of proteins, fats and micronutrients needed for human babies as well as acting as a laxative to help the passing of the first tarry meconium stools.

Some babies may experience difficulties with feeding or maintaining their blood sugar levels during the first few days after birth and therefore may require supplementary feeds.

These include babies:

whose mother had diabetes in pregnancy or who has a history of diabetes.

with a cleft lip or palate identified during pregnancy.

with congenital conditions e.g. Down syndrome or cardiac complications.

diagnosed with intrauterine growth restriction.

whose mother is taking beta blockers to control high blood pressure.

who are twins or triplets.

Where there is a family history of cow's milk protein sensitivity or type 1 diabetes, families may be particularly keen to avoid the use of early formula supplementation.

Some women may need to consider supplementing feeds from an early stage if there are concerns over their ability to make and/or secrete milk.

These include women:

who have a breast hypoplasia (limited breast development).

who have had previous breast surgery.

It is important for a mother to discuss her plans to express antenatally with her healthcare provider. It may not be recommended if you've been at risk of preterm labour in previous pregnancies, or have a surgical stitch, for example.

It is recommended to express antenatally by hand rather than use an electric or manual breast pump. Colostrum will be produced in quite small quantities and can easily stick to the bottles or pump parts and be harder to collect. A pump at this stage is likely to be more uncomfortable than gentle hands. Try hand expressing for a few minutes, 2 or 3 times a day.

If you hand express and use a syringe to draw up the individual drips of colostrum, you can use these syringes for storage prior to birth. Your health care provider may be able to supply you with sterile syringes.
How to hand express:

Always wash your hands before expressing.

Applying a warm compress to your breast or expressing after a warm bath or shower can help the flow of colostrum.

Get yourself comfortable. Perhaps seated and leaning slightly forward but find what works best for you.

Start with a gentle breast massage, stroking from the back of your breast towards the nipple to encourage the let-down reflex.

Put your thumb above the nipple and your first few fingers below the nipple. You will be cupping the breast in a 'C' shape.

With your thumb and fingers, feel a few centimetres back from the nipple.

Press back towards your chest, then compress (press your fingers together), and release.

Repeat this process, building up a rhythm. Press, compress, release.

It may be useful to look online for videos of hand expression techniques.

Colostrum should start to arrive drop by drop. Initially it may just be a glisten on the end of your nipple, and it may take a few days of practice before drops appear.

Collect the colostrum into a clean container, like a syringe (1ml or 2ml syringe). If nothing happens, adjust your finger position slightly to find the spot that works for you. Try not to pinch your nipple or slide your fingers uncomfortably over the skin.

Rotate the position of your fingers and thumb around the areola (imagine a clock face) and repeat the expressing process to stimulate and remove colostrum from different parts of your breast.

Express each breast twice during each session.

Colostrum can vary in appearance. Sometimes it may appear quite thick and yellow or orange and at other times paler and thinner. Expressing colostrum antenatally will not decrease or increase your milk supply after baby is born.
Storage of human breast milk
Colostrum can be collected two to three times each day in the same syringe. You will need to store the syringe in the fridge between uses.

At the end of the collecting day, the colostrum can be frozen - place the syringe into a zip-lock bag before putting into the freezer. Label the syringe and bag (separately) with the date and time of when you expressed.

The frozen colostrum can be stored for up to six months in the freezer. Once thawed, it should be used within 24 hours.
Is it safe?
The oxytocin hormone released when expressing, stimulates the uterus. Opinions differ on whether expressing colostrum antenatally is likely to induce labour. Those who advocate it do not believe that expressing would constitute sufficient stimulation to start labour. Sex while pregnant and breastfeeding through pregnancy both release oxytocin and both are generally considered safe while pregnant. If you experience any cramping in your uterus however, you should stop expressing and discuss your choice with your healthcare provider.
Transporting your frozen colostrum
You can take syringes of frozen colostrum into hospital using a freezer block and insulated bag. The colostrum can be defrosted under a running warm tap or at room temperature.

It's a good idea to mention your colostrum stores on your birth plan and make sure staff are aware in advance of your wishes in certain situations. The hospital may have access to a freezer for storage once you arrive.

After the birth, breastfeeding should usually be unrestricted. Ideally, a baby should feed successfully at the breast and the antenatally expressed colostrum would remain unused.

If your baby is experiencing difficulties with breastfeeding at this time, you may be encouraged to express some fresh colostrum to give to your baby. You may also use any colostrum you have brought into hospital with you in preference to using any formula.

If harvested colostrum ends up being 'wasted' because you are able to establish early exclusive breastfeeding, this is a cause for celebration rather than commiseration!

The process of antenatal expressing however, gives you a back-up if things don't go to plan which many families find reassuring. You'll also start your breastfeeding with a good sense of how to hand express and confidence about how your breasts work.

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Expressing your milk before your baby arrives - ABM

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This technique involves expressing colostrum in the final few weeks of pregnancy. It can also be referred to as 'colostrum harvesting' and is advocated by some NHS Trusts. Mothers are normally advised to wait until around 36 weeks before starting antenatal expression.

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Children under the weather?

CATCH is a free NHS health app for parents and carers of children from pregnancy to age 5.

CATCH eases the sense of information overload, particularly regarding pregnancy and children’s health. With the number of resources available, it can be difficult to know who to trust. CATCH provides local NHS-approved information with your best interests at heart, so you won’t need to look elsewhere.

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CATCH - Common Approach To Children's Health

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CATCH eases the sense of information overload, particularly regarding pregnancy and children's health. With the number of resources available, it can be difficult to know who to trust. CATCH provides local NHS-approved information with your best interests at heart, so you won't need to look elsewhere.

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Feel better, live better

Your new St Helens Wellbeing service makes it easier to access a wide range of healthy living and wellbeing support through a ’one stop shop’.
Please see the links below to find out what services we offer and how we can help you

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An introduction to 'Understanding Your Baby'

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What to do if Your Baby is Choking - First Aid Training - St John Ambulance

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How to recognise when a  baby is drinking well

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How to recognise when a  baby is drinking well

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How to recognise when a  baby is drinking well

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Breastfeeding tips, including how to get your baby attached (latched on) properly at the breast, and getting comfortable when you're breastfeeding.

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You've made it through your first 24 hours as a new mom. Maybe you have other children, but you are a new mom all over again... and now it's your baby's second night.

All of a sudden, your little one discovers that he's no longer back in the warmth and comfort - though a bit crowded - womb where he has spent the last 9 months - and it is SCARY out here! He isn't hearing your familiar heartbeat, the swooshing of the placental arteries, the soothing sound of your lungs or the comforting gurgling of your intestines. Instead, he's in a crib, swaddled, in a diaper, a tee-shirt, a hat and a blanket. All sorts of people have been handling him, and he's not yet become accustomed to the new noises, lights, sounds and smells. He has found one thing though, and that's his voice... and you find that each time you take him off the breast where he comfortably drifted off to sleep, and put him in the bassinet - he protests, loudly!

In fact, each time you put him back on the breast he nurses for a little bit and then goes to sleep. As you take him off and put him back to bed - he cries again... and starts rooting around, looking for you. This goes on - seemingly for hours. A lot of moms are convinced it is because their milk isn't "in" yet, and the baby is starving. However, it isn't that, but the baby's sudden awakening to the fact that the most comforting and comfortable place for him to be is at the breast. It's the closest to "home" he can get. It seems that this is pretty universal among babies - lactation consultants all over the world have noticed the same thing.

So, what do you do? When he drifts off to sleep at the breast after a good feed, break the suction and take your nipple gently out of his mouth. Don't move him except to gently slide him into an upright neutral position with his head to the side. Don't try and burp him - just snuggle with him until he falls into a deep sleep where he won't be disturbed by being moved. Babies go into a light sleep state (REM) first, and then cycle in and out of REM and deep sleep about every ½ hour or so. If he starts to root and act as though he wants to go back to breast, that's fine... this is his way of settling and comforting. During deep sleep, the baby's breathing is very quiet and regular, and there is no movement beneath his eyelids.

Another helpful hint... his hands were his best friends in utero... he could suck on his thumb or his fingers anytime he was the slightest bit disturbed or uncomfortable. And all of a sudden he's had them taken away from him and someone has put mittens on him! He has no way of soothing himself with those mittens on. Babies need to touch - to feel - and even his touch on your breast will increase your oxytocin levels which will help boost your milk supply! So take the mittens off and loosen his blanket so he can get to his hands. He might scratch himself, but it will heal very rapidly - after all, he had fingernails when he was inside you, and no one put mittens on him then!

By the way - this might happen every once in a while at home too, particularly if you've changed his environment such as going to the doctor's, to church, to the mall, or to the grandparents! Don't let it throw you - sometimes babies just need some extra snuggling at the breast, because for the baby, the breast is "home."

Copyright © by Jan Barger, RN, MA, IBCLC, FILCA
Lactation Education Consultants

No portion of this text may be copied or reproduced in any manner, electronically or otherwise, without the express written permission of the author (IBCLC@aol.com).

Jan Barger is a mom of three, and proud Grammie of three and one due in 2017. She has been in private practice as a lactation consultant, worked for many years for a pediatric practice in the Chicago 'burbs as their lactation consultant, has a background in all aspects of maternal-child health nursing, and currently teaches with Lactation Education Consultants - an organization that provides education for those aspiring to become IBCLCs. Jan is a past president of ILCA, was on the IBLCE board and exam committee, and is a co-author of Clinical Experience in Lactation: A Blueprint for Internship, and Clinical Instruction in Lactation: Teaching the Next Generation. She lives in Wheaton IL with husband Bob and loves to travel and read.

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You've made it through your first 24 hours as a new mom. Maybe you have other children, but you are a new mom all over again... and now it's your baby's second night.

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Infant milks for parents & carers — First Steps Nutrition Trust

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

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Expressing your milk by hand is a useful skill to have. It may take a bit of time and practice, but once you've mastered it, you'll find it's very helpful.

And the great thing is you only need your hands and a container - rather than a shop-bought breast pump.

Hand expression can be useful in various situations, for example if your baby isn't feeding or latching on well, if you want to stimulate your milk production, or if your breasts become engorged (this is a good way to relieve them).

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Expressing breast milk by hand - Start for Life

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Watch our video and read our step-by-step guide to expressing breast milk by hand.

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

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

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

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

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

Your breastmilk

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

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

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

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

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

Expressing breastmilk

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

When might I need to express?

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

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

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

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

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

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

Hand Expressing

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

Remember to wash your hands first.

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

Relax with a warm drink, music or TV.

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

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

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

Take care not to drag your skin:

Stroke with your fingertips

Roll using your knuckles.

Try using circular movements.

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

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

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

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

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

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

Good hygiene is very important:

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

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

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

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

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

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

Storing expressed breastmilk

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

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

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

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

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

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

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

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

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

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

Safe Storage of breastmilk in the home

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

Why are there variations in recommendations for storing expressed breastmilk?

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

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

Feeding baby expressed breastmilk

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

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

Defrosting frozen breastmilk

How do I defrost my milk?

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

How long can I keep defrosted breastmilk?

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

Why can't I defrost breastmilk in a microwave?

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

Travelling with expressed breastmilk

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

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

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

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

Re-heating expressed breastmilk

How do I re-heat expressed breastmilk?

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

If the milk smells sour DO NOT USE.

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

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

Finding a breast pump

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

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

References

(links checked May 2023)

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

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

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

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

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

Page reviewed and updated November 2019

Variations in Recommendations for Storing Expressed Breast Milk

Written by Anabel Hands

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

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

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

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

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

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

References

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

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

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

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

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

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

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Expressing and storing breastmilk - The Breastfeeding Network

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

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By choosing to make your baby a breastfed baby, you and your partner are giving your baby the very best start. USeful information for partners.

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Dad Matters is a Home-Start project, reaching, engaging and supporting dads in the perinatal period with attachment and bonding, mental health, supporting partners and accessing services.

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Home-Start HOST| Dad Matters| Fatherhood, mental health charity and Dad’s support network

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How can dads and partners support breastfeeding?

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How can dads and partners support breastfeeding?

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When it comes to breastfeeding, you might wonder what you can do to support your partner and baby. The truth is you can make a huge difference.

Did you know that a mum is more likely to choose to breastfeed if she's sure her partner is positive about it? And if she does decide to breastfeed, she's much more likely to have a good experience and manage any difficulties if her partner supports her decision (Tohotoa, 2009; Rempel, 2011). A partner's emotional support is so important for helping mums to breastfeed for longer too (Tohatoa et al, 2009; Su, 2016).

Why is breastfeeding important?

If your partner is breastfeeding your baby - or planning to - that's fantastic because breastmilk has so many benefits for babies. For instance, breastmilk can help to reduce the risk of your baby getting infections and diseases (NHS, 2017). It also contains hormones that help your baby's development (Victora et al, 2016).

Overall, breastfeeding will have a positive impact on your baby's health. What's more, it can influence their health as an adult too (Victora et al, 2016).

Is breastfeeding hard or will my partner just know what to do?

Many parents see breastfeeding as a natural process but it can take time for mum and baby to learn this new skill together. It might take around six weeks to get the hang of it fully (NHS, 2016).

The good news is that with the right support, your partner can overcome any challenges and continue breastfeeding if she wants to. If you think your partner needs more information, support or just someone to talk to, why not give one of our trained breastfeeding counsellors a call on our support line: 0300 330 0700. The line is open every day from 8am to midnight, including bank holidays.

You might find it helpful to read up about breastfeeding and attend a breastfeeding session before your baby is born. This can help you know what to expect and perhaps give you a little more confidence. It can also help you both talk about feeding your baby and raise any questions or worries you might have.

What do I need to know about breastfeeding?

You might find it helpful to know how breastfeeding works and what normal behaviour is for breastfed babies. Here are a few quick and handy facts:

Babies are happier if they're fed as soon as they show signs of being hungry.

Babies usually feed frequently (anything from eight to 12 times or more in 24 hours) in the early weeks, especially during the evenings.

Some babies are slow feeders at first, but they get quicker as they get older.

The more a baby feeds, the more milk their mum makes because it's the removal of milk that drives the production of it.

The Department of Health recommends exclusive breastfeeding for at least your baby's first six months. Breastfeeding is also beneficial for toddlers because it gives them a health boost every time they feed. So your partner can breastfeed your baby for as long as they both want to.

Nipple soreness or pain during feeding might be a sign that a baby needs some adjustment to their attachment at the breast. If there is soreness or pain when breastfeeding, talking to a healthcare professional or breastfeeding counsellor can help.

Women enjoy feeding more when they are comfortable and relaxed.

(Department of Health, 2011; La Leche League, 2016; NHS, 2016)

What can I do to help support my partner with breastfeeding?

There are lots of things you can do to support and encourage breastfeeding.

Here are 10 tips:

1. Boost your partner's confidence by encouraging her and being positive about her progress. As with learning any new skill, reassurance and praise are a massive help.

2. Listen and talk honestly about how you each feel about finding your way with your new baby.

3. Be involved with your baby in other ways so that the caring is shared (see below).

4. Help to reduce the household chores so your partner can feed your baby for as long and as often as they need.

5. Try to help your partner to relax by giving them a massage.

6. Women don't need to eat anything special while breastfeeding, but it's a good idea to encourage your partner to eat and drink regularly.

7. Help her get specialist support if she's struggling with breastfeeding. As mentioned above, you can both talk to one of our breastfeeding counsellors on 0300 330 0700.

8. Help out by bottle feeding your baby expressed milk once your partner and baby have got the hang of breastfeeding (see below).

9. Accept your partner's decision on when to stop breastfeeding.

10. Try to remember that with your support, breastfeeding can quickly become just another part of your family life.

(Rempel et al, 2010)

What practical support can I give to my baby if my partner is breastfeeding?

You might expect to feel like a bit of a spare part with feeding but it's good to remember that each parent plays a different and vital role. The decision on how you feed your baby is certainly a joint one (deMontigny et al, 2018). It might take a while to get used to the different parts you play though.

Whatever you decide to do, you might actually find feeding is less important to you than you expected anyway. Especially if you're hands-on with your baby in different and rewarding ways.

Tips for being a hands-on partner with your baby

Changing nappies and generally caring for your baby - it's great if you can spend time with your baby and interact (see below) with them while you're looking after them.

Bathing your baby - you could bath your baby or even have a bath with your baby. You'll both enjoy the bonding benefits of skin-to-skin contact and one-to-one time together (NHS, 2018).

Talking and playing - babies enjoy hearing gentle sounds. They even recognise the muffled tones of people talking from their time in the womb and they'll be aware of familiar voices like yours (Lee and Kisilevsky, 2013). So a chat with your baby might be a little one-sided but rest assured, they know it's you. Socially interacting with your baby through their senses helps to stimulate their brain development; for example, you could pull some different expressions (Boucenna et al, 2010).

Baby carrying - this means taking your baby out and about in a sling. It can be a rewarding and comforting experience for both you and your baby (Miller, 2019).

For more ideas on being a hands-on parent, see our article about bonding with and getting to know your baby.

How can I share feeding our baby?

If you're keen to feed your baby, you could give them expressed breastmilk from a spoon, syringe, cup or a bottle. But only introduce your baby to a bottle once breastfeeding is going well. For more on expressing, see our 10 bottle feeding tips for breastfed babies article.

And once your baby's moved on to solid food, there are so many ways you can get involved with that...chopping, mashing, cleaning up all the food that ends up on the floor...

I want to support breastfeeding but will it affect our sex life?

Possibly, but tiredness - and your partner's birth experience and recovery - is more likely to affect their sex drive rather than breastfeeding (Rowland et al, 2005). See our article about breastfeeding and sex for more details.

What if I feel uncomfortable about my partner breastfeeding in public?

If you're feeling uncomfortable or nervous about your partner breastfeeding in public, have a chat with her so you can talk it through. Maybe you're worried about your partner showing her breasts in public? Yet in reality, very little breast actually shows when a baby is feeding. You might have even seen a mum breastfeeding before without realising it.

It might also help to talk to other families where the mum is breastfeeding and find out about both partners' experiences of it. The chances are, you'll change your mind as you get used to seeing breastfeeding.

It's good to know that breastfeeding in public is protected by the law under the Equality Act 2010. That means providers of any services or facilities open for the public are not allowed to discriminate against women who are breastfeeding (Maternity Action, 2019).

Many places now welcome breastfeeding and have special facilities for mums if they'd prefer to feed in private.

Some mums might feel uncertain themselves about feeding in public at first and may appreciate the reassurance of having their partner with them.

At the end of the day...

Don't underestimate the huge difference you can make if your partner is breastfeeding. With you both on board, breastfeeding can quickly become an everyday part of your lives (Rempel, 2011).
This page was last reviewed in October 2017.
Further information

NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our helpline on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.

You might find attending one of our Early Days 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.

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.

Visit our breastfeeding support contacts page.

NHS Choices breastfeeding information.

National Breastfeeding Line (government funded): 0300 100 021.

Health Talk has some interesting videos about different people's experiences of breastfeeding, click here to view them.

Boucenna S, Gaussier P, Andry P, Hafemeister L. (2010) Imitation as a communication tool for online facial expression learning and recognition. 2010 IEEE/RSJ International Conference on Intelligent Robots and Systems, Taipei: 5323-5328. Available at: https://ieeexplore.ieee.org/abstract/document/5650357 (Accessed 1st July 2018)

deMontigny F, Gervais C, Larivière-Bastien D, St-Arneault K. (2018) The role of fathers during breastfeeding. Midwifery. 58:6-12. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29272696 (Accessed 1st July 2018)

Department of Health. (2011) Breastfeeding. Available at: http://webarchive.nationalarchives.gov.uk/+/http://www.dh.gov.uk/en/Publichealth/Nutrition/Nutritionpregnancyearlyyears/DH_127625 (Accessed 1st July 2018)

La Leche League. (2016) Still nursing? Available at: https://www.laleche.org.uk/still-nursing/ (Accessed 1st July 2018)

Lee GY, Kisilevsky BS. (2013) Fetuses respond to father's voice but prefer mother's voice after birth. Dev Psychobiol. 2014 Jan;56(1):1-11. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23817883 (Accessed 1st July 2018)

Miller R. (2019). Babywearing education in the neonatal intensive care unit. The International journal of childbirth education: the official publication of the International Childbirth Education Association. 34. 43-47. Available at: https://www.researchgate.net/publication/334151320_Babywearing_Education_in_the_Neonatal_Intensive_Care_Unit (Accessed 1st July 2018)

NHS. (2016) How to combine breast and bottle feeding. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/combining-breast-and-bottle/ (Accessed 1st July 2018)

NHS. (2017) Benefits of breastfeeding. Available at: http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/benefits-breastfeeding.aspx (Accessed 1st July 2018)

NHS. (2018) Washing and bathing your baby. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/washing-your-baby/ (Accessed 1st July 2018)

Rempel LA, Rempel JK. (2010) The breastfeeding team: the role of involved fathers in the breastfeeding family. J Hum Lact. (2):115-21. Available at: http://journals.sagepub.com/doi/abs/10.1177/0890334410390045 (Accessed 1st July 2018)

Rowland M, Foxcroft L, Hopman WM, Patel R. (2005) Breastfeeding and sexuality immediately post partum. Can Fam Physician. 2005 Oct;51:1366-7. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1479788/ (Accessed 1st July 2018)

Su M, Ouyang YQ. (2016) Father's role in breastfeeding promotion: lessons from a quasi-experimental trial in China. Breastfeed Med. 11:144-9. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26836960 (Accessed 1st July 2018)

Tohotoa J, Maycock B, Hauck Y, Howat P, Burns S, Binns C. (2009) Dads make a difference: an exploratory study of paternal support for breastfeeding in Perth, Western Australia. Int Breastfeed J. 4:15. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2788531/ (Accessed 1st July 2018)

Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC; Lancet Breastfeeding Series Group. (2016) Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 387(10017):475-90. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26869575 (Accessed 1st July 2018)

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How can dads and partners support breastfeeding? | Baby & toddler, Feeding articles & support | NCT

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This article looks at how dads and partners can help support a new mum who is breastfeeding in the early days.

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This information was updated in December 2022. A PDF version is available here.

"I was surprised by how suddenly I felt ill. We went to a wedding and I only missed one feed.
Within a couple of hours I felt fluey and achey. My GP was reluctant to prescribe antibiotics,
saying they were often not needed if I kept feeding. I also took ibuprofen tablets which helped
me cope. I was surprised how well the self-help worked and that I never needed a prescription.
I felt very miserable and depressed when I had the symptoms, wondering whether
breastfeeding was worth all this - but once I felt better I remembered how good it feels."

Mastitis means inflammation of the breast.

The first sign of mastitis is a swollen usually painful area on the breast. On darker skin tones
there might be a darkening of the skin and on lighter skin tones this might be visible as a red
area on the breast. However, it is important to note that there could be no visible change in
skin colour at all. The inflammation and swelling is not always a sign of infection (WHO, 2000).
Harmful bacteria are not always present: antibiotics may not be needed if self-help measures
are started promptly. Very rarely mastitis can develop into a more serious condition which
needs urgent hospital admission and IV antibiotics (RCOG, 2012).

You may get mastitis when milk leaks into breast tissue from a blocked duct. The body reacts
in the same way as it does to an infection - by increasing blood supply. This produces the
inflammation.
NB You may not have all of the above signs during mastitis.
Prevention of Mastitis

A localised area in the breast which is painful to the touch, often in the outer upper
area. Some mums might notice a change of colour or a red area on their breast.

A lumpy breast which feels hot to touch.

The whole breast aches and may appear swollen and skin may be reddened or darker,
depending on skin tone.

Flu like symptoms - aching, increased temperature, shivering, feeling tearful and tired
(Jahanfar et al., 2013). This feeling can sometimes start very suddenly and get worse very quickly.

Signs that the Baby is Well Attached

Try to avoid suddenly going longer between feeds. If you are intending to reduce breastfeeding, cutting down gradually reduces the risk of mastitis.

Make sure your breasts don't become overfull

Avoid pressure on your breast from clothing and fingers

Start self-help measures at the first sign of any lumpy or swollen areas on your breast

Factors which make mastitis more likely:

Difficulty with attaching your baby to the breast - this may mean that the milk is not

being removed effectively and milk may leak into the breast tissue

Pressure from tight fitting clothing, particularly your bra, or a finger pressing into the

breast during feeds

Engorgement or a blocked duct

Sudden changes in how often the baby is feeding, leaving the breasts feeling full

Injuries, such as bumps or knocks from toddlers

Self-Help Measures
Mastitis starts with poor milk drainage. If your baby is not effectively attached to your breast,
or has difficulty feeding, it may be hard for the baby to remove the milk and some parts of
your breast may not be drained during a feed. Improving the way your baby is attached at
the breast will reduce the chance of you getting mastitis again. If in doubt, contact your
midwife, health visitor or breastfeeding peer supporter for help with attaching your baby for
feeding. You can also contact the National Breastfeeding Helpline.

Your baby's chin is firmly touching your breast.

Your baby's mouth is wide open

Your baby has a large mouthful of breast.

If you can see the darker skin around your nipple, you should see more dark skin above your baby's top lip than below your baby's bottom lip.

It doesn't hurt you when your baby feeds (although the first few sucks may feel strong).

No change in shape or colour of the nipple after feeds e.g. it should not be lipstick shaped or have a pressure line across the nipple

Your baby's cheeks stay rounded during sucking.

Your baby rhythmically takes sucks and swallows (it is normal for your baby to pause from time to time).

Your baby finishes the feed and comes off the breast on his or her own.

Your baby produces 6 or more heavy wet nappies every 24 hours (from 7 days old)

Your baby produces at least two yellow poos at least the size of a £2 coin every 24 hours (from 7-28 days old). See UNICEF's breastfeeding checklist for more details.

If your mastitis comes back after you have taken a full course of antibiotics, or is unusually severe, it is good practice to send a sample of milk for bacteria tests. This will help the GP chose the correct antibiotic for your symptoms (Jahanfar et al., 2013). For public health reasons doctors try to avoid antibiotics that are not essential or are unlikely to be effective. It is important that you finish the whole course of antibiotics to make sure that you recover fully and to help prevent the mastitis coming back with resistant bacteria (NICE NG15).
When should I contact my GP or health visitor? If you do not begin to feel better after 24 hours despite using self-help measures, or especially if you start to feel worse, you should speak to your GP or health visitor. You may need to take antibiotics.
These will also help to clear blocked ducts and engorgement. Most cases of mastitis can be improved or resolved with self-help measures.
When should I seek help urgently?

Keep on breastfeeding - you may feel ill, in pain, tearful or discouraged but continuing to breastfeed will help you to get better, and your breastmilk is still the best food for your baby

Feed your baby frequently and responsively (whenever your baby seems like they want to feed), and/or pump to your normal routine (Mitchell et al., 2022; Douglas 2022)

Don't attempt to "empty the breast" by prolonging feeds or expressing extra milk between feeds. You may see this suggested in some places, but the current research suggests you should aim to meet your baby's needs, but avoid increasing your supply beyond that as it could make the inflammation worse. (Mitchell et al., 2022; Douglas 2022)

Try to rest as much as you can, as this will help you recover

Check that your baby is effectively positioned and attached to your breast - if in doubt seek help from your midwife, health visitor or breastfeeding supporter, as even a minor tweak can make a difference.

Try feeding with your baby in different positions.

If necessary, soften your breast, by expressing a little milk or running warm water over it, so that the baby finds it easier to feed well.

Some mothers find warm compresses are soothing, and warmth on the nipple can aid let-down. However, take care using these as compresses that are too hot or used frequently could increase swelling and inflammation. Cool compresses may ease symptoms in between feeds. (Mitchell et al., 2022; Douglas 2022)

Avoid any firm pressure or massage to the breast, or use of items such as an electric toothbrush to massage lumps or sore areas. This could cause tissue damage and increase inflammation (Mitchell et al., 2022; Douglas 2022). Any pressure you apply to your breast should be no firmer than stroking a cat.

Check for clothing or anything else which is pressing into your breast. This includes a bra - some women find it helpful to go without.

Medical Treatment for Mastitis
If you feel these symptoms beginning again, start self-help measures right away.

You should contact your GP if the area becomes round and swollen or, if you can see redness or a change of colour on your skin and the pattern of the colour change/redness changes. Redness may be less visible on darker skin tones. Mastitis can develop into an abscess (a painful collection of pus). There is more information about this here: https://www.nhs.uk/conditions/breast-abscess/.
The World Health Organisation (WHO) recommend Flucloxacillin 500 milligrams four times a day as first line treatment with erythromycin 250-500 milligrams four times a day or cefalexin 250-500 milligrams four times a day if the mother is penicillin allergic. Other options have been suggested by Jahanfar et al., (2013).
If you feel seriously unwell, dizzy, confused, develop nausea, vomiting or diarrhoea or slurred speech along with the symptoms of mastitis you need to seek urgent medical attention. These can be signs that mastitis is developing into sepsis. If severe, this is a medical emergency which needs urgent hospital admission and IV antibiotics. (NHS Choices: Sepsis, RCOG, 2012:6.1)

This information comes from the Drugs in Breastmilk Service.
References

Ibuprofen reduces the inflammation, relieves pain and reduces temperature. Take 400mg three times a day after food. Ibuprofen should not be taken by women who have asthma, stomach ulcers or are allergic to aspirin. The levels of ibuprofen which pass to the baby are small. Ibuprofen is safe to take whilst breastfeeding. See https://www.breastfeedingnetwork.org.uk/analgesics/ for more information.

Paracetamol relieves pain and reduces temperature but has no anti-inflammatory action. Take two 500mg tablets four times a day.

Aspirin should not be taken by breastfeeding mothers.

Antibiotics may be needed if no improvement is seen with self-help measures. Mostantibiotics can be safely taken whilst breastfeeding.

It is essential that breastfeeding is not interrupted during mastitis.

Note: Antibiotics can make the baby produce loose, runny motions and become irritable, colicky and restless. This lasts for a short time and will get better when you finish the antibiotics.

Jahanfar S, Ng CJ, Teng CL. Antibiotics for mastitis in breastfeeding women. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD005458. DOI:10.1002/14651858.CD005458.pub3 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005458.pub3/abstract (accessed 19 November 2020)

Crepinsek MA, Crowe L, Michener K, Smart NA. Interventions for preventing mastitis after childbirth. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD007239. DOI:10.1002/14651858.CD007239.pub3. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007239.pub3/full (December 2022)

Hale T., Medications and Mothers' Milk 2014 (16th Ed),

NICE guideline [NG194] Published: 20 April 2021 https://www.nice.org.uk/guidance/ng194/chapter/Recommendations (accessed December 2022)

World Health Organization. 2000, Mastitis: causes and management, WHO: Geneva http://apps.who.int/iris/bitstream/10665/66230/1/WHO_FCH_CAH_00.13_eng.pdf?ua=1.(accessed December 2022)

NICE guidelines [NG15] Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use www.nice.org.uk/guidance/ng15 (accessed December 2022)

NHS Choices: Sepsis www.nhs.uk/conditions/Bloodpoisoning/Pages/Introduction.aspx (accessed December 2022)

Royal College of Obstetricians and Gynaecologists (RCOG) (2012) Green-top Guideline No. 64b. Bacterial Sepsis following Pregnancy: 6.1. www.rcog.org.uk/globalassets/documents/guidelines/gtg_64b.pdf (accessed December 2022)

Unicef: https://www.unicef.org.uk/babyfriendly/wpcontent/uploads/sites/2/2016/10/mothers_breastfeeding_checklist.pdf (Accessed December 2022)

Mitchell, K. B., Johnson, H. M., Rodríguez, J. M., Eglash, A., Scherzinger, C., Zakarija-Grkovic, I., Cash, K. W., Berens, P., Miller, B., & Academy of Breastfeeding Medicine (2022). Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022 Breastfeeding medicine : the official journal of the Academy of Breastfeeding
Medicine, 17(5), 360-376. https://doi.org/10.1089/bfm.2022.29207.kbm
Please note this information is not yet available in print. The previous print version has now been withdrawn and should no longer be used. A new print version is planned for 2023.
Douglas P. (2022). Re-thinking benign inflammation of the lactating breast: Classification,
prevention, and management. Women's health (London, England), 18, 17455057221091349.
https://doi.org/10.1177/17455057221091349

Original leaflet compiled by Wendy Jones MBE Pharmacist and Phyll Buchanan
Breastfeeding Network Supporter and Tutor, in 2015. With thanks to Magda Sachs who
developed earlier versions

This version revised 22 December 2022.

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Information on mastitis and breastfeeding, updated December 2022 and provided by the Breastfeeding Network

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Every day hundreds of babies are being breastfed outside the home - it is a bit like being pregnant, you don't notice that anyone else is until it happens to you and then suddenly it seems like everyone is expecting a baby!

So even though babies are feeding when out and about, most of the time we just don't notice and neither does anyone else. And even when they do realise most people rarely comment.

If someone stares at you it doesn't mean they disapprove. We heard from one mum who was feeding her baby and an elderly couple were watching her. When they got up and began making their way over to her she wondered what they were going to say. It was only to comment on how lovely it was to see a breastfeeding baby. The women had breastfed her own children and it had brought back fond memories.

But, sadly, very rarely, someone, somewhere decides to make a fuss, which may get a lot of publicity and make mothers think that it happens all the time. This just isn't the case - babies are being fed out and about everyday but we don't see them all in the newspaper so we know that, almost all of the time, breastfeeding goes on without any fuss or bother at all.

If you have been unlucky enough to have someone make you feel uncomfortable or they have tried to stop you feeding your baby then it can be useful to know what your rights are.

In England and Wales the Equality Act states that it is sex discrimination to treat a woman unfavourably because she is breastfeeding.

In Scotland breastfeeding is protected by the Breastfeeding etc. (Scotland) Act 2005 under which it is an offence to stop someone in a public place from feeding their child, if under two, with milk. The legislation allows for fines for preventing breastfeeding in public places.

There is more information on Citizens' Advice Website.
Information for mothers
The NHS have a webpage about breastfeeding in public, which includes video's and useful suggestions.

The Equality Act 2010 is the law which bans unfair treatment and helps achieve equal opportunities in the workplace and in wider society.

The Breastfeeding etc (Scotland)Act 2005 gives the letter of the law.

The Scottish government booklet Advice for Employers gives accessible advice for employees and employers.

Maternity Action (a national charity working to end inequality) have an information sheet available to download on Breastfeeding in public places.

It may also be useful to contact the Government equalities office if you have been unfairly treated.

External websites also have some ideas and tips on Breastfeeding in Public:

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Breastfeeding in Public - The Breastfeeding Network

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Every day hundreds of babies are being breastfed outside the home - it is a bit like being pregnant, you don't notice that anyone else is until it happens to you and then suddenly it seems like everyone is expecting a baby! So even though babies are feeding when out and about, most of the time ...

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Including Reverse Pressure Softening

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It is quite normal for breasts to become larger and feel heavy, warmer and uncomfortable when your breastmilk supply increases, often about 2 to 5 days after your baby is born.

This usually doesn't affect milk flow or the ability of your baby to attach to your breast.

However, in some cases, a mum's breasts can become very hard, swollen and tender and her nipples become stretched and flattened. The milk will not flow well and it can be difficult for her baby to attach to the breast. This is called engorgement.

Engorgement happens in both breasts at the same time. It can involve the whole breast, even under the armpit.

Is it really engorgement?

You can get symptoms similar to engorgement beyond the early weeks if one or both of your breasts become very full. This may happen if:

your baby goes longer between feeds or feeds for less time.

they sleep for longer.

they wean too quickly.

You can relieve very full breasts by feeding your baby or by hand expressing some milk to soften your breast. Some of the tips below may also be helpful.

Could it be oversupply?

If your breasts continue to fill up quickly after feeds beyond the first 6 to 8 weeks, it may be taking a little longer than usual for them to match your baby's needs. You may have an oversupply.

If you are pregnant or in the early days or weeks after your baby's birth, read on to find out how to prevent and relieve engorgement.

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Baby can't attach? Huge swollen boobs? Frequent feeding and reverse pressure softening can help.

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College of Human and Health Sciences, Swansea University

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An update on our information on, and approach to, persistent breast and nipple pain when breastfeeding - The Breastfeeding Network

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by the DiBM staff team and Emma Thomas You may have noticed recently that the Drugs in Breastmilk (DiBM) factsheets on thrush of the nipple or breast have been taken down. This is because our clinical pharmacy team have spent the last six months challenging the status quo when it comes to persistent nipple or breast […]

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How can I tell if breastfeeding is going well?

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How can I tell if breastfeeding is going well?

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

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BabyBeats Exercise & Sensory Classes - SHIFT20 - 20% Discount Code

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BabyBeats Exercise & Sensory Classes - SHIFT20 - 20% Discount Code

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BabyBeats

Suitable from post 6 week check.

Using exercises, moves and stimulating sensory play to enhance your baby's development and support your postnatal body after pregnancy and birth.

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Suitable from conception to birth.

Our well designed programme follows the progress of each trimester making exercises suitable for each woman with opportunities throughout to modify or progress each movement.

Use SHIFT20 to receive a 20% on your booking :)

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Mother and Baby Classes in Warrington at BabyBeats

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Mother and Baby Classes in Warrington at BabyBeats

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BabyBeats is a unique mum and baby class that uses a combination of elements such as Baby Massage, Baby Yoga, Sensory Play, Postnatal exercise, Pelvic Floor and Stretching to allow Mum and Baby to get the most from each class. Classes running across Warrington.

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Read more for support for parents on tongue-tie

Many babies have a piece of membrane under their tongue (the frenulum) which does not usually cause problems. Tongue-tie (ankyloglossia) occurs when the frenulum is abnormally short, stopping the tip of the tongue from protruding beyond the lower gum. This may cause problems with feeding as a result of the inability to move the tongue in a normal way and therefore attach and suck effectively. The frenulum may reach the tip of the tongue and be easily seen, and may be either thin and stretchy or thicker/tighter. A posterior frenulum, which is at the back of the tongue, can be less easy to see and in some cases may only be felt. If you and/or your baby are experiencing feeding difficulties, an assessment of your baby's tongue function and a feeding assessment by a specially trained professional will determine whether a division of the membrane ( frenulotomy) could help.

Many tongue-ties are asymptomatic and do not require treatment, and some may resolve spontaneously over time. In some instances, support to improve attachment is all that is needed. However, if the condition is causing problems with feeding, surgical division of the lingual frenulum can be recommended and carried out as early as possible. This may enable the mother to continue breastfeeding rather than having to switch to artificial feeding.
NICE has approved the division of tongue-tie.

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Many babies have a piece of membrane under their tongue (the frenulum) which does not usually cause problems. Tongue-tie (ankyloglossia) occurs when the frenulum is abnormally short, stopping the tip of the tongue from protruding beyond the lower gum.

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The 0-19+ Service includes:
• Health Visiting
• School Nursing
• Enhancing Families Programme

Parents, carers and health professionals can contact the service on the new telephone number - 01744 411277.

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Wirral Community Health and Care NHS Foundation Trust

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New timetable - starting Tuesday 3 January 2023

Every Monday, 10.00am - 12noon (drop-in)
Newton Children's Centre, Patterson Street, Newton-le-Willows, St Helens WA12 9PZ
Every Tuesday, 9.30am - 11.30am (drop-in)
Sutton Children's Centre, Ellamsbridge Road, Sutton, St Helens WA9 3PY
Every Wednesday, 9.30am - 11.30am (appointment only)
Moss Bank Children's Centre. Kentmere Avenue. Moss Bank. St Helens. WA11 7PQ
Every Thursday, 9.30am - 11.30am (drop-in)
Lowe House Health Centre, 103 Crab Street St Helens WA102DJ

Fourways Children's Centre, Burnage Avenue, St Helens WA9 4QB
Every Thursday, 9.20am - 12noon (appointment only)
Woodside Health Centre, Woodside Road, Haydock, WA11 0NA
To book an appointment please call the team on 01744 411277 .

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Well Baby Clinics - timetable (St Helens) - Wirral Community Health and Care NHS Foundation Trust

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Well Baby Clinics across St Helens - Monday to Friday. Drop-in and appointment only clinics.

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0151 290 4166
Monday-Friday 9-5

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Whiston Hospital Maternity & Special Care Baby Unit

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Whiston Hospital Maternity & Special Care Baby Unit, Prescot, Merseyside. 4.3K likes. All the latest news from Whiston Hospital's Maternity Unit

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Are you experiencing pain while breastfeeding, possibly combined with slow weight gain for your baby? While the vast majority of such breastfeeding problems can be resolved by adjusting positioning and attachment, and with good breastfeeding management, occasionally tongue tie might be the cause of the problem.

Tongue tie (ankyloglossia) is caused by a tight or short lingual frenulum (the membrane that anchors the tongue to the floor of the mouth). The frenulum normally thins and recedes before birth. Where this doesn't happen, the frenulum may restrict tongue mobility. Tongue tie often runs in families and is thought to be more common in boys than girls. There is an association between high or unusual palates and tongue tie, because restricted tongue movement can affect the shape of the palate.

Breastfeeding challenges can also occur for other reasons. Identifying the cause is important when deciding on appropriate solutions, so seek help from someone skilled.

Identifying tongue tie

When your baby tries to lift their tongue or move it forwards it may appear misshapen, short or heart-shaped, with the frenulum clearly pulling its centre down and restricting its movement. Or you may be able to see or feel firm tissue where their tongue meets the floor of his mouth. Degrees of tongue tie vary and it can be difficult to diagnose accurately. A short, tight, posterior tongue tie is rarer, but may be particularly hard to spot.

How breastfeeding may be affected

Tongue tie affects tongue movement to varying degrees. The shorter and tighter it is, the more likely it is to affect breastfeeding. Some babies with a tongue tie breastfeed well from the start, others do so when positioning and attachment are improved. But any tongue tie that restricts normal tongue movement can lead to breastfeeding difficulties. A baby needs to be able to move their tongue freely and extend it over the lower gum with their mouth open wide to be able to breastfeed well. The symptoms below are all associated with poor attachment that may be caused by tongue tie.

A baby may:
* Be unable to latch on to the breast at all.
* Be unable to latch on deeply, causing nipple pain and damage.
* Have difficulties staying on the breast, making a clicking sound as he loses suction.
* Splutter and choke when coping with fast flowing milk.
* Breastfeed constantly to get enough milk.
* Have poor weight gain or need supplementation to maintain adequate weight gain.
* Develop jaundice that needs treating.
* Be fussy at the breast when the milk flow slows.
* Develop colic.

A mother may experience:
* Pain during feeds, with damaged nipples. Her nipple may be compressed or distorted into a wedge shape like that of a new lipstick immediately after feeding, often with a stripe at its tip.
* Engorgement, blocked ducts and mastitis because of ineffective milk removal.
* Low milk production because of ineffective milk removal.
* Oversupply-if her baby compensates for not being able to breastfeed well by nursing very frequently.
* Tiredness, frustration and discouragement.
* A premature end to breastfeeding.

Breastfeeding is important for every baby

Though sometimes needed as a temporary supplement if your milk production is very low, introducing infant formula is not the answer. It has short-term and long-term health risks for both your baby and you. A baby with tongue tie can also have difficulties with bottlefeeding. Milk may leak from his mouth during feeds and he may suffer from colic.

Treatment

Where a tongue tie is causing breastfeeding problems, treatment options are available and effective- especially if the treatment is prompt. Although attention to positioning and attachment can help maintain breastfeeding and improve comfort to a certain extent, there is evidence that treating tongue tie by frenotomy (see below) is effective in resolving breastfeeding difficulties. Weight gain can improve dramatically. As well as the continued breastfeeding benefits, continuing to breastfeed after frenotomy maximises a baby's chance of normal mouth (palate), speech and dental development. This includes tongue mobility for licking and moving particles of food around the mouth, helping prevent tooth decay.

Keeping breastfeeding going

Mastering the art of breastfeeding can sometimes be a challenge and it takes determination to keep going if you are in pain. The information here can help you keep breastfeeding, both before and after treatment.

Soften your breast

A baby with tongue tie may find it easier to latch on if your breast is soft so breastfeed frequently to avoid engorgement. When your baby bobs their head and licks the nipple, they naturally makes it easier to latch on. Or you can use reverse pressure softening to move fluids away from the nipple area so your baby can latch on well. Press all five fingertips of one hand around the base of the nipple. Apply gentle steady pressure for about a minute to leave a ring of small dimples on the areola. You can also press with the sides of your fingers. Place your thumb on one side of the nipple and two fingers on the other side where your baby's lips will be. Gently hand express a little milk if needed.

Biological nurturing™
A baby often instinctively attaches more deeply and comfortably if they can snuggle up close to their mother's chest for periods of time. Try letting your baby lie on your body as you recline so both their chest and tummy are against you. This kind of 'laid-back' breastfeeding contact is known as Biological Nurturing™ and can be done skin-to-skin or with you and your baby lightly clothed-whatever is more comfortable and convenient for you both. Because gravity helps a baby keep their tongue forwards, this can make a real difference to how well your baby feeds and how much milk you make. See picture above and Online Information section for details of an online video.

A deeper latch
Help your baby get as deep a latch as possible at the breast. This will maximise the amount of milk they get and minimise nipple pain.

If your baby retracts (pulls back) their tongue when they open their mouth, try sliding their chin a little further from the nipple so he can feel the 'fatter' part of the breast with his tongue. Denting the breast at the edge of the areola with a finger and placing your baby's chin in the dent may also help.

You could also try placing your thumb or finger near the base of the nipple where your baby's upper lip will be. If you press, your nipple will tilt away from your baby, presenting them with your breast rather than your nipple. As they open wide, snuggle them in close and use your thumb or finger to tuck the breast into their mouth. Your nipple will be taken in last and unroll in their mouth. If needed, you can then slip your finger out. An LLL Leader can give you further suggestions to help you improve your baby's positioning and attachment

Encourage tongue mobility

To encourage your baby to move their tongue forward, you can also try:
* Reclining with your baby on top of you. Try leaning forward and back yourself to understand how gravity affects tongue position.
* Encouraging them to lick milk from their lips or from your nipple before and after feeds.
* Sticking your tongue out at your baby to encourage them to copy you.

Maintain milk production

If your baby is sleepy or has jaundice, or if you have engorgement or inverted nipples, then a tongue tie can make things worse. If they are not able to take enough milk directly at the breast then you will need to express it and give it to your baby until they are able to breastfeed effectively. Express by hand and/or with a pump at least 8 times a day if your baby is not draining the breast well. This will maintain your milk production and ensure they get enough milk.

Small amounts of expressed milk can be offered by spoon, cup or syringe while you both learn how to breastfeed. Bottles or dummies can confuse your baby's sucking technique so consult an LLL Leader about breastfeeding friendly ways to bottlefeed or about using a nursing supplementer. This device delivers extra milk through a tube along your breast as your baby nurses, avoiding the need for bottles.

An unusual palate

Restricted tongue movement caused by tongue tie may affect the shape of a baby's palate, leading to a high palate or a bubble palate with a high spot. These may be a factor in broken suction, a clicking sound and pain during breastfeeding. A baby with an unusual palate may also resist a deeper latch due to gagging.
The following may help.
* Start with a clean finger with closely trimmed nail.
* Touch your baby's lips and wait until they open their mouth.
* Gently slide in your finger, pad side up along his hard palate, stopping just before the gag reflex is triggered.

Make this a pleasant game and, over a few days, gradually move your finger back to overcome sensitivity. After a tongue tie is divided, a baby's increased tongue movement helps the palate shape become more normal

Treating Tongue Tie

What can be done?
Frenotomy-dividing the tongue tie-can dramatically improve breastfeeding comfort and efficiency for both mother and baby. Dividing a tongue tie is a quick and simple procedure. No anaesthetic is needed for a baby under six months of age.

There are health professionals around the UK who have been specifically trained to divide tongue ties. For treatment on the NHS, you will need a referral from your midwife, health visitor or GP. Knowledge about tongue ties and how they affect breastfeeding varies, so it is worth persisting and seeking a second opinion. In areas where only GPs can refer, your midwife or health visitor may be able to give a recommendation to your GP or suggest seeing a particular GP. Private treatment may also be an option. See Further Reading for information on finding a practitioner trained to divide tongue ties

Is waiting an option?
Sometimes a very thin tongue tie breaks spontaneously or can be stretched by gentle massage of the frenulum. The earlier a tongue tie is divided, the easier it is to resolve any breastfeeding difficulties. Dividing a tongue tie in a baby over six months old is also a more complicated procedure and usually requires a general anaesthetic.

Frenotomy-what will happen?
After the health professional's initial assessment, your baby will be swaddled and held (often by an assistant) so they stay still during the procedure, which only takes a minute or two. The health professional lifts the tongue and divides the frenulum by cutting it with a pair of round-ended sterile scissors or by cauterising it.

Does it hurt?
No anaesthetic is needed for a very young baby as having a tongue tie divided only hurts a little, if at all. Some babies protest more at being swaddled than about the treatment. Others sleep right through the procedure! You will be asked to breastfeed your baby as soon as the procedure is over, to offer comfort, clean the wound and get their tongue moving as soon as possible. The inside of a baby's mouth heals very quickly. The only treatment usually needed is to breastfeed to keep the wound clean and keep his tongue mobile. There may be a white patch under your baby's tongue, but this heals within 24 to 48 hours.

If things don't resolve
Usually a mother notices an instant improvement in her comfort during breastfeeds. Sometimes it takes a week or two for a baby to adjust to their tongue's greater mobility. An older baby may find it harder to adjust to increased tongue mobility and tongue exercises may be recommended. Occasionally a baby's frenulum needs dividing a second time, usually because the division was not quite extensive enough the first time. If you suspect that the initial procedure has not resolved your baby's breastfeeding problems arrange another consultation. Do persist with finding solutions. If several factors are involved it can take time and expertise to resolve the problem. An LLL Leader can suggest further paths to explore and provide ongoing support.

Painful nipples

Using different feeding positions can help if breastfeeding is painful. Or use the position you find most comfortable until your nipples heal. Check your baby's attachment later in the feed-if they slip down your nipple, this may cause you pain. Reclining breastfeeding positions or extra support under your arms may help.

Ask your LLL Leader about breast compression, which can help your baby get more milk quicker. An increase in milk flow may also help them breastfeed more effectively.

Hand express to stimulate milk flow before feeding. Or start on the least painful side, switching sides once your milk lets down. Pain can reduce milk flow, leading to engorgement and mastitis. Ask your doctor, midwife or health visitor about using a suitable painkiller. Applying warmth and using gentle massage and relaxation exercises just before feeds can help milk to flow.

Moist wound healing

When the underlying problem is corrected, moist wound healing can help your nipples heal without scab formation. After each feed gently pat your nipples dry to remove surface wetness. Apply a tiny smear of ultra pure modified lanolin to each nipple, dabbing it on rather than rubbing. Hydrogel pads without a cloth backing can also be used.

Blood from cracked nipples
Blood from cracked nipples is not harmful to your baby. You can continue to breastfeed whilst working to improve positioning and attachment.

If healing is slow
Once your baby starts latching on well you should feel more comfortable and notice signs of healing within a few days. If not, visit your GP-sometimes a bacterial or fungal infection can prevent healing. Continued pain may be a sign that treatment (or further treatment) of your baby's tongue tie is needed.

Seek support

This is a time when the support of other mothers in your local LLL group can be invaluable. You can find your nearest Leader or by calling our Helpline.

Further Reading

Find a tongue tie practitioner- Association of Tongue Tie Practitioners, has details of both NHS and Private Practitioners
Biological Nurturing™
Lactation Consultants of Great Britain

The Womanly Art of Breastfeeding. LLLI. London: Pinter & Martin, 2010: p63-81, 428-430.
Comfortable Breastfeeding
Engorged Breasts - Avoiding & Treating
Expressing Your Milk
Hand Expression of Breastmilk
My Baby Needs More Milk
Nipple Know-How
Nipple pain
Nursing Supplementers
Sleep Baby - Why and What To Do
Storing Your Milk
LLLI Resources
Tongue Tie & the Breastfed Baby
References

Hazelbaker, AK. Tongue-Tie: Morphogenesis, Impact, Assessment and Treatment. Columbus, OH: Aidan and Eva Press, 2010.

Mohrbacher, N. Breastfeeding Answers Made Simple. Amarillo Tx: Hale Publishing, 2010.

Watson Genna, C. Supporting Sucking Skills in Breastfeeding Infants. Burlington, MA. Jones & Bartlett, 2012.

Geddes, DT. et al. Frenulotomy for breastfeeding infants with ankyloglossia: Effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics 2008; 12(1):e188-94.

Hogan, M. Westcott, C. and Griffiths, M. Randomized, controlled trial of division of tongue-tie in infants with feeding problems. J Paediatr Child Health 2005; 41:246-50.

Hong, P. et al. Defining ankyloglossia: A case series of anterior and posterior tongue ties. Int J Ped Otorhinolaryngology 2010; 74:1003-6.

Knox, I. Tongue tie and frenotomy in the breastfeeding newborn. Neoreviews 11 (9) Sept 2010.

Miranda, BH. and Milroy, CJ. A quick snip-a study of the impact of outpatient tongue tie release on neonatal growth and breastfeeding. JPRAS 2010; 63:e683-5.

NICE Guideline s

Watson Genna, C. And Coryllos, EV. Breastfeeding and tongue-tie. J Hum Lact 2009; 25(1):111-2.

You can buy this information in printed form from the LLLGB Shop.

Copyright LLLGB 2016

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Treating and coping with breastfeeding a baby with tongue tie

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NCT Breastfeeding Line 0300 330 0700 (8am - midnight, 7 days a week) https://www.nct.org.uk/about-us/contact-us

Association of Breastfeeding Mothers 08444 122 949 (9.30am - 10.30pm, every day) http://abm.me.uk/

National Breastfeeding Helpline 0300 100 0212 http://www.nationalbreastfeedinghelpline.org.uk/

La Leche League 0845 120 2918 https://www.laleche.org.uk/

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At the Bump to Baby drop in parents can weigh their own baby

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From Bump to Breastfeeding: Baby Graphic

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Positioning and Attachment - Whiston Maternity Unit Infant Feeding Team

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If baby struggles at breast, what can I do?

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If baby struggles at breast, what can I do?

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If baby struggles at breast, what can I do?

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Shel Banks IBCLC Infant Feeding Specialist

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Technique for getting gas out of the baby's stomach

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Shel Banks IBCLC Infant Feeding Specialist

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Technique for getting gas out of the baby's stomach

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Hand Expressing - Whiston Maternity Unit Infant Feeding Team

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Hand Expressing - Whiston Maternity Unit Infant Feeding Team

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Positioning with a newborn when you have large breasts

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What feeding positions work if I'm large breasted?

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What feeding positions work if I'm large breasted?

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What feeding positions work if I'm large breasted?

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What adjustments make early breastfeeding easier?

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What adjustments make early breastfeeding easier?

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What adjustments make early breastfeeding easier?

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How to recognise when a  baby is drinking well

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How to recognise when a  baby is drinking well

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How to recognise when a  baby is drinking well

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How do I know my baby is getting enough milk?

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How do I know my baby is getting enough milk?

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How do I know my baby is getting enough milk?

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Research-based information on baby sleep for parents and practitioners, covering normal infant sleep, sleep safety, where and how babies sleep, SIDS and SUDI, parental sleep and free resources.

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Hello from the St Helens Infant Feeding Team

We are here to support you 7 days a week
Monday-Friday 8am-8pm
Saturday-Sunday 10am-4pm (including Bank Holidays)

You can call us on 07919 305 174 / 01744 371111

Our team of experienced Infant Feeding Support Workers, including an IBCLC Lactation Consultant, are here to support you with your feeding journey, from bump to broccoli!

We contact all new families living in the St Helens area who have birthed at Whiston.  If you are choosing to birth in a different location, please contact us for support

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A tongue-tie (also known as Ankyloglossia) is caused by a short or tight membrane under the tongue (the lingual frenulum).

Where the membrane is attached at, or close to the tongue tip, the tongue tip may look blunt, forked or have a heart shaped appearance. However, where the membrane is attached further back the tongue may look normal in appearance.

Research suggests that approximately 1 in 10 babies may be born with some restrictive membrane under the tongue. But only about half of those babies display significantly reduced tongue function, making breast or bottle feeding difficult.

These babies may benefit from treatment to release the restriction that the membrane is having on the tongue and enable a baby to feed effectively.

Tongue-tie assessment

Tongue-tie practitioners often talk to parents who have had conflicting advice around whether or not their baby has a tongue-tie so it may be helpful for parents, and professionals who do not assess and divide tongue-ties, to have an understanding of what an assessment for tongue-tie involves.

The decision on whether or not a tongue-tie is impacting on feeding and whether it is appropriate to offer to divide it should be made after a detailed feeding history has been taken. This will usually include information about the pregnancy and birth and the medical history of both mum and baby. The baby is usually observed at the breast. This may be done by the person who divides tongue-ties or by someone who has been supporting you with feeding, prior to you being referred for division, such as a midwife, Health Visitor or breastfeeding counsellor/lactation consultant. The function of the tongue will also be assessed to establish if the baby is tongue-tied and if this is impacting on feeding.

The video clip shows part of an assessment for tongue-tie: Assessment of a Tongue Tie video curtesy of Sarah Oakley .

Assessment for tongue-tie requires training and skill and involves placing a finger in the baby's mouth. It cannot be done by just taking a look. Assessment is usually carried out with the baby on the assessor's lap or a flat surface such as a table or couch. It involves observing how the baby uses their tongue.

Professionals assessing babies for tongue-ties should assess elevation, lateralisation and extension. Elevation can most easily be assessed when baby cries. With the mouth wide open, the tongue tip should lift up to at least the mid mouth. In tongue-tied babies the tongue often stays quite flat in the floor of the mouth or the edges curl up to form a bowl shape or 'v' shape. Babies should be able to poke their tongue tip out well over the bottom lip when the bottom lip is stimulated. When the assessor runs their finger along the top ridge of the bottom gum the tip of the baby's tongue should follow the finger so the tongue sweeps side to side (lateralisation).

Some assessors perform a suck assessment by placing their finger in the baby's mouth (pad side up, nail side down) and feeling how the baby is cupping and using their tongue. Assessors sweep their finger under the baby's tongue so they can feel the extent of the tongue tie and the tongue will also be lifted to visualise the frenulum. The appearance of the frenulum is also documented including the shape of the tongue tip, where it attaches to the floor of the mouth and the underside of the tongue and how long and elasticated it is.

Problems which may be due to a restrictive tongue-tie:

Breast/Chest Feeding Parent:

Sore/damaged nipples

Nipples which look misshapen or blanched after feeds

Low milk supply or fast, quick let-down

Exhaustion from frequent/constant feeding

Distress from failing to establish breastfeeding

Infant/Baby:

Restricted tongue movement

Small gape resulting in biting/grinding behaviour

Unsettled behaviour during feeds

Difficulty staying attached to the breast or bottle

Frequent or very long feeds

Excessive early weight loss/ poor weight gain/faltering growth

Clicking noises and/ or dribbling during feeds

Colic, wind, hiccoughs

Reflux (vomiting after feeds)

Your baby may not display all of these signs and there can be other causes for these symptoms too so a thorough assessment by a practitioner skilled in breastfeeding is essential.

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A tongue-tie (also known as Ankyloglossia) is caused by a short or tight membrane under the tongue (the lingual frenulum). Where the membrane is attached at, or close to the tongue tip, the tongue tip may look blunt, forked or have a heart shaped appearance.

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ATP Position Statements | Tongue-tie Practitioners

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Find ATP position statements on lip-tie, COVID-19 PPE, and disruptive wound management. Access information and support regarding infant tongue-tie.

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To refer yourself or someone else, or to find out more please contact Catherine on parentsinmind.nw@nct.org.uk or call her on 0770 290 0894 for more information.

If you are feeling low, anxious, disinterested in your usual activities and are pregnant or within two years of giving birth, then our friendly, welcoming support may be for you.

Our trained peer supporters can offer time and support through the Parents in Mind groups running in the local area. A welcome, friendly, safe space is available to meet others going through similar experiences, seek information, talk things through, or simply relax.

Babies and toddlers welcome.

Attendance is by referral and this can be done by you, or through a health professionals such as your midwife, health visitor, GP, family nurse.

Please contact Catherine on parentsinmind.nw@nct.org.uk or call her on 0770 290 0894 for more information.

If you are interested in becoming a volunteer then please get in touch.

We are looking for local women, aged 18+y, who have experienced mental health difficulties themselves in pregnancy and/or after the birth of their baby and who are now well enough to support others.

We provide free accredited training, full support and a great team to be a part of! Training starts at the end of September.

Further details can be found below or by contacting Catherine on parentsinmind.nw@nct.org.uk.

Parents in Mind: Partners service in St Helens

Parents in Mind North West have launched a peer to peer support group for new dads and carers of children. Offering one to one support and group sessions, with weekly podcasts covering all aspects of mental health and being a new parent.

Helping to open up the conversations, break the stigma, to learn from each other and build relationships from shared experiences. Offering a space to talk, along with sign posting and connection to other organisations and services in the area.

If you or anyone you know is interested in finding out more, please email parentsinmind.nw@nct.org.uk

Follow us on Instagram: @nctparentsinmindpartners and Facebook: NCT Parents in Mind

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Parents in Mind - Halton and St Helens | About us, Community support programmes | NCT

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We are running weekly groups in Halton and St Helens. We are also currently recruiting volunteers.

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Infant Feeding Service - St Helens Wellbeing

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Infant Feeding Service - St Helens Wellbeing

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Infant Feeding Service - St Helens Wellbeing

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Infant Feeding Service - St Helens Wellbeing

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Infant Feeding Service - St Helens Wellbeing - Baby Massage with Chris - Session 4 | Facebook

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Part 4 of The St Helens Wellbeing Community Infant Feeding Team 4 part taster of Baby Massage.

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Me and my girls have really enjoyed the class after school, it is fun for all the family to get involved in. We've learnt a lot about healthy eating and things we shouldn't be eating. It's fun and free! Really enjoyed it.

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Me and my girls have really enjoyed the class after school, it is fun for all the family to get involved in. We've learnt a lot about healthy eating and things we shouldn't be eating. It's fun and free! Really enjoyed it.

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We deliver a variety of practical activities, information and guidance around food and nutrition for all ages, Including information on the Eatwell Guide, healthy weight, active play, good oral health in schools and community settings.

Our fun, friendly Cook and Taste sessions encourage you and your family to make small changes to the food that you buy, prepare and eat, taste new foods, learn cookery skills and make tasty healthy meals on a budget, Sessions are free.

Cook and Taste - Practical cooking sessions

Fit 4 all early years - Parent programme to support healthy eating and physical activity for 2 - 4 year olds

Fit 4 all schools - classroom based healthy eating and physical activity programme for key stage 2

Nutrition training- for professionals working with children in early years settings

Healthy early year status (HEYS) - An award given to settings that demonstrates a community commitment to health and wellbeing of children

Tasty tuck - An award given to schools who promote the provision of healthy snacks throughout the school day

Recipes

How do I access the service?

Get in touch with us today for support, advice and to book a place on any of our activities

Telephone 01744 371111 or Email chcp.sthelens@nhs.net

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We deliver a variety of practical activities, information and guidance around food and nutrition for all ages, Including information on the Eatwell Guide, healthy weight, active play, good oral health in schools and community settings.

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Exercise and keeping active are an important aspect of having positive health and wellbeing
We provide activity and information sessions for all the family, physical activities, information about your body and what is needed to lead a happy healthy life. You can make changes, big or small, to be more active.
Exercise has so many benefits such as reducing blood pressure, cholesterol and keeping your weight maintained. Not only that, there is strong evidence that shows taking in some regular activity really does keep you mentally feeling well too... and the good news, there is something for everyone.

We also provide some referral only services including one-to-one support and tailored activity plans as well as rehabilitation activity programmes for people who have had heart related problems, balance issues or falls, chronic pain and those recovering from a stroke.

How do I access the service?

You can access support, advice, or book an activity

Telephone 01744 371111 or Email chcp.sthelens@nhs.net

Services are currently booked on a project or session basis.

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Exercise and keeping active are an important aspect of having positive health and wellbeing We provide activity and information sessions for all the family, physical activities, information about your body and what is needed to lead a happy healthy life. You can make changes, big or small, to be more active.

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Weight Management - St Helen's Wellbeing

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If you're looking to start on a weight loss journey, look no further. For most people, adopting a healthier eating pattern means making small changes to the foods that we buy, prepare and eat.

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We will help you to change your smoking habits and will offer a variety of proven stop smoking therapies to help you to achieve your goal. We are e cig friendly and support anyone who is using a vape to quit.

TIME TO QUIT!

COVID-19 has changed the way that we all live our lives and how we think about our health.

The NHS Better Health campaign reminds us that there has never been a better time to kickstart your health. Quit smoking today and you will see immediate health benefits. You will also be protecting those around you from the harmful effects of secondhand smoke including children and those who are vulnerable.

St Helens Wellbeing has a wide variety of free services to help you improve your health, so take a look at what's on offer and if YOU want to achieve better health, today or give us a call!

Covid 19 Information
New clients
Smokers wishing to quit can still self-refer on the phone number or email contact details below or by filling in the contact us form here. We will arrange a full consultation by an agreed method (usually by telephone) to assess and agree an individual plan to support you to quit. PLEASE NOTE our drop-ins are not running at the moment in line with social distancing guidance.
Existing Clients
People who are registered will continue to be supported throughout their quit attempt by an agreed method of contact i.e. telephone, email, text or video call.

Choose a QUIT method to suit you...

One to one telephone support 01744 371 111

Text support - text QUIT to 61825

Online support available here.

Covid update - Appointment only to help us manage social distancing

Hear about Karla's QUIT journey on the video below:

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We will help you to change your smoking habits and will offer a variety of proven stop smoking therapies to help you to achieve your goal. We are e cig friendly and support anyone who is using a vape to quit. TIME TO QUIT!

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Giving you one to one support to make realistic, positive lifestyle changes.

Due to COVID19 we are currently offering support packages by telephone and virtually. We are hoping to return to face to face support in the near future.

You will have a 1 hour health check, which will include a discussion of your eating patterns, exercise levels, stress levels & alcohol intake. Also checking your blood pressure, weight, height, body mass index (BMI) and cholesterol measured to give you a starting point. We will then work with you to produce a personalised support plan just for you.

Your Health Trainer will keep in touch to offer support and arrange follow-up appointments to see how you are getting on and offer you practical support for up to 12 months on the following:

Healthier eating

Increasing your activity levels

Managing your weight

Improving your health and wellbeing

Reducing stress

Supporting with alcohol/smoking cessation

Signposting to other support services/community groups.

How do I access the service?

Anyone aged 16 and over can access the service either by self referral, or by being referred by a health professional. You must either live in St Helens, be registered with a St Helens GP or work in St Helens.

Get in touch with us today to book an appointment

Telephone 01744 371111 or Email chcp.sthelens@nhs.net

"Please watch this short video, where Health Trainer Roy Evans explains about Blood Pressure readings".

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Giving you one to one support to make realistic, positive lifestyle changes. Due to COVID19 we are currently offering support packages by telephone and virtually. We are hoping to return to face to face support in the near future.

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Support through a 'prescription for wellbeing'.

Due to COVID19 we are currently offering support packages by telephone and virtually. We are hoping to return to face to face support in the near future.

What is Prescription for Wellbeing?

Often referred to as social prescribing, your GP refers you to a Link Worker who can signpost you to a range of free local community groups, activities and services that provide practical, social or emotional support.

At the first appointment, your Link Worker will work closely with you on a one-to-one basis. They will listen to you, support you to make plans and help you choose what will work for you to improve your wellbeing, keeping you in control. You will receive ongoing support from your Link Worker whilst accessing the service.

We can provide support with:

* Social contact and emotional support
* Advice and information
* Support to continue/take up new hobbies and interests
* Support to improve your general health and wellbeing
* Reduced isolation and loneliness
* New friendships

How do I get support?

If you are aged 16 or over, ask your doctor, nurse or receptionist at your GP practice for a 'prescription for wellbeing' today.

To self refer or for more information get in touch today on 01744 371 111, chcp.sthelens@nhs.net or click Here

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Support through a 'prescription for wellbeing'. Due to COVID19 we are currently offering support packages by telephone and virtually. We are hoping to return to face to face support in the near future.

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Please note that during COVID-19, all Mental Health training will be online. Training available at this time is shown here.

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Keeping a bright, healthy smile
We offer a range of services

Supervised toothbrushing programme NICE2SMILE in nursery settings and special educational needs schools.

Toothbrush and fluoride toothpaste packs to primary school children in St Helens.

Support Health Visitor assessment clinics with child oral health packs and oral health family support.

Training for early year's staff, health visiting teams, school health teams, school staff, dental teams, nursing and care staff, carers of vulnerable groups and a range of health professionals.

Provide educational resource loan box for schools, nurseries, care homes, vulnerable groups and colleges, to access and deliver consistent and current oral health information to their groups.

Work with local dental teams to promote oral health within their practices.

The Oral Health team attend and support a number of local and national campaigns and community based events throughout the year.

Offering information and training to a range of health professionals and other health care professionals on how to support local people to improve their oral health. We also provide information to the public at community events. The Oral Health team - won the National Patrons Prize Award from the National Oral Health Promotion Group in June 2017 The award was presented to the team by Jenny Godson MBE (National Lead for Oral Health Improvement PHE, Chair of the Child Oral Health Improvement Programme Board) for their partnership working embedding good oral health across the borough. The team provide training and resources for schools, nurseries, health visitors, care homes and other agencies.
How do I access the service?

Get in touch with us today

Telephone 01744 371111 or Email chcp.sthelens@nhs.net

What can your NHS dentist do for you? For more information Click Here

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We offer a range of services Supervised toothbrushing programme NICE2SMILE in nursery settings and special educational needs schools. Toothbrush and fluoride toothpaste packs to primary school children in St Helens. Support Health Visitor assessment clinics with child oral health packs and oral health family support.

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St Helens Wellbeing services have a number of volunteering opportunities.

We can help support and guide you, increase your confidence, gain work experience or simply meet new people. Whatever the reason, we can boost your wellbeing alongside the communities we work with.

Helping you give something back to your community. Volunteers work across various locations, and sessions that need support.

Investing in Volunteers

Thank you for your expression of interest regarding volunteering / placement opportunities with St Helens Wellbeing.

We will always try and place volunteers in a role that is suitable to their interests and skills and there is a role for everyone.

How much time do I have to give?

There is no minimum number of hours that you have to give to us. Where possible we will tailor the role to you and your availability, whether that be once a day or once a month.

Due to Covid 19, We are unable to accommodate any requests at this current time.

We work to the highest standard with all our volunteers. We care and encourage which means we have recently been awarded Investing In Volunteer Kite accreditation.

For more information about Investing In Volunteer Kite accreditation click here

How to get involved.

If you are 18+ you are eligible to volunteer for St Helens Wellbeing Service.

Speak to a member of the team, alternatively you can contact us on

Telephone 01744 371111 or Email chcp.sthelens@nhs.net or click on the 'I want to volunteer' page below to complete ur online form.

A member of our friendly team will be in touch.

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St Helens Wellbeing services have a number of volunteering opportunities. We can help support and guide you, increase your confidence, gain work experience or simply meet new people. Whatever the reason, we can boost your wellbeing alongside the communities we work with. Helping you give something back to your community.

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Unicef UK Baby Friendly Initiative | Meeting baby for the first time