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0300 100 0212

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Attaching your baby at the breast - video

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Attaching your baby at the breast - video

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

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Attaching Your Baby at the Breast - Video - Global Health Media Project

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Good attachment will help a baby get more milk and make breastfeeding more comfortable. This video shows why good attachment is so important to breastfeeding

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Everything you need to know about expressing and storing your breast milk, including tips on hand expressing and electric breast pumps, and how to freeze, defrost and warm breast milk.

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An A-Z guide on positioning and attachment

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An A-Z guide on positioning and attachment

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Getting your baby positioned and attached comfortably at the breast is an art-mothers often say it takes a little while for breastfeeding to feel entirely comfortable and natural, even if they've breastfed before. In the past girls grew up learning about breastfeeding by watching mothers in their families and communities. These days many of us become mothers having never seen a baby breastfeed.
But breastfeeding has worked for mothers and babies for thousands of years and it can work for you too.
Many babies can find their way to the breast by themselves, especially if they haven't been too affected by birth interventions. Other mums and babies need a little longer to work it out with maybe some help from a skilled breastfeeding supporter such as an LLL Leader.

When all is going well, specific holds and positions don't really matter because you and your baby will work out what suits you best. However if you are finding it awkward, uncomfortable or downright painful then the following information is designed to help you think about where you can make adjustments and get breastfeeding working comfortably for you.

Good positioning and attachment is important for maintaining milk production. A baby who attaches deeply at the breast is able to remove milk effectively. This is important for maintaining milk production. Well-drained breasts make milk quickly. If there is any concern about how much milk you are making, working on improving positioning and attachment is an important first step.

There's no 'right' or 'wrong'. If you are comfortable, your baby is producing plenty of dirty nappies and is gaining weight after the first few days, then breastfeeding is going well for you. There are no rules-but there are a few principles that can help you work out what to do if things aren't going well: see Latching on - getting a good attachment.

Positioning describes how you sit or lie and how you support your baby as he takes the breast. How you hold your baby can make a big difference to how well he can breastfeed. Even small adjustments can be significant. Attachment describes the way he latches onto the breast.

Tips for getting started
The laid-back approach
Latching on - getting a good attachment
Different breastfeeding positions
As time goes by

Tips for getting started

If it hurts then make changes

If it doesn't feel right to you, then it isn't fine, whatever anyone says. Pain is your body's way of letting you know something is wrong. Start by trying to improve positioning and attachment. A few quick adjustments to how you are sitting or lying or how your baby comes towards the breast may be all that are needed.

Sometimes it can take a little longer. You may need to work with one or more skilled breastfeeding supporters over a period of time to get to the point where everything falls into place and breastfeeding starts feeling natural.

Each mother and baby pair is different and what works well for one mother and baby may not work for you. This is one reason why you may hear different suggestions from different helpers. You are the best judge of what is helpful so don't be afraid to use what feels right for you and discard the rest.

Your baby needs to be calm

You can offer the breast at any time when you are both calm. You may even find it easier if your baby isn't obviously hungry. Feed your baby before he needs to cry. Early cues for wanting to eat include suckingtheir hand, smacking their lips, turning their head towards you, or fussing. They won't latch well if they are distressed. If your baby is upset take time to soothe them. Hold them upright against you, stroke them and talk to them. A little expressed colostrum or breastmilk given on a spoon can help to calm them if they are desperately hungry.

Your baby needs full body contact

When your baby is held in full body contact against you, they will feel stable and be better able to coordinate their movements. Laid back positions ensure full body contact. If you're sitting up, you'll need to hug your baby in as tightly as if you were standing up holding them against you. Babies who don't feel stable tend to wave their arms around, which can make latching more difficult. Pillows can get in the way and aren't always necessary. So wait until after your baby's latched on, and then tuck them in only if you need them for support.

Some babies need time

Some babies find it difficult to latch on, or simply nurse ineffectively at the breast. Often a difficult birth or interventions during labour or birth are the cause. Giving a baby time to recover, and using laid-back breastfeeding positions with skin-to-skin contact can maximise your baby's natural instinct to breastfeed. If your baby isn't latching or feeding well seek help from an LLL Leader and read our page My Baby Won't Breastfeed. With time and patience, most babies will breastfeed. In the meantime express your milk for your baby to maintain milk production and give you both the time to work it out.

Laid-back breastfeeding

Many people assume you have to sit up to breastfeed. Not so. In fact evidence suggests humans evolved to breastfeed in laid-back positions with our babies upright against our chests. You may have experienced this type of position when you had your first feed, soon after your baby's birth. There is more and more evidence that laid-back breastfeeding positions (also called Biological Nurturing) help babies breastfeed more effectively and are more comfortable for mothers, especially in the early days and weeks.

Laid back breastfeeding is really useful for those first few days and weeks when you want to rest and recover and your baby needs to be in close contact with you to get breastfeeding established. It can be done skin-to-skin or with you both lightly dressed. You don't have to be in bed; the sofa or a reclining chair is a comfortable alternative.

You can also use laid-back breastfeeding principles when sitting in an upright chair by shifting your weight back onto your tail bone and reclining your body back a little, to open up a space for your baby. This allows more of their weight to be supported by your body and less by your arms. It isn't safe to sleep with your baby on a chair or sofa.

Sleepy babies

If your baby is sleepy, perhaps because of birth interventions, then using laid-back positions with skin-to-skin contact can encourage your baby's interest in feeding. In laid-back positions babies often attach and feed when in light sleep so it helps to spend substantial periods of time with your sleepy baby against you. When you notice the little movements that indicate your baby is moving into a light period of sleep you can encourage them to latch.

How laid back breastfeeding works

You lay back in a comfortable, supported semi-reclining position (not flat) that opens up your body, creating space for your baby.

Your baby lies against you, their whole front against your body, vertically or at any comfortable angle.

Your baby feels stable and secure and their instinctive feeding reflexes are triggered, prompting them to bob their head and seek out the breast.

Gravity helps them latch deeply and stay latched, rather than hindering the process.

Your hands are free to support and caress your baby and help them attach.

Your body releases the hormones that stimulate milk production and make you experience loving feelings towards your baby.

There are no rules-you and your baby are free to work it out between yourselves.

Latching on - getting a good attachment

Your baby needs to tip their head back and reach forward with their lower jaw. As your baby tips their head back their jaw drops and their mouth opens wide, so they can anchor their chin and lower lip firmly against your breast. If they have to tuck their chin in to reach the nipple they won't be able to open their mouth so wide. Tipping their head back also makes a deep latch possible, swallowing easier, and frees up their nose for comfortable breathing. In laid-back positions lay your baby with their head between your breasts. If you are sitting up, keep your supporting hand away from the back of their head. Babies tend to creep forward, so try shifting them so that their eyes and nose are opposite the nipple to encourage them to reach forward and anchor their chin first. In sitting or side lying positions a little push between the shoulder blades with your supporting hand or arm as they latch brings their chest in closer and helps their head tip back.

Their lower jaw needs a clear space to anchor. Think about how you might take a mouthful from a big sandwich by placing your lower jaw first then opening your mouth to accommodate the top of the sandwich-the principle is the same. Your baby's lower jaw needs to be deeply placed on your breast well away from the nipple. Keep the fingers of your supporting hand away from the place where their chin and lower jaw need to be so their lower lip and chin can sink into your breast. Your baby's chin needs to stay firmly in contact with your breast.

Your baby needs a big mouthful. When a baby chews on a nipple, this compresses the milk ducts, prevents milk flowing and hurts. When a baby has a good big mouthful of breast beyond the nipple, breastfeeding is comfortable and milk can flow. Some women like (or need) to hold their breast when nursing. They flatten their breast as they would a big sandwich they were offering to the baby, matching it to the oval of his mouth. This can help their baby grasp more breast tissue. It doesn't matter if fingers are closer to the upper jaw but try to keep the "lower jaw fingers" out of your baby's way. Biological Nurturing™ positions make use of gravity to help a baby get a bigger mouthful.

The exaggerated latch. To get an even deeper latch you could try this optional extra. Place your thumb or finger near the base of the nipple where the middle of your baby's upper lip will be, lined up with their nose. If you press, your nipple will tilt away from your baby, presenting them with your breast rather than your nipple. Avoid pressing your nipple into their mouth. 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. You can then slip your finger out.

Our own video below demonstrates flipple technique (aka exaggerated latch), it can be very helpful for getting an effective pain free latch:

Let your breast rest at its natural level. It can be tempting to lift your breast and move it towards your baby's mouth. If you do this, your baby probably won't get a full mouthful, and after a while your hand will get tired and the breast will drop and slip out of their mouth. Breastfeeding pillows can get in the way too because they lift a baby up too high and prevent you tucking them in against your tummy. See where your breasts naturally rest and hold your baby accordingly. If you need them, tuck pillows in after they are well attached.

Bring baby to breast, not breast to baby. Since breasts are attached to you and you baby is moveable it makes much more sense to bring your baby to the breast, not the other way round! And it works better too. With their body tucked firmly against you (or laid on top of your body), your baby will feel more stable and have better head control, and you'll feel a lot more comfortable too.

It's easier to latch onto a softer breast. It's much easier to get a deep mouthful if the breast is soft so breastfeed frequently to avoid engorgement. When your baby bobs their head and licks the nipple, it naturally makes it easier to latch on. If your breast is full and hard, you can use reverse pressure softening to move fluids away from the nipple area so your baby can latch on well. Apply gentle steady pressure with your fingertips on the areola around your nipple for about a minute. You can also press with the sides of your thumbs or fingers. Denting the breast at the edge of the areola with a finger and placing your baby's chin in the dent may also help. Gently hand express a little milk too if needed.

Your baby needs to choose his own timing. Your baby will probably do best if they pick the moment to latch on. You can help by supporting them in a position that lets them do this when they are ready. To encourage your baby to gape hold them close against you, close enough to the breast so they know the nipple is there, but where they can't quite reach it. Be prepared for your baby to lick and nuzzle for several minutes before they are ready to open wide.

The natural or laid-back breastfeeding positions shown in the following videos can be a great help in encouraging your baby to latch on well, as well as being comfortable for you. You can recline comfortably with your baby on top of you with their whole front against you and their body completely supported by yours.

Best Beginnings' video demonstrates clearly how to make sure your baby is attaching well to the breast, you can view it here.

This video demonstrates how to enable your baby to latch deeply on to your breast so that breastfeeding is comfortable for you and means your baby get enough milk:

This video shows how to attach your baby well, and shows a variety of comfortable breastfeeding positions:
http://m.raisingchildren.net.au/articles/breastfeeding_attachment_video.html

Using different breastfeeding positions

The cradle hold

Although the cradle hold is one of the most common nursing positions it can be a challenge for new mothers to learn. You need to hold your baby's body firmly against you to give them stability because their weight is supported mainly by your arms. Shifting so you are sitting on your tailbone, rather than upright can help stability and reduce the strain on your arms (see picture right). It can be difficult to control a baby's head and to keep them high enough and close enough to your breast. A small baby may tend to curl up in a ball in this position if not pulled in closely enough against your body. It may not be the best choice at first if you're experiencing any problems with latch-on, milk transfer or if you have sore nipples. Once you're more confident with breastfeeding, you may find you use a version of the cradle hold much of the time, especially when out and about.

Your baby's whole front is against your tummy, their hip resting on or near your thigh, tucked around you like a comma. Their chest will be snuggled into the breast and your nipple near their nose.

Their head is resting on your forearm and/ or wrist (not the crook of the elbow).

As your baby opens their mouth to take the breast, pull their body in firmly against you.

Once your baby is attached, settle back a little for your own comfort and so that more of their weight is taken by your body.

Laid back breastfeeding

Remember that Biological Nurturing™ positions aren't just for the first week or two. They can be really useful later on when you want to relax, and especially if you are breastfeeding more than one baby or if your baby is fussy or unwell.

The cross-cradle hold

The cross-cradle position can be useful in the early days because it gives you more control in guiding your baby to the breast. It can be uncomfortable to maintain without good support under your arms, especially with larger babies, so once your baby is attached, switch arms as shown in the picture below. After the first few weeks and as your baby grows longer and heavier, you may prefer to use other comfortable holds. Avoid touching the top or back of your baby's head because it often causes a baby to pull back from the breast. Forcing a baby onto the breast by firmly holding the back of the head usually has the opposite effect and can put a baby off breastfeeding.

Cross cradle

Tuck their whole front against your tummy, their hip near or resting on your thigh.

Your hand supports their neck (not the back of the head) with your palm between their shoulder blades.

Your other hand is free to shape or stabilise your breast if needed.

Make sure your baby isn't too far round the front-line them up so their eyes and nose are near the nipple.

As your baby opens their mouth, give a little push with the palm of your hand to bring their chest in close against you.

This will help their head tip back and let them plant their chin deeply against your breast.

Once your baby is attached you can bring your other arm round to support your baby's body and settle back a little for your own comfort and so that more of his weight is taken by your body. Hold your baby with the arm opposite to the breast he's going to latch onto.

The underarm (clutch or rugby) hold

The underarm hold is useful if you have had a caesarean birth. It helps keep the weight of your baby off your incision. It is also a good position for mothers with flat or inverted nipples and for babies with latch-on or sucking problems because it offers you a good view of baby and breast and control of your baby's head. You can also feed two babies at once in this position. For larger, longer babies you may need extra cushions behind your back to bring you further forward and allow space for your baby's length.

Your baby's front is close against your side, with your hand under their shoulders and neck.

Your elbow keeps them tucked closely against your body.

Your baby approaches your breast from below. This can work well if you have large breasts. If you have smaller breasts you may need to bring your baby into a semi-sitting position.

Make sure your baby isn't too far round the front. You may need a cushion between your back and the chair back to allow room for your baby's length and prevent them pushing themselves forward with his feet.

Side lying

This side-lying position is helpful if you are recovering from a caesarean birth or an episiotomy and invaluable for nursing in bed during the night.
It can take a while to get the knack but it's well worth persisting because it can make night feeds so much easier.
Some mothers decide to sleep with their baby alongside them. Others choose to move their baby back onto a separate sleep surface.
Safe Sleep and the Breastfed Baby will help you decide on the safest sleep arrangements for your family, based on your own individual circumstances.

* Lie on your side, with your knees bent up and a pillow under your head.
* Place your baby on their side facing you so that their body and your body form a V-shape, meeting at your hips, with your nipple level with their nose or eyes.
* You can put your arm under your baby's head as shown, or up by the pillow with your baby lying on the bed.
* As your baby latches, give a little push between their shoulder blades to bring their chest in closer and help their head to tip back and their mouth to
open wide.
* You may find it helpful to tuck a small pillow or rolled blanket behind the small of your back and/or between your knees.

Standing up

At some feeds babies just do better if you stand up. You can sway or bounce gently to help calm your baby, and the lack of a lap can be helpful. As always keep your baby nice and stable and let them lead the way. Try angling their legs down instead of holding them horizontal, and see what happens. Or try starting with them against your shoulder, supporting them as he moves down to the breast. Even when using other positions, sometimes just standing up and sitting down again straight away helps everything settle into a comfortable position.

As time goes by

Whether you choose to breastfeed sitting up, reclining or lying on your side, you will need to adjust how you support your baby as he grows in length and weight. Use the principles shown here as you experiment with different positions. Sometimes there are physical or medical causes for pain or discomfort such as tongue tie or a thrush infection. If you are still finding it difficult to get comfortable, do persist with seeking further and continued support. There is almost always a breastfeeding solution to breastfeeding problems. You can contact an LLL Leader by calling our Helpline. You can also find support and encouragement from breastfeeding mothers in your local LLL group.

Written by Sue Upstone, Karen Butler and mothers of LLLGB

Further Reading

The Womanly Art of Breastfeeding. LLLI. London: Pinter & Martin, 2010.

Mastitis
Beginning Breastfeeding
Breastfeeding Your Baby - easy read
Caesarean Birth & Breastfeeding
Comfortable Breastfeeding - easy read
Skin-to-Skin
Engorged Breasts - Avoiding & Treating
Hand Expression of Breastmilk
Inverted Nipples
My Baby Needs More Milk
My Baby Won't Breastfeed
Nipple Confusion?
Nipple Pain
Nipple Shields
Nursing Supplementers
Safe Sleep & the Breastfed Baby
Sleepy Baby - Why & What To Do
Tongue Tie
Too Much Milk & Oversupply

LLLI Resources
Position to breastfeed

Other resources
How to do Biological Nurturing: www.biologicalnurturing.com/video/bn3clip.html
Best Beginnings videos to watch online: www.bestbeginnings.org.uk/watch-fbtb

References
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, TX: Hale Publishing, 2010.
Biological Nurturing: Laid-back breastfeeding for mothers (DVD). Colson, S. et al. 2012.
An Introduction to Biological Nurturing; New angles on breastfeeding, Colson S. Amarillo, TX: Hale Publishing, 2010.
Supporting Sucking Skills, Watson Genna, C. Burlington, MA: Jones & Bartlett, 2012.

This information is available to buy in printed form form the LLLGB Shop.
It is also available in kindle edition.

Information, references and links on this page are taken from La Leche League resources, unless stated otherwise. Please note that LLLGB does not endorse information from outside sources, extra information is provided for you to consider. Information supplied is not intended as advice, and you are in the best position to make a decision as to how the information offered will affect you and your baby.

Copyright LLLGB 2016

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Positioning & Attachment - La Leche League GB

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Good positioning and attachment is important for maintaining milk production. A baby who attaches deeply at the breast is able to remove milk effectively.

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How to tell breastfeeding is going well - UNICEF checklist

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How to tell breastfeeding is going well - UNICEF checklist

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Skip to main content

If you're returning to work after maternity leave, you might wonder whether you can continue breastfeeding your baby. The answer is yes, it's completely possible and many women do it.

Make breastfeeding at work as easy as possible

Find childcare close to work

If you're lucky enough to be able to have your baby close to you in the daytime, you can breastfeed in your breaks.

Negotiate a flexible working pattern

See if there's an option for you to work flexibly. This could include working part time, working from home, breaking up the working week, having shorter workdays or working fewer but longer days.

Experiment with partial breastfeeding

This involves breastfeeding while you're at home and expressing milk while you're at work so that your baby can drink your breast milk the next day, even when they're away from you.

Whatever you decide, it might be worth doing a trial run before you return to work, so you can see if the new breastfeeding pattern works for you and your baby. If it doesn't, there'll be plenty of time to try something different.

Chat to other mums about how they managed breastfeeding and going back to work - you can do this online via forums like mumsnet. Talking to other mums who've been through the same thing will be really helpful.

Maternity Action has lots of practical advice on continuing to breastfeed when you return to work.

How do I express at work?

Your workplace is legally required to provide suitable facilities for you to rest while you're pregnant or breastfeeding. This might be a mother and baby room, first aid room, spare office or private room. You can use this space to express milk throughout the day. It shouldn't be a toilet - you wouldn't prepare your own food in a public loo, so you shouldn't have to prepare your baby's there either.

You'll probably need to express your breast milk at least every 3 hours when you're first away from your baby. It's a good idea to practice before you go back to work, so that you're used to it.

Your legal rights

Let your employer know in writing that you'll still be breastfeeding when you return. They're required to provide somewhere for you to rest during the day, including somewhere for you to lie down.

For more information on the legal side of breastfeeding while you're at work, including examples of best practice, the ACAS guide on returning to work after having a baby is a really useful resource.

When should I stop breastfeeding?

It's entirely your decision. Ideally, aim to breastfeed your baby exclusively for the first 6 months. When you start your baby on solid foods, they'll need breast milk or first infant formula as their main drink, until (at least) their first birthday.

The World Health Organization recommends breastfeeding for up to 2 years (and beyond if you choose). Basically, the longer you breastfeed, the longer you share all that natural goodness with your baby - but the first 6 months is the most important part.

Remember, there are many benefits of breastfeeding for you both from the natural (germ killing) antibodies, and vitamins and nutrients it gives your baby; to the fact it protects your health too - did you know breastfeeding lowers your risk of breast cancer, ovarian cancer, osteoporosis, diabetes and cardiovascular disease?

How do I stop breastfeeding?

Stopping breastfeeding should be done gradually. You need to give your body time to adjust to making less milk - phasing it out will also help prevent you getting mastitis and engorged breasts.

Lots of mums find dropping one feed at a time the best way. For every feed you drop, allow yourself about a week to adjust.

Weaning your baby off breast milk should be a gradual process, it's best if you can be flexible and not rush it. You may need to slow things down at times, for example if your baby is poorly, they tend to want to feed more frequently. Remember, if weaning off breast milk is proving tricky, try to be patient - you can always take a break and try again in a few weeks.

Babies under 1

Replace dropped feeds with first infant formula. Babies under 6 months will need to be bottle fed. Babies older than 6 months can have their feed in a beaker or cup.

Babies 1 year and older

As long as your baby is having a well-balanced diet, they won't need a replacement feed.

Breastfeeding Friend from Start4life

The Breastfeeding Friend, a digital tool from Start4Life, has lots of useful information and expert advice to share with you - and because it's a digital tool, you can access it 24 / 7.

For confidential breastfeeding information and support, call the National Breastfeeding Helpline on 0300 100 0212. Lines are open 9:30am to 9:30pm every day.

Sign up now for our pregnancy, baby and toddler guide

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Breastfeeding and returning to work? Have a look at our tips and advice

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Skip to main content If you're returning to work after maternity leave, you might wonder whether you can continue breastfeeding your baby. The answer is yes, it's completely possible and many women do it. If you're lucky enough to be able to have your baby close to you in the daytime, you can breastfeed in your breaks.

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Paced bottle feeding - video demonstration and explanation

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Paced bottle feeding - video demonstration and explanation

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Is my baby getting enough milk? - visual nappy guide

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Is my baby getting enough milk? - visual nappy guide

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Newborn baby poo in nappies: what to expect | Baby & toddler articles & support | NCT

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Your baby’s nappy can tell you a lot - find out more here.

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Many mums wonder how others might respond to them breastfeeding in public. So it's good to know that public opinion is behind you - a survey said 72% of people support breastfeeding in public (gov.uk, 2015).

And you do of course have the right to breastfeed in public. NCT spent many years campaigning to bring about the specific protection of breastfeeding in public (NCT, 2011). Specific laws now protect breastfeeding in public in England, Wales and Scotland, and other laws protect it in Northern Ireland.

But breastfeeding in public isn't just accepted and protected, it can have a bunch of benefits. Here's how and why you could make breastfeeding in public work for you...

Why breastfeed in public?

Breastfeeding is a convenient way of feeding your baby when you're out and about as you don't need any extra equipment. In fact, with a little practice it can become virtually effortless. You'll have the great tool at your disposal of being able to feed your baby anywhere and to calm them when they're fretful at any time.

"I found breastfeeding useful when we were out for the day as the only 'kit' that was needed was me! But especially so if my baby became overstimulated with the sounds and lights of busy shops - if she started getting restless or agitated, holding her close for a feed would help to calm her down."

How do I start breastfeeding in public?

In the early days, before going out with your baby, it can help to gain confidence with different breastfeeding positions and making sure your baby's achieving an effective latch. That way you'll feel more comfortable feeding in front of others. Some mums find it useful to practice in advance - either in front of the mirror or in front of someone else, such as their partner, a close family member or a friend.

If you want to keep covered up, having easily accessible clothing can help with that. You could try wearing a loose vest underneath a t-shirt - so one layer goes down and the other goes up. You could also try wearing a loose cardigan or a scarf.

"I would wear stretchy vest tops underneath so that I kept warm still while feeding. Plus, I was more concerned about flashing my mummy tummy than anything else!"

It's possible to feed in a sling or carrier too. A sling or carrier has the added advantage of keeping your baby close and the oxytocin flowing, which aids milk production (Knowles, 2019).

How do I get more confident about breastfeeding in public?

Some new mums worry about feeling embarrassed or uncomfortable breastfeeding in front of others (Public Health England, 2017). So it can be really helpful to look for support around you and check what groups your local NCT branch run.

You could also ask your midwife, health visitor, breastfeeding counsellor or lactation consultant about local drop-in groups. At these groups, you're likely to meet other breastfeeding mums and this will help you gather some tips, ideas and general support.

Attending a local Baby Café or other breastfeeding drop-in provides an environment where you're likely to be around other parents at a similar stage of parenting and feeding. This peer support and having the support of a qualified practitioner might increase your confidence in many areas of breastfeeding, not just feeding in public (Fox et al, 2015).

It can be handy to have someone with you that first time you head out with your baby. It's also good to look ahead for information about breastfeeding friendly places to go. You can find breastfeeding friendly places on social media, websites, and local/national initiatives where breastfeeding friendly businesses can register.

Is breastfeeding in public difficult?

It's not difficult but there can be challenges. One challenge of breastfeeding in public is dealing with breastmilk leaks. Most mums find that breastpads provide sufficient protection from leaks should you experience them.

If you're out and can feel a let down of milk but you're unable to feed your baby, then applying compression to your nipples for a few seconds might help stop the leaking. You can do this by folding your arms over and using the palms of your hand to press down firmly on your nipples (La Leche League GB, 2016).

When your baby is older, feeding in public may seem more challenging as your child is mobile and vocal. So it's good to read their body language and be ready to move if they do and if you want to keep covered up. You could also consider having some snacks or toys to offer as a distraction until you are somewhere more comfortable to breastfeed (kellymom, 2018).

What exactly are my rights about breastfeeding in public?

A mum has a right to breastfeed her child across the UK, but the area of the UK you live in will govern which legislation covers this right:

England and Wales - the Equality Act 2010 (British Chambers of Commerce, 2010) states that 'a business cannot discriminate against mums who are breastfeeding a child of any age.' This means that anybody providing a service, and their employees, cannot ask a mum to stop breastfeeding or to leave their premises.

Scotland - the Breastfeeding etc. (Scotland) Act 2005 states that 'it is an offence deliberately to prevent or stop a person in charge of a child from feeding milk to that child in a public place or on licensed premises.' (The age of the child is determined as up to the age of two years and feeding is determined as breast or bottle feeding.) This means that any person feeding a child milk cannot be asked to stop or leave the area or premises.

Northern Ireland - there is no specific legislation currently in Northern Ireland covering rights to breastfeed. But there is some protection within the Sex Discrimination (Northern Ireland) Order 1976 for women who have been treated unfavourably while pregnant and for the duration of their maternity leave. In January 2017 a potential Breastfeeding Bill was announced but progress on passing this Bill was on hold at the time of writing (Department of Health, 2018).

Are there any circumstances where I can't breastfeed in public?

Across the UK, there are two main categories where it is not unlawful to prevent a mum from breastfeeding:

1. If there is a valid health and safety reason to do so. For example, the mum and/or child may be at harm if they do not leave.

2. If there is a justified reason for a single sex service where women would not ordinarily be permitted.

(Maternity Action, 2019)

If you have reason to complain about how you were treated while feeding your child, the first course of action would be to complain to the business/organisation where the mistreatment occurred, where possible (Maternity Action, 2019). Ask them for their complaints procedure, which will explain how to lodge your complaint. If you're not satisfied with the outcome, you could make a claim in a county court in England, Wales and Northern Ireland, or in a Sheriff court in Scotland.
This page was last reviewed in August 2019.
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.

Breastfeeding etc. (Scotland) Act 2005. Available at: http://www.legislation.gov.uk/asp/2005/1 (Accessed 25th August 2019)

British Chambers of Commerce. (2010) Equality Act 2010: What do I need to know? Quick-start guide for businesses who sell goods and services. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/85008/business-quickstart.pdf (Accessed: 25th August 2019)

Department of Health (NI). (2018) Breastfeeding - a great start. A strategy for NI 2013-2023 Mid-term review. Available at: https://www.health-ni.gov.uk/sites/default/files/publications/health/draft-mid-term-review-breastfeeding-strategy.pdf (Accessed 25th August 2019)

Fox R, McMullen S, Newburn M. (2015) 'UK women's experiences of breastfeeding and additional breastfeeding support: a qualitative study of Baby Café services', BMC Pregnancy and Childbirth, 15: 147. doi: 10.1186/s12884-015-0581-5

Gov.uk (2015) New mothers are anxious about breastfeeding in public. Available at:

https://www.gov.uk/government/news/new-mothers-are-anxious-about-breastfeeding-in-public (Accessed 9th December 2019)

Kellymom. (2018) Breastfeeding in public. Available at: https://kellymom.com/bf/concerns/legal/bfip/ (Accessed 26th August 2019)

Knowles R. (2019) Breast and bottle feeding safely in a sling. Available at: https://www.carryingmatters.co.uk/breast-and-bottle-feeding-safely-in-a-sling/ (Accessed 29th August 2019)

La Leche League GB. (2016) Out and about with your breastfed baby. Available at: https://www.laleche.org.uk/out-about-with-your-breastfed-baby/ (Accessed 26th August 2019)

Maternity Action. (2019) Breastfeeding while out and about. Available at: https://maternityaction.org.uk/advice/breastfeeding-in-public-places/ (Accessed 25th August 2019)

NCT. (2011) Historic month for NCT as women win right to breastfeed in public. Available at: https://www.nct.org.uk/about-us/news-and-views/news/historic-month-for-nct-women-win-right-breastfeed-public (Accessed 11th December 2019)

NHS. (2017) Breastfeeding in Public. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-in-public/ (Accessed 25th August 2019)

Sex Discrimation (Northern Ireland) Order 1976, c. 5A. Available at: http://www.legislation.gov.uk/nisi/1976/1042/article/5A (Accessed 25th August 2019)

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How to breastfeed in public | Baby & toddler, Feeding articles & support | NCT

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You're not alone if you have questions about breastfeeding in public. Here we explain how to do it comfortably and confidently and what your rights are.

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Is it safe to breastfeed with COVID-19? 

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Is it safe to breastfeed with COVID-19? 

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This NCT resource includes some information on breastfeeding and the COVID vaccine.

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Our breastfeeding counsellors have been receiving lots of questions about coronavirus and breastfeeding. So here we answer your most frequent questions.

Does breastmilk contain coronavirus?

From the limited evidence that is currently available, it's not thought that breastmilk contains or can transmit coronavirus (RCOG, 2020). The biggest risk of infection is through close contact between mother and baby. We know that transmission is by airborne droplets from coughing and sneezing (RCOG, 2020).

Can I still breastfeed if I might or do have coronavirus?

Absolutely. In fact, experts think that the benefits of breastfeeding to bonding and feeding outweigh the potential risks of passing on the virus (RCOG, 2020). Breastmilk boosts a baby's immune system (Unicef, 2020).

You might find it helpful to talk everything through with one of our breastfeeding counsellors, or your healthcare provider. You can call our Infant Feeding Support line for information and support: 0300 330 0700, between 8am and midnight.

How can I breastfeed more safely if I think I might have coronavirus?

Experts recommend the following precautions for breastfeeding (these also apply to parents using formula milk):

1. Thorough hand washing before you touch your baby or anything to do with feeding. This may include nipple shields, breast pumps and dummies. Use soap and water and wash your hands for 20 seconds.

2. Not sneezing or coughing on your baby - make sure you cover your mouth and nose with a tissue or sleeve when you sneeze or cough.

3. Wearing a face mask, if available, while feeding.

4. Very carefully follow sterilisation instructions for breastfeeding equipment after using it - for more information see our article about how to sterilise feeding equipment. This includes making sure all food preparation areas are clean, such as kitchen worktops.

5. Potentially ask someone else to feed your baby your expressed breastmilk - see our article about expressing breastmilk for more information.

(NHS, 2020; RCOG, 2020)

Where can I go for support now many social activities have stopped?

It's always helpful to talk to other women who are breastfeeding for support, tips and company. Although breastfeeding drop-ins may be closed to limit the spread of coronavirus, peer support can be found on most social media platforms online, like this one.

As well as support from our breastfeeding counsellors and your health care providers, our breastfeeding commissioned services are offering virtual breastfeeding support via zoom groups, text messaging and one-to-one calls.

If you live in any of these areas and would like some support from a breastfeeding peer supporter, please get in touch:

Many of our local NCT branches are also providing online breastfeeding peer support via closed Facebook groups. Get in touch to find out more - search on your postcode and message your closest branch to see if they have any online peer support.

Will I be offered the coronavirus vaccine if I'm breastfeeding?

The Joint Committee on Vaccination and Immunisation (JCVI) say that it's safe for breastfeeding women to have the Covid-19 vaccination.

So if you are breastfeeding your baby, you should be offered the COVID-19 vaccine and booster. Further information can be found on the Royal College of Obstetricians and Gynaecologists website.

A health professional such as a GP or midwife can talk you through the risks and benefits to help you make an informed decision about vaccination. Be aware that lots of anti-vaccine stories are spread online and they're not based on scientific evidence. Find out more about breastfeeding and the vaccine here.

Further information

We support all parents, however you feed your baby. You can call our feeding support line on 0300 330 0700 (option 1) to talk to a breastfeeding counsellor about your questions or concerns, whether you're breastfeeding, using formula milk or introducing solids. They have had extensive training, will listen without judging or criticising, and will offer relevant information and suggestions. The line is open everyday from 8am to midnight, including bank holidays.

Read the the NHS advice on what you should do when you're self isolating.

Take a look at the latest public health guidance for pregnant women and parents.

Interactive, engaging and social, our antenatal course is a great way for you to meet other local parents, and get essential unbiased information and knowledge about pregnancy, birth and early days with your baby.

Click on the following links for guidance on self-isolation and social distancing in Arabic, Bengali, Cantonese, French, Gujarati, Mandarin, Polish, Portuguese, Punjabi, Urdu and Welsh.

For more information about coronavirus in various languages see here.

For more information and support, click on the links to see our articles about:

Coping with self-isolation and being stuck at home with your baby
How to look after your baby when you're not feeling well
Coronavirus: top tech and apps to keep you connected to friends
Dealing with anxiety over coronavirus
Coronavirus outbreak: surprising things you can get delivered

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Is it safe to breastfeed with coronavirus? | Baby & toddler, Feeding articles & support | NCT

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The thought of getting coronavirus while breastfeeding your baby might feel worrying. Here are the facts.

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Getting breastfeeding on track after a difficult start

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Getting breastfeeding on track after a difficult start

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Challenges in the early days can feel disheartening.
This La Leche League article offers some useful information on getting breastfeeding back on track after a difficult start.

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When you have early breastfeeding problems, it can feel as if it's "all gone wrong" and the dreams you had about feeding your baby are in ruins. Fortunately, babies are very adaptable and resilient, and so are their mothers! With time, patience and, if necessary, skilled help, it is almost always possible to get feeding back on track after a difficult start. It is always possible to have a close, warm, happy feeding relationship with your baby - even if it might look different from what you had expected. It is important to act quickly, as soon as there are signs that things aren't going well, but even if more time has passed, things can still get better.

Some examples of early difficulties:

You had a more complicated birth. Babies born with the aid of forceps, for example, often take a few days to recover and feed well. If you needed a lot of pain relief in labour, your baby may be sleepy at first.

Your baby was born early, or small for their gestational age. See also breastfeeding premature babies and late preterm babies (those born between 34 and 37 weeks).

You and your baby were separated after birth because one or both of you needed medical care.

Your baby is very sleepy and doesn't have enough energy to breastfeed. See also sleepy baby and newborn jaundice.

Your baby gets frustrated or upset when they try to breastfeed. See also my baby won't breastfeed and the unhappy breastfed baby.

Breastfeeding is very painful for you. See also nipple pain.

Your baby has a physical challenge such as tongue-tie.

Your baby is growing more slowly than expected. See also my baby needs more milk.

Your milk production is lower than you would like it to be. See also my baby needs more milk.

You have plenty of time
Parents sometimes worry that if their baby isn't breastfeeding well, or at all, in the first few hours, days or weeks after birth, it will never happen. While breastfeeding in the first hour after birth is ideal, the window of opportunity for babies to start breastfeeding, and to get better at it, is much longer than this. The early feeding reflexes, which keep babies seeking and attaching to the breast, last for at least two to three months. Where there is milk, there is always the possibility of breastfeeding.
First things first
Sorting out breastfeeding problems can feel overwhelming. There seems to be so much to do, and you might feel you have to do it all at the same time! It is helpful to know what is urgent and what is less urgent. This can help you to work out what to do in what order, and how best to use your time and energy.
Priorities - the "3 Keeps" If it's taking time for breastfeeding to get going:
This useful summary can be downloaded as a free A4 poster here.
Understanding how milk production works
It is possible to restart your milk production after stopping breastfeeding. It is even possible to start milk production if you have never been pregnant! [i] But it is usually much easier to get your milk supply going if you have just given birth - your body expects to make milk at this time.

It is easiest to increase milk production in the first month or so after birth, when your breasts are most receptive. After this, it usually becomes more difficult, because your body is not expecting to make more milk. Even so, some women are able to get a big increase in their milk production later than this. It's always worth giving it a go, if you want to!

Milk production usually increases quickly in the early days after birth and reaches almost peak production by about 10 days. By about a month after birth, most women are making as much milk as their babies will ever need. Babies need about the same amount of milk each day from one to six months of age (from about six months, as they start eating other foods, the amount of milk that they need starts to reduce).

When your baby is born, even if they are born early, you are already making milk. After birth, milk will only keep on being made if milk is being removed from your breasts. If no milk is removed, your milk will dry up within about two weeks. Your breasts will adjust to make the amount of milk that is being removed from them.

If your baby is feeding well and taking as much milk as they need to feel satisfied and grow well, you will continue to make plenty of milk for your baby - or two or more babies, if you have more than one!

Whenever a baby is not feeding well enough to take as much milk as they need, or is not feeding at the breast at all yet, the risk is that your breasts will adjust to making less milk than your baby needs. This is why, if your goal is to breastfeed your baby exclusively (only on your milk) when they are ready, it is vital to make sure that you remove enough milk from your breasts in the early days and weeks after birth. You are removing enough milk if your baby is growing normally and producing wet and dirty nappies as expected, without needing anything other than your milk.
Why breastfeeding might be difficult at first
The most common reason for a baby not to feed well is that they are not quite getting a deep enough mouthful of breast. When this happens, breastfeeding might hurt, the skin on your nipples may become damaged and/or your nipples might look pointy, like a new lipstick, when your baby comes off the breast. Skilled face to face breastfeeding support usually helps most in this situation.

Another common reason for babies not to feed well is that they don't yet have enough energy. They may be keen to breastfeed, and feed well for a short time, but they get tired before they get as much milk as they need. This group may include babies who were born early, had a more difficult birth, are small, unwell, jaundiced, tongue-tied, etc. They need more time and support (and medical treatment if necessary) until they are ready to breastfeed fully.

Some mothers are not able to make all the milk their babies need. Reasons for this include:

A history of infertility due to hormonal imbalances.

Past breast surgery, especially breast reduction.

Breast hypoplasia/Insufficient Glandular Tissue (IGT). Breasts may be unusually small, unevenly sized, long and thin, with a wide space between them. There may be no breast changes, such as increase in size and tenderness, during pregnancy and after birth.

Very large blood loss after birth - enough to make you very unwell.

PCOS (polycystic ovary syndrome).

Thyroid problems (over- or under-active).

Obesity (BMI over 30).

If any of these apply to you, you may still be able to make enough milk for your baby. However, if your breastfed baby isn't growing well, and any of the reasons above apply to you, it is very important to find skilled breastfeeding support quickly.

If you have done all you can to:

Help your baby attach deeply to the breast

Make sure your baby feeds at least 8-12 times in 24 hours

Keep your baby active at the breast by using compressions and switching sides when your baby stops actively feeding (you can find out how to do both of these here)

but your baby still isn't growing as expected, or there are other reasons to think that your baby is not getting all the milk they need, then it is important to start expressing your milk quickly. Your baby also needs to be checked by a doctor. Most babies who grow slowly are well, but occasionally slow growth can be a first sign of underlying illness, so it's important to rule this out.
Turning feeding around - changing direction
When a baby is breastfeeding but is not feeding efficiently yet and is growing slowly, it is tempting to spend more and more time trying to breastfeed your baby. This can end up being a negative cycle:

because not enough milk is being removed, milk production decreases;

because milk production is decreasing, the milk is harder for the baby to remove;

because the baby is getting less milk than they need, their energy decreases;

because they are feeding with less energy, breastfeeding becomes less effective and less milk is removed.

Expressing your milk creates a positive cycle:

because more milk is being removed, your breasts make more milk;

because milk production is increasing, the milk is easier for your baby to remove;

because your baby is getting more milk, their energy increases;

because your baby is feeding with more energy, breastfeeding becomes more effective and more milk is removed.

Active breastfeeding
If your baby is spending a lot of time breastfeeding but is not growing as expected, you may need to limit their time at the breast, to give you enough time to express. Breastfeed while your baby is actively feeding, with deep sucks and swallowing after every one-two sucks. When your baby is only swallowing after every three sucks, or more, they are no longer actively feeding, and it would be more efficient to end the feed and express milk instead. A baby who breastfeeds "all the time" is probably asleep and not feeding actively for much of this time (light, fluttery sucks, very little swallowing).
Expressing milk
This protects milk production by removing more milk from your breasts than your baby is able to take on their own. If your goal is for your baby only to have your milk, your aim will be to express enough milk so that your baby can grow as expected and seem satisfied just on your milk.
How often to express
If your baby is able to get almost enough milk at the breast, you might only need to express once or twice a day. If next time your baby is weighed, they are still growing slowly, increase the number of expressions.

If there is a big gap between the amount of milk your baby is able to get at the breast and the amount your baby needs, you will need to express more often, if your goal is for your baby to be fed only or mostly on your milk. If your baby is not breastfeeding at all, you would need to express at least 8-12 times in 24 hours, which is how many times most babies need to breastfeed.

You don't need to express regularly (most babies don't feed regularly), just whenever you can. The important thing is how many times you express in 24 hours - it's up to you when you do it. Experiment to see what works best. It's fine to take a break for a few hours to go out or to sleep! More, shorter expressions often work better than fewer, longer ones and it's fine to stop in the middle of expressing, if you need to do something else. You might find that you get a new flow of milk when you start again. Even if you only have a few minutes, it's worth expressing.
How to express
For most women, the best tool for doing a lot of expressing (more than once or twice a day) is a double electric breast pump. Manual and single pumps are very small tools for this very big job, though some people find that they can express plenty with a small pump, or just using their hands. You can find more information about how to express milk here.
Expressing longer-term
Mothers who need to express milk beyond the early weeks may find that they can reduce the number of times they express, while still getting the same amount of milk. You can read more about this (sometimes called the "magic number") here and find out why it varies so much between women here. Some mothers can get all the milk they need just by expressing two or three times in 24 hours! Some mothers feed their babies exclusively on expressed milk. You can read more about this in the book " Exclusively Pumping Breastmilk ".

Babies always feed as well as they can - they are never "lazy" or uncooperative! If feeding is not going well yet, it is because it is difficult for your baby at the moment. They need extra support with feeding until they are able to do all the work by themselves.

If your baby is able to do almost all the work of feeding, breast compression and switching sides when they are no longer actively feeding may be enough to help them get all the milk they need at the breast.

If your baby is unable to get all the milk they need at the breast even with some help, they will need extra milk, for the time being.
How much milk do babies need?
In the first 24 hours of life babies need an average of about 7ml (1 ½ teaspoons) of milk per feed. This roughly doubles every day for the first few days. If you are expressing your milk, for example because your baby was born early, it helps to know how much to aim for:
500ml of milk in 24 hours by 10 days old; 750ml of milk in 24 hours by two-three weeks old.
Some babies need more or less milk than this - these are average amounts. Some babies need as much as 1300ml of milk in 24 hours.

If your baby was born early, they might need much less milk than this at the moment, but this gives you an idea of how much milk they are likely to need when they reach term age and size. It is important to aim for these amounts in the early weeks (if your goal is to feed your baby only on your milk) because it becomes more difficult to increase milk production later on. It is helpful to keep a record of how much you are expressing, so you can see how things are changing over time. If you are not expressing anything like these amounts yet, it is important to find a skilled feeding supporter quickly.
What kind of milk?
The first choice of extra milk is always a mother's own expressed milk, which is tailor-made for her baby. The second choice is donated milk from another mother. The safest way to get donated milk is from a registered Milk Bank.[ii] When these are not available in the amounts needed, infant formula milk may be necessary.
Formula milk
When you were looking forward to breastfeeding your baby, it can feel disappointing to realise that they need formula milk as well. You might even wonder whether it is worth carrying on breastfeeding, or whether your baby will come to prefer formula milk. It can help to think of formula milk as a kind of medication, to give your baby the energy they need to breastfeed well. You can read here about how to use formula milk strategically to support breastfeeding. It is often possible to reduce the amount of formula milk that your baby needs, as they get better at breastfeeding and your milk supply increases. If you need to use formula milk during the whole time your baby is fed only with milk, you may be able to reduce it after your baby starts eating other foods as well, from about six months.
How to feed extra milk to your baby
There are many options for feeding your baby extra milk. You can find information about choosing and using bottles, cups and more here and about nursing supplementers (a tool that enables you to feed extra milk at the breast while your baby breastfeeds) here. Your feeding supporter can help you decide which options might work for your baby.

Breastfeeding provides more than just milk - it gives you and your baby lots of time to touch, gaze at and enjoy being with each other. These, much more than the milk itself, are what builds strong connections between breastfeeding mothers and their babies. Mothers (and dads, co-parents and other key adults) are able to build strong relationships with their babies when they are feeding in other ways, too.

Skin to skin contact is an amazing way for your baby to connect with the important people in their life. Babies held skin to skin are calmer, more relaxed, warmer, cry less and have more stable heart rates and breathing than babies who are wrapped up. They are also protected against infection by being exposed to the "good bacteria" on your skin. And it feels lovely! You can read more about the magic of holding your baby skin to skin here.

"Wearing" your baby in a sling or carrier is a great way to keep your baby close while you get on with other things. Being carried gives your baby many benefits, including more to look at, physical exercise, and less crying. You can read more about carrying your baby here.
When breastfeeding is stressful
When breastfeeding is difficult for your baby it may become stressful for both of you. Babies who have had stressful experiences at the breast can develop negative associations with breastfeeding. This might happen, for example:

When a baby is in pain or discomfort after birth.

When a more sensitive baby is handled in a way they don't like.

When milk supply is low, or a baby has a physical restriction that makes attaching and sucking difficult.

A baby who is finding feeding hard may become upset:

A short time into the feed, when milk flow slows down.

At the start of the feed, when milk doesn't come straight away.

When offered the breast.

When put in a breastfeeding position.

When they see the breast.

When feeding isn't going well, babies may come to associate the breast with feeling hungry and frustrated. They may develop a preference for another feeding method, such as a bottle, if they associate it with feeling full and satisfied.

If you and your baby are in this situation, you might need a "breastfeeding break". You could stop trying for a few days, while expressing your milk to keep your baby fed and protect your milk supply. When you're both ready, you can try again.
Happy time at the breast
However hard feeding has been, your baby can still discover that the breast is a great place to be, where they feel calm, relaxed and satisfied. Here are some things you could try:

If your baby has been refusing to feed, then try offering the breast when they are calm rather than when they are already hungry or upset. If your baby is having extra milk, give some or most of their feed by cup, bottle, etc. before letting your baby finish the feed on the breast.

Laid-back breastfeeding. Allowing your baby to find their own breastfeeding position and to attach themselves can work especially well for babies who have had stressful experiences of being "put" to the breast.

If you are giving extra milk, try giving it with your baby's cheek resting against your bare breast.

Consider using a nursing supplementer so your baby can have extra milk while they breastfeed. This can be helpful when milk supply is low.

"Breast-sleeping". Let your baby end a feed by sleeping with their cheek pillowed on the breast. Babies who are having all their milk by cup, bottle, etc. can enjoy doing this too.

Take a bath with your baby. Low lighting and relaxing music can help set the scene! Some babies will find their own way to the breast, and even if they don't latch and feed, the bath can be a good place to learn to feel comfortable near the breast.

Consider sleeping with your baby. Some babies will attach and feed in their sleep, if the breast is near enough to smell and feel when they stir in the night. Always consider sleep safety before sleeping with your baby in your bed. It is never safe to sleep with a baby on a sofa.

Babies are hardwired to breastfeed
Breastfeeding is an essential survival behaviour and all healthy babies will continue to try for many weeks after birth. As long as your milk supply is protected, and your baby is fed, you and your baby have plenty of time to learn to breastfeed. You can find a feeding relationship that works for you both - even if it isn't quite what you imagined before your baby arrived. 'Successful breastfeeding' can look like many different things for different families.

Getting skilled support can help, as can hearing from other mothers who had a difficult start with breastfeeding and have found their way through it. La Leche League groups welcome anyone who is breastfeeding or providing their own milk for a baby or trying to do so. Please don't feel awkward about needing to give your baby extra milk, in any way you need to, at an LLL meeting! We would love to meet you and your baby. You can find your nearest group here.

Jayne Joyce & Emily Tammam

LLL Oxfordshire

April 2020

[i] https://www.laleche.org.uk/relactation-induced-lactation/

[ii] LLL's policy on informal sharing of breastmilk.

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Getting breastfeeding on track after a difficult start - the "3 Keeps" - La Leche League GB

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When you have early breastfeeding problems, it can feel as if it's "all gone wrong" and the dreams you had about feeding your baby are in ruins. Fortunately, babies are very adaptable and resilient, and so are their mothers! With time, patience and, if necessary, skilled help, it is almost always possible to get feeding [...]

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Simple guide to formula - First Steps Nutrition Trust

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Simple guide to formula - First Steps Nutrition Trust

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This guide contains useful information on formula milks, how to safely make up powdered milks and answers frequently asked questions regarding formula milks.

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Wolverhampton's face-to-face breastfeeding support and social groups

Many pregnant women find it very helpful to attend a breastfeeding support group before the birth of their baby, to talk to other mothers, ask questions and meet breastfeeding supporters.

New mothers also value support groups to gain practical breastfeeding support and information from peer supporters, and to meet other mothers to share their experiences.

Run by Wolverhampton's Infant Feeding Team and 0-19 Health Visiting Team, our face-to-face support groups operate on a drop-in basis, so there is no need to book to attend. Partners, friends, and family members are welcome to join you.

Tuesdays, 10am-12pm - Low Hill Strengthening Families Hub, Fourth Avenue, Wolverhampton, WV10 9LZ

Wednesdays, 10am-12pm - Pendeford Health Centre, Whitburn Close, Wolverhampton, WV9 5NJ

Wednesdays 10.30am-12.30pm- The Children's Village Strengthening Families Hub, Graiseley Lane, Wolverhampton, WV11 2PE

Thursdays, 10am-12pm - Bingley Strengthening Families Hub, Norfolk Road, Pennfields, Wolverhampton, WV3 0JE

If you are working, you may be able to ask your workplace for time off work to 'attend' one or more group sessions if they've been recommended by a health professional - ask your doctor or midwife for details.

Wolverhampton's 'virtual' breastfeeding support and social groups

Many pregnant women find it very helpful to attend a breastfeeding support group before the birth of their baby, to talk to other mothers, ask questions and meet breastfeeding supporters.

New mothers also value support groups to gain practical breastfeeding support and information from peer supporters, and to meet other mothers to share their experiences.

We are also continuing to offer 'virtual' breastfeeding groups online, which are being run by The Breastfeeding Network via Zoom, on a Tuesday and Thursday morning each week from 10:00am - 12:00pm.

If you are working, you may be able to ask your workplace for time off work to 'attend' one or more group sessions if they've been recommended by a health professional - ask your doctor or midwife for details.

For more information and to book a place onto one of the sessions, visit Wolverhampton Virtual Breastfeeding Group's Facebook page or email wolverhampton@breastfeedingnetwork.org.uk.

Flo - a free text message system for pregnant women and new mothers

If you are pregnant or a new mother, you can sign up to a free text message service known as 'Flo', to receive informative and motivational text messages.

The 'Flo' message service will send you regular helpful and supportive tips, videos and messages before and after baby arrives, on topics such as relationship building, what to expect, feeding your baby and safer sleep, by text to a mobile phone.

While you are pregnant, the friendly and reassuring texts will arrive from 28 weeks until baby your baby is born.

After your baby's birth, if you text Flo with 'BIRTHDAY' and baby's date of birth, Flo will continue to send you useful informative texts to help you as a new mother also.

Flo is interactive too - if you need further help with feeding your baby you can text Flo, to receive a message with details of how to access the support and information you need.

To sign up to Flo for free, just need to speak to their midwife or email the Trust's Infant Feeding Team.

National sources of breastfeeding support

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

The Breastfeeding Network
Supporterline - 0300 100 0210
Supporterline in Bengali / Sylheti - 0300 456 2421
Drugs in Breastmilk Helpline - email druginformation@breastfeedingnetwork.org.uk
http://www.breastfeedingnetwork.org.uk/

The Breastfeeding Network also offers support via:

Twitter (@BfN_UK)

Instagram

@TheBreastfeedingNetworkUK Facebook page

@BfNDrugsinBreastmilkinformationservice Facebook page

@NationalBreastfeedingHelpline Facebook page

Webchat and email via the BfN website

The Association of Breastfeeding Mothers
Breastfeeding Helpline - 0300 330 5453
http://www.abm.me.uk/

La Leche League
Breastfeeding Helpline - 0845 120 2918
http://www.laleche.org.uk/

The National Childbirth Trust
Breastfeeding Helpline - 0300 330 0771
http://www.nct.org.uk/

On-line Support
For video clips of mothers talking about their experiences of breastfeeding and how to position and latch your baby:

Start4Life Breastfeeding Friend (BFF) Chatbot
Public Health England's Breastfeeding Friend (BFF) ChatBot provides day and night support and information. To access the BFF chatbot simply open Facebook and search "Start4Life Breastfeeding Friend" or visit the Start for Life - Breastfeeding website

You can access the Start4Life Breastfeeding Friend (BFF) Chatbot from:

Baby Buddy App
The Baby Buddy App for parents and parents to beis from the child health and wellbeing charity Best Beginnings to guide you through your pregnancy and the first six months of your baby's life, including information on infant feeding, local services, a question and answer function, plus helpful videos.

Resources in Other Languages

There is also support available in other languages, plus infosheets on breastfeeding and bottle feeding in different languages - see our Resources in Other Languages webpagefor details.

Breastfeeding support out of the area

Do you live outside Wolverhampton? Please use the following links to find breastfeeding support in your area:

Staffordshire and Stoke-on-Trent

Walsall

Sandwell

Birmingham

Dudley

Telford & Wrekin

Lactation Consultants

Work on a fee basis, in private practice, providing additional support to women in their own homes. For more information visit the Lactation Consultants of Great Britain website.

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Resources provided to support breastfeeding.

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Wolverhampton's face-to-face breastfeeding support and social groups Many pregnant women find it very helpful to attend a breastfeeding support group before the birth of their baby, to talk to other mothers, ask questions and meet breastfeeding supporters. New mothers also value support groups to gain practical breastfeeding support and information from peer supporters, and to meet other mothers to share their experiences.

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Different breastfeeding positions & tips

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Different breastfeeding positions & tips

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The way you hold your baby or position them will affect how easy it is for them to breastfeed effectively. You can breastfeed your baby in many different positions, so it's good to try different ones. This helps you find what's most comfortable for you and allows your baby to get just the right mouthful of breast to feed effectively and easily.

Breastfeeding positions for newborns

When you first start breastfeeding, you and your baby may take a while to master this new skill. Patience and trying different positions will help you find a position that works for you both.
Our video has some great tips on different ways to hold your baby.
If you're having problems breastfeeding, or with latching or attachment, do call our infant feeding support line on 0300 330 0700 to talk to a breastfeeding counsellor. Your midwife or health visitor may know about local breastfeeding support groups.

Getting some support with breastfeeding can help you to get comfortable in one or more of the breastfeeding positions that we describe in this article.

Here's how to get started...

Preparing to feed

Your baby will be happier and will latch more easily if you can identify and respond to their early feeding cues. If they are crying or upset, they need to be calmed before they are ready to feed.

Holding them against you, talking to them, walking around or gently rocking might help if they need to be calmed. Most babies like to have their hands free to touch and stroke your breast; this helps to reassure them that they are in the right place.

Read more about getting started with breastfeeding in our article here.

Laid-back position

Sitting upright

Lying down

Underarm or rugby ball

Holding your baby under your arm may be suggested to women who have given birth by caesarean, to avoid pressure on the wound. This position might also be suggested to mothers of twins. However, it can be difficult to maintain this position as the baby's weight is being taken by the mother's hand. Babies soon outgrow this position, and it doesn't allow them to use their instincts and reflexes to attach on to the breast (NHS, 2020; La Leche League, 2022).

Breastfeeding positions for a fast milk flow

If you have a fast milk flow, this could be due to a large supply of breast milk. A fast milk flow can make your baby cough, splutter and come off the breast, which is sometimes similar to reflux symptoms. If they're having problems, it could be that the baby needs more control when they're feeding. If this is the case, laid-back feeding, where the baby is more in control, could be useful as it helps your baby to attach better and pull back if they need to take a break.

Breastfeeding your baby as they grow

As your baby grows, they become more active in getting themselves into position, and they're longer and heavier. So you might need to adjust you and your baby's position to continue to feed comfortably and effectively.

A laid-back breastfeeding position could be useful with larger or older babies as you do not have to use your arms to hold their weight. You can always ask a breastfeeding counsellor for support with finding positions that suit you and your baby.

Breastfeeding position tips

Whichever breastfeeding position you choose, remember...

Get comfortable before you start.

Tuck your baby in closely to you.

Bring your baby to your breast or let them attach themselves rather than leaning towards them.

Avoid putting the breast in your baby's mouth; let them take it in themselves.

Check that their ear, shoulder and hip are all in a line - not twisted round.

If you are bringing your baby to your breast, make sure they are turned towards your breast, with your nipple level with baby's nose - they shouldn't have to turn their head.

Cushions, special breastfeeding pillows and other supports can prevent your baby's body from getting close enough to your body or may raise your baby's body too high for effective attachment. It's best to get your baby attached to the breast, then if support is needed tuck a pillow in under your arm at the point where you are feeling strain from the weight of the baby.

(UNICEF and NHS, 2022)

Many women and babies take a while to get used to breastfeeding and it can take a while to find the position(s) that work best for you. Experimenting with different positions can help you find the ones that work best for you and your baby.
Page last reviewed December 2022.
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.

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

For further information on how to breastfeed, including positioning and breastfeeding attachment, and a section on expressing your breastmilk by hand, visit Unicef's Baby Friendly Initiative support area for parents.

Bump to Breastfeeding DVD: available from your midwife or library - see more at www.bestbeginnings.org.uk

Coulson S. (2012) Biological nurturing: the laid-back breastfeeding revolution Midwifery today. 101. Available at: https://midwiferytoday.com/mt-articles/biological-nurturing/ [Accessed 7th November 2022]

La Leche League. (2022) Positioning. Available at: https://www.llli.org/breastfeeding-info/positioning [Accessed 7th November 2022]

Milinco M, Travan L, Cattaneo A, Knowles A, Sola MV, Causin E, et al. (2020) Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial. Int Breastfeed J. 15(1):21. Available at: https://doi.org/10.1186/s13006-020-00261-4

NHS. (2020) How to breastfeed. Available at: https://www.nhs.uk/start4life/baby/feeding-your-baby/breastfeeding/how-... [Accessed 7th November 2022]

UNICEF; NHS. (2022) Off to the best start. Available at: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfe... [Accessed 25th November 2022]

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Breastfeeding positions: which are best for you? | Baby & toddler, Feeding articles & support | NCT

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Here we provide tips on breastfeeding positions, including laid-back, lying down, sitting upright and underarm positions.

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Why won't my newborn baby breastfeed?

Sometimes, newborn babies struggle to latch on to breastfeed after they're born. It can be worrying for new parents when this happens - you might think something's wrong.

There may be a simple explanation. This information could help you find your own solution, or decide if you need further support.

Some of the more common reasons for newborn babies finding it difficult to latch onto the breast could be:

a difficult labour or birth - your baby might feel sore or have a headache if the mother has had interventions in labour or if they were born very quickly

medication used during labour - anaesthesia, epidural or pethidine can make your baby sleepy or groggy

your baby being separated from you after birth - even for a few minutes

discomfort due to a birth injury or bruising

swallowing mucus at birth can make your baby feel congested, nauseous or uncomfortable

an early unpleasant experience of attempting to breastfeed, such as being forced onto the breast

the baby might have tongue-tie

Why won't my baby breastfeed anymore?

Sometimes, older babies seem to refuse to breastfeed when they'd been breastfeeding just fine until then. This is known as a 'nursing strike.' They might refuse to breastfeed for 2-4 days, but it can be up to 10 days (Mohrbacher, 2013).

Reasons that your older baby might refuse to feed at the breast could include:

something has changed that makes it difficult for baby to latch

a strong or fast flow of milk, which your baby is struggling to take

a painful mouth, due to an infection like thrush or because they're teething

being more aware of their surroundings and being easily distracted, for example by noise

a change in the taste of your milk, such as that due to your menstrual cycle

the introduction of more solid food

a small number of babies might struggle because of severe or persistent reflux, known as gastro-oesophageal reflux disease (GORD), so they may link feeding with pain.

(Mohrbacher, 2013; Gonzalez, 2014; BellyBelly, 2016; NICE, 2017; Public Health England, ND)

What can I do when my baby refuses to breastfeed?

8 top tips to help your baby who's refusing to breastfeed:

1. Try to identify what's going on for your baby. Knowing the cause can help not only with a plan but it can be reassuring to understand what is happening and know there's a solution. You could think about the following:

Do they have a cold or an infection?

Was there something that might have caused them to not want to feed?

Talk to one of our Breastfeeding Counsellors or contact our Infant Feeding Line on 0300 330 0700 (option 1) for further support. It can be a great way to get some help to find out what's happening.

You could also contact a health professional to investigate any medical reasons why your baby might not be feeding.

2. Try to stay calm and not force a feed. Instead, allow your baby to take the lead.

3. Especially for young babies, many mums find skin-to-skin contact in a laid-back position helps to take the pressure out of the situation. It allows your baby to use their own natural instincts to feed (Burbridge, 2017).

4. Don't worry if your baby bobs their head or moves it from side to side, they're not rejecting the breast as it might appear. These are your baby's natural ways of finding your breast (Coulson, 2012).

5. Try a different feeding position to see if you can get your baby more comfortable. Some babies find a laid-back breastfeeding (also called biological nurturing) position helpful if they are struggling to get a deep latch or if you have a strong let-down of milk (Coulson, 2012).

6. Sometimes, feeding your baby while they're sleepy or even asleep can be helpful. Many mums say that these 'dream feeds' can be very effective for a baby who is uninterested when awake (Pitman and Bennett, 2008).

7. You could try feeding your baby while rocking them or walking around, singing or playing with them or playing white noise or background music to them (Australian Breastfeeding Association, 2017).

8. You might want to try feeding in a quiet room, away from distractions, as some babies are so keen to be involved that they limit their feeds (Gonzalez, 2014).

What can I do if I've tried everything but my baby still won't breastfeed?

One of the key things to consider is maintaining your milk supply. You might need to consider expressing, either by hand or with a pump. You can find more information about expressing and storing your milk here.

Another consideration is making sure your baby is getting enough milk. How might you know how much milk your baby is getting, you might ask. The answer lies in their dirty and wet nappies. You can expect six wet nappies in 24 hours if your baby is over a week old (UNICEF, 2016). If you're unsure, it's best to ask for support from your health visitor, GP or NCT breastfeeding counsellor.

In the short term, you might need to look at alternative ways to feed your baby if you think they're not getting enough milk. A newborn baby needs to be fed regularly and parents can use syringe or cup feeding as an alternative to a bottle in the early days (Flint et al, 2016; NHS, 2016).

If you decide to use a bottle, it might be helpful to feed with plenty of skin-to-skin contact (UNICEF, 2018). Gently offering the bottle to your baby by tickling their top lip, waiting for the wide-open gape might also help mimic a breastfeed (UNICEF, 2019). That can support the transition back to the breast.

Taking frequent breaks during the bottle feed, and perhaps swapping sides, can be helpful (UNICEF 2018). Continuing to have skin-to-skin time with your baby and allowing them access to the breast will help this. It'll also be a bonding and calming experience for you both.

How can I deal with the stress of my baby refusing to breastfeed?

When a newborn refuses the breast, or an older baby goes through a nursing strike, it can be very upsetting for both you and your baby. You're definitely not alone in struggling with the emotions of breastfeeding problems. So here are some tips that might help:

1. Try to take time to enjoy plenty of extra cuddles and quiet time together.

2. Many mums find a 'babymoon' helpful for allowing their baby access to the breast in a non-pressurised way. A babymoon means spending some hours together in a relaxed setting, such as lying down snuggling in bed. This can allow you to enjoy your baby without worrying about feeding.

3. For older babies, some mums find that having a bath with their baby or bringing their baby into bed with them helps their baby to latch.

4. Try to find some support from other mums and trained breastfeeding supporters. Chatting with other people about this can help to unburden the stresses and worries you might be feeling. Breast refusal is not uncommon and you might find that chatting to someone who understands is invaluable while you're struggling.

5. For many mums, time and patience can help the situation. Your baby's instincts and behaviour can change and develop, especially in the early days.

6. If you're struggling, do contact the NCT Infant Feeding Line and speak to a breastfeeding counsellor. They'll listen, offer you information and will support you to find your own path.

This page was last reviewed in August 2019.
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.

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

NHS information on mastitis.

Best Beginnings - Bump to Breastfeeding DVD Chapter 7 'Overcoming Challenges'.

Healthtalkonline.org: Managing Breastfeeding - dealing with difficult times.

Australian for Breastfeeding Association (2017) Breast refusal. https://www.breastfeeding.asn.au/bf-info/breast-refusal [Accessed 22nd February 2019]

BellyBelly. (2016) Breast refusal - 13 tips for a baby that refuses the breast.
https://www.bellybelly.com.au/breastfeeding/breast-refusal/ [Accessed 22nd February 2019]

Burbridge A. (2017) Nursing strikes. La Leche League GB. Available at: https://www.laleche.org.uk/nursing-strikes/ [Accessed 1st August 2019]

Coulson S. (2012) Biological nurturing: the laid-back breastfeeding revolution. Midwifery Today, 101 Available at: https://midwiferytoday.com/mt-articles/biological-nurturing/ [Accessed 1st August 2019]

Flint A, New K, Davies MW. (2016) Cup feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed. Cochrane Database Syst Rev. (8):CD005092. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005092.pub3... [Accessed 1st August 2019]

Gonzalez C. (2014) Breastfeeding Made Easy. London: Pinter &Martin

LLLGB. (2016) My baby won't breastfeed. Available at https://www.laleche.org.uk/my-baby-wont-breastfeed/ [Accessed 1st August 2019]

Mohrbacher N. (2013) Is your formerly nursing baby refusing to breastfeed? Breastfeeding Reporter Blog. Available at http://www.nancymohrbacher.com/articles/2013/1/26/is-your-formerly-nursing-baby-refusing-to-breastfeed.html?rq=refusing [Accessed 1st August 2019]

NICE. (2017) Breastfeeding problems. National Institute for health and Care Excellence, Clinical Knowledge Summaries. Available at: https://cks.nice.org.uk/breastfeeding-problems#!scenario [Accessed 1st August 2019]

Pitman T, Bennett H. (2008) 0-1 year: nursing strikes; breastfeeding while baby's falling asleep may help end a nursing strike. Today's Parent. 7:137.

Public Health England. (ND) Breastfeeding challenges. NHS, Start 4 life. Available at: https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/reflux/ [Accessed 1st August 2019]

UNICEF. (2016) Breastfeeding checklist for mothers - How can I tell that breastfeeding is going well? UNICEF UK Baby Friendly Initiative. Available at https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2016/10/mothers_breastfeeding_checklist.pdf [Accessed 1st August 2019]

UNICEF. (2018) Skin-to-skin contact. Available from: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/guidance-for-health-professionals/implementing-the-baby-friendly-standards/further-guidance-on-implementing-the-standards/skin-to-skin-contact/ [Accessed 1st August 2019]

UNICEF. (2019) Responsive bottle feeding. Available from: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2019/04/Infant-formula-and-responsive-bottle-feeding.pdf [Accessed 1st August 2019]

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Why is my baby refusing the breast? 8 tips that help | Baby & toddler, Feeding articles & support | NCT

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Sometimes, newborn babies struggle to latch on to breastfeed after they're born. It can be worrying for new parents when this happens - you might think something's wrong. There may be a simple explanation. This information could help you find your own solution, or decide if you need further support.

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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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Learning you are pregnant with twins, triplets or more changes your expectations and plans. But you can still plan to breastfeed. Breastmilk is a complete and perfect food for your baby. It is especially important for multiples, who are often small at birth. Breastfeeding also helps you create a spe…

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When should I feed my baby?

As a rough guide, babies need to feed at least eight to 12 times (sometimes more) over 24 hours during the first few weeks (NHS, 2019a; UNICEF, 2010). That means they'll probably need to feed every two to three hours.

Watch our video for tips on how often and how long to breastfeed your baby for.

It's best to feed babies responsively or in a baby-led way rather than sticking to a feeding schedule (WHO, 2009; Entwistle, 2013; Fallon et al, 2016). Letting your baby feed when they want will help them get the milk they need. It will also stimulate your milk supply (Infant and Young Child Feeding, 2009).

What if I'm struggling or worried about the number of feeds?

We know from the experiences of new mums that breastfeeding responsively can feel emotionally and physically challenging (Fallon et al, 2016).

A baby that breastfeeds frequently can give parents a sense of reassurance but it can also cause worry. Some people may think frequent feeding is a sign of insufficient milk, or that baby isn't getting enough breastmilk during feeds. This sometimes leads to women supplementing feeds with formula milk or deciding to stop breastfeeding (Leurer, 2015).

Try and keep in mind that a newborn baby's stomach is really small. They need to feed little and often (NHS, 2020). It's really common for babies to have a good feed and then appear to be hungry again quite quickly. This doesn't mean something is wrong or that they're not getting enough milk. It's just the way newborn babies feed (Kent et al, 2012).

All of this also means that newborn feeding is frequent. In fact, much of the time, it's not really a question of clearly-defined 'feeds' with clear beginnings and endings (WHO 1998).

Your baby knows your voice, your smell and your taste but they are much less familiar with the 'world' outside your womb. Staying close to you gives them a vital sense of safety and reassurance. This builds their confidence that they are loved and cared for (Crenshaw, 2007).

If you're worried, it can really help to talk through your concerns with a breastfeeding counsellor. So call our Infant Feeding Support line on 0300 330 0700.

Will I produce enough milk?

The more you breastfeed your baby, the more milk you will produce (Daly & Hartmann, 1995). If your baby is attached properly, and you're both comfortable and feeding them when they ask for it, you will make enough milk for them (Kent et al, 2012; WHO 2019).

How do I know when to feed my baby?

When your baby is hungry they may give you little signals, known as early feeding cues (NHS, 2019a,b). They might:

* get restless

* suck their fist or fingers

* make murmuring sounds

* turn their head and open their mouth (rooting).

Looking out for and responding to these cues is important. It can help prevent your baby from becoming upset and frustrated, which will make it more difficult to feed them (WHO, 2009). Here's what you might see...

How long should each feed last?

Every baby is different and they will go through different patterns of feeding as they grow (Kent et al, 2012). How much milk a baby needs per breastfeeding session will vary. It's best to be guided by your child (Kent et al, 2012).

Some feeds will seem to last a long time, with your baby dozing for short periods before wanting more. And more. And still more! It's normal for a young baby to be on the breast many times a day and night. 12-15 'visits' to the breast is well within a normal range (Entwistle, 2013).

As a general rule, babies who are feeding well will feed for between five and 40 minutes at each feed (UNICEF, 2010). Your baby will let you know when they've had enough milk. They will usually come off the breast themselves, look sleepy or calm, and look around (UNICEF, 2010).

During each breastfeed, your milk changes slightly. So the milk at the end of the feed is more creamy and filling than the milk at the beginning of the feed (Ballard and Morrow, 2013). Offer one breast and let your baby feed until they stop drinking. If they still appear hungry, offer the second breast - allowing them to drink as much as they want (NICE, 2015).

Should I wake my baby up to feed?

In most cases, healthy, thriving newborns will wake up for feeds and, provided they are well latched on, get all the milk they need (Australian Breastfeeding Association, 2017). But there might be reasons why a newborn might be more sleepy and therefore need to be woken up for feeds.

This includes medical reasons, such as jaundice, infection or a heart problem, or perhaps because the pain relief used during birth is still affecting them (Australian Breastfeeding Association, 2017). If you're worried your baby might be sleeping too much and this is affecting their feeding, talk to your health visitor or call our Infant Feeding Support line on 0300 330 0700.
This page was last reviewed in March 2021
Further information

We support all parents, however they feed their child. 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.

National Breastfeeding Line (government funded): 0300 100 0212.

Australian Breastfeeding Association. (2017) Do I need to wake my baby for feeds? Available at: https://www.breastfeeding.asn.au/bfinfo/do-i-need-wake-my-baby-feeds [Accessed 20 March 2021].

Ballard O, Morrow AL. (2013) Human milk composition: nutrients and bioactive factors. Pediatric Clinics of North America. 60(1):49-74. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586783/ [Accessed 20 March 2021].

Crenshaw J. Care practice #6: No separation of mother and baby, with unlimited opportunities for breastfeeding. Journal of Perinatal Education2007;16(3):39-43. Available at: doi:  10.1624/105812407X217147 (Accessed 26 Apr 21)

Daly SEJ, Hartmann PE (1995). Infant Demand and Milk Supply. Part 1: Infant Demand and Milk Production in Lactating Women. Journal of Human Lactation. 11(1):21-26. doi:10.1177/089033449501100119 Available at https://journals.sagepub.com/doi/10.1177/089033449501100119 [Accessed 13 April 2021]

Entwistle FM. (2013) The evidence and rationale for the UNICEF UK Baby Friendly Initiative standards. UNICEF UK. Available at: https://www.unicef.org.uk/babyfriendly/about/evidence-and-rationale-for-the-baby-friendly-standards/ [Accessed 20 March 2021].

Fallon A, Van der Putten D, Dring C, Moylett EH, Fealy G, Devane D. (2016) Baby-led compared with scheduled (or mixed) breastfeeding for successful breastfeeding. Cochrane Database of Systematic Reviews. (9):CD009067. Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009067.pub3/full [Accessed 20 March 2021].

Kent JC, Prime DK, Garbin CP. (2012) Principles for maintaining or increasing breast milk production. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 41(1):114-121. Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1552-6909.2011.01313.x [Accessed 20 March 2021].

Leurer MD, Misskey E. (2015) "Be positive as well as realistic": a qualitative description analysis of information gaps experienced by breastfeeding mothers. International Breastfeeding Journal. 10(10):2-11. Available at: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-015-0036-7 [Accessed 20th March 2021].

NHS. (2019a) Breastfeeding: the first few days. Available at: http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/breastfeeding-first-days.aspx#building [Accessed 20 March 2021].

NHS. (2019b) Breastfeeding: is my baby getting enough milk? Available at: http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/breastfeeding-is-baby-getting-enough-milk.aspx [Accessed 20 March 2021].

NHS. (2020) Your breastfeeding questions answered. Available at: http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/your-breastfeeding-questions.aspx [Accessed 20 March 2021].

NICE (2015) Postnatal care up to 8 weeks after birth. CG37. Available at: https://www.nice.org.uk/guidance/cg37 [Accessed 20 March 2021].

UNICEF. (2010) Baby Friendly Initiative. Breastfeeding checklist for mothers - How can I tell that breastfeeding is going well? Available at: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2016/10/mothers_breastfeeding_checklist.pdf [Accessed 20 March 2021].

World Health Organization. (1998) Evidence for the Ten Steps to Successful Breastfeeding. Geneva: World Health Organization.

World Health Organization. (2009) Session 2 The physiological basis of breastfeeding. In: Infant and Young Child Feeding. Model Chapter for Textbooks for Medical Students and Allied Health Professionals. Available at: https://www.ncbi.nlm.nih.gov/books/NBK148970/ [Accessed 20th March 2021].
Further reading
Hoddinott P, Craig, LCA, Britten J, McInnes RJ. (2012) A serial qualitative interview study of infant feeding experiences: idealism meets realism. BMJ Open 2:1-14. Available at: https://bmjopen.bmj.com/content/2/2/e000504 [Accessed 20 March 2021].

Martin CR, Ling PR, Blackburn GL. (2016) Review of infant feeding: key features of breast milk and infant formula. Nutrients, 8(5):279. Available at:   https://www.mdpi.com/2072-6643/8/5/279 [Accessed 20th March 2021].

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How often should I breastfeed my baby? | Baby & toddler, Feeding articles & support | NCT

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Read our tips on when to breastfeed your baby and how much milk they need.

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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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Is my baby getting enough milk?

This is a very common question, especially when you first start breastfeeding.

Feeds should begin with a few rapid sucks followed by long, rhythmic sucks and swallows with occasional pauses. Your baby's cheeks should stay rounded, not hollow, during sucking and you should be able to hear and see them swallowing.

Other signs your baby is feeding well:

your baby should seem calm and relaxed during feeds

when they've had enough, they will come off the breast by themselves

they appear content and satisfied after most feeds

after feeds, your breasts feel softer and your nipples should look the same (not flattened, pinched or white)

In the first 48 hours, your baby is likely to have only 2 or 3 wet nappies. Wet nappies should then become more frequent, with at least 6 every 24 hours from the fifth day onwards.

If your baby is feeding well, they should start gaining weight steadily after the first 2 weeks (it's normal for babies to lose some of their birth weight in the first 2 weeks).

In the beginning, your baby will produce a black tar-like poo called meconium. After about 5 or 6 days, they should pass at least 2 soft yellow poos.

Breastfed babies' poo is runny and does not smell.

Have a look at the NHS website for more information on signs your baby is feeding well.

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If you're breastfeeding and worried your baby is not getting enough, have a look at these tips on how to increase your breast milk

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NCT breastfeeding support groups in Wolverhampton

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NCT breastfeeding support groups in Wolverhampton

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Our free NCT breastfeeding group runs every Thursday 10:30-12:30pm at: Action 4 Independence, Albert road, Wolverhampton WV6 0AF.
These drop-in sessions are run by an NCT Breastfeeding counsellor and our team of NCT trained peer supporters, who will be on hand to offer friendly support and information regarding breastfeeding - from pregnancy to infancy and beyond!

It is also a great place to come and meet other parents and support each other. Free to attend, free refreshments and there are toys and activities for babies and children of all ages. Partners, siblings and family members welcome, you do not need to be an NCT member to attend the group.

Other local Breastfeeding Support Groups

Bingley Breastfeeding Support Group When: Monday 1.15 - 2.45pm (term time only) Where: Bingley Strengthening Families Hub, Norfolk Road, Pennfields, Wolverhampton, WV3 0JE Contact: 01902 551979

Bump to Boob Support Group When: Tuesday 10 - 12noon (term time only) Where: Gatis Community Space, Gatis Street, Whitmore Reans, Wolverhampton WV6 0ES Contact: 01902 651155

The Childrens Village Breastfeeding Support Group When: Wednesday 10.30 - 12.30pm Where: The Children's Village, Graiseley Lane, Wolverhampton, WV11 1PE Contact: 01902 553945

Low Hill Breastfeeding Support Group When: Friday 9.30-11am (term time only) Where: Low Hill Strengthening Families Hub , 26-28 Fourth Ave, Low Hill, WV10 9LZ Contact: 01902 553285

NCT Infant Feeding Line: We get lots of calls to our feeding line about breastfeeding and bottle feeding. Whether you need information or reassurance, give us a call on 0300 330 0700 (choose option 1). The line is open everyday from 8am to midnight, including bank holidays. A call to an 0300 number costs the same as a call to a normal home or business landline. If your phone includes free calls to landlines, calls to 0300 numbers will be part of this. You'll speak to one of our friendly breastfeeding counsellors. They've had extensive training, will listen without judging or criticising and offer relevant information and suggestions - whether you're breastfeeding, formula feeding or a bit of both.
You can also ring your Midwife, Health Visitor or Children's Centre for advice during office hours and a midwife is available on the postnatal ward 24 hours a day. Other reputable websites and sources of support: https://www.royalwolverhampton.nhs.uk/services/service-directory-a-z/in... NHS National Breastfeeding Helpline- 0300 100 0212 http://www.breastfeeding.nhs.uk/ The Breastfeeding Network Supporterline - 0300 100 0210 Supporterline in Bengali / Sylheti - 0300 456 2421 Drugs in Breastmilk Helpline - emaildruginformation@breastfeedingnetwork.org.uk http://www.breastfeedingnetwork.org.uk/ The Association of Breastfeeding Mothers Breastfeeding Helpline - 0300 330 5453 http://www.abm.me.uk/ La Leche League Breastfeeding Helpline - 0845 120 2918 http://www.laleche.org.uk On-line Support For video clips of mothers talking about their experiences of breastfeeding and how to position and latch your baby: www.bestbeginnings.org.uk/ www.unicef.org.uk/babyfriendly

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Breastfeeding in Wolverhampton area | Wolverhampton

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Our free NCT breastfeeding group runs every Thursday 10:30-12:30pm at: Action 4 Independence, Albert road, Wolverhampton WV6 0AF. These drop-in sessions are run by an NCT Breastfeeding counsellor and our team of NCT trained peer supporters, who will be on hand to offer friendly support and information regarding breastfeeding - from pregnancy to infancy and beyond!

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La Leche League telephone support - Midlands

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La Leche League telephone support - Midlands

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Please remember, if you think that your or your child's health are at immediate risk, please contact your health professional urgently or consider going to A&E.

Before calling please consider checking our extensive list of articles which provide up to date information about a wide variety of breastfeeding topics covering: early days, breastfeeding challenges, health concerns, weaning and much more.

If you wish to receive breastfeeding support and information from a LLL Leader on the telephone, you may choose one of the following options:

Call your local LLL Leader directly. Please see below a list of all the LLL Leaders in Great Britain who are willing to take local calls. Please respect their wishes and only call directly a Leader who is local to you, at the times and days she stated. LLL Leaders are volunteers who take calls in their own homes.

If you don't have a local Leader on the list please call our national helpline on 0345 1202918 (This is open from 8am to 11pm, 365 days a year).

You can also search for your local LLL group to give you a range of ways of making contact with them.

All LLL Leaders are volunteers with families, jobs and other commitments and sometimes this means there is no-one available to speak to you immediately. If we are unable to take your call on the helpline, please consider leaving a message and someone will get back to you as soon as possible.

(LEADERS -to amend your entry please contact Jenny by email)

List of Local Leaders:

Temporary shortage of leaders in this area available for calls. Please use the national number.

Lesley, 01520 755260 (leave a message if no answer), takes calls from Ross shire

Marion, 07805 848566, takes calls from Fife and Tayside

Ingrid, 07918 188811 (Please leave a message if no answer and you'll get a call back ASAP), takes calls from Fife and Tayside

Mhairi, 07919 353186, Please text or leave a message,takes calls from Fife and Tayside

Florence, 01224 318931 , Fridays only, takes calls from Aberdeen and Aberdeenshire

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Kerrie, 02085789403, weekdays 10am-3pm and weekday evenings, or leave a message, takes calls from boroughs of Ealing and Hillingdon

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Eva, 01295 722917, Mon-Fri mornings from 9.30am- 2pm, takes calls from North Oxfordshire and surrounding areas

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Efrat, Evenings and weekends call 01273 846548, Otherwise please TEXT ONLY 0758 7701590, she will get back to you when available, takes calls from Sussex

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Lizzie, 07546 364204 , takes calls from South East London & West Kent. Please feel free to text or alternatively call and leave a message if the call cannot be taken immediately.

Harriet, 07342 127689, please text to arrange a call, takes calls from South East London, West Kent and East Surrey

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Heather, Fran, Gloria, Sharon and Greet., 01727 537527, any time (leave a message if no answer), take calls from Hertfordshire

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Getting support by telephone - La Leche League GB

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La Leche League Leaders are able to provide breastfeeding information and skilled support on the telephone. Please remember, if you think that your or your child's health are at immediate risk, please contact your health professional urgently or consider going to A&E. ________ Before calling please consider checking our extensive list of articles which provide [...]

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Baby's hunger cues & info on baby-led feeding

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Baby's hunger cues & info on baby-led feeding

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A baby will display these feeding cues no matter how they are fed.

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How can family and friends support breastfeeding?

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How can family and friends support breastfeeding?

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Whether or not you yourself have breastfed, you obviously want to do all you can to support your friend or family member who's become a new mum. If breastfeeding is something they've decided to do, your support does count. Here's what you can do...

Try to offer your help

You can't exactly join in with the breastfeeding but you could see whether she wants a nice warm cup of tea or a snack. You could go a step further and offer to bring her some lunch or dinner. You could even pop out to the shops for her.

Lots of new mums will share their experiences with other mums they meet with their new baby. But old friends are just as important and you being supportive of her breastfeeding will help her a lot.

While family members might like the idea of feeding the baby, there is generally no need for bottles when breastfeeding. That is unless mum and baby have to be apart and she has expressed her breastmilk. Formula feeds can reduce the amount of breastmilk produced and are likely to interfere with the benefits of breastfeeding (see our article About breastfeeding) (Fliesler, 2017).

Perhaps see whether the mum needs some space when breastfeeding

Plenty of women are happy to chat away as normal while they breastfeed but it's best not to assume that's the case with your friend or family member. Breastfeeding is a skill she's trying to learn, so she might want to be on her own to build her confidence in it.

If you walk in on her breastfeeding, it's worth asking what she'd prefer rather than trying to make a swift exit or pretending you hadn't noticed.

On the other hand, if you do feel a bit awkward about the prospect of being there while the mum's breastfeeding, you could sit next to her rather than opposite. That way, you might feel less like you're looking straight at her breastfeeding.

Try to remind yourself that it's nothing to feel embarrassed about - she's only feeding her baby. And if she's happy with you in the room, you can relax knowing that breastfeeding is becoming so normal to her that you can think of it like that too.

You could find breastfeeding friendly meeting places

If you're going out to meet your friend or family member who's breastfeeding, you could try to find a breastfeeding friendly meeting place. If your chosen spot isn't breastfeeding friendly, you might not want to stick around.

There are some really welcoming places out there - here's what happened to one mum in a breastfeeding friendly place:

"When I was breastfeeding my daughter, we went to a café/restaurant for lunch and I fed her at the table, quite undisturbed. When we were leaving, the owner came up to me and said 'I'm really pleased that you felt comfortable about feeding your baby in my restaurant', which I found really supportive."

Try to think out any questions thoroughly

It's a massive new mum thing - a whole load of questions are coming her way about sleep, feeding and who knows what. She'll be glad you care but it's best to keep the questions or stories that might make her worry unnecessarily to yourself. You could even google them later or ask someone who's been there and done that years ago.

If you're worried that your friend or family member is struggling with breastfeeding, you could gently suggest she talks to someone who knows all about it. Our infant feeding support line is open from 8am until 12am daily, with trained breastfeeding counsellors who will listen to and help her.

If you've breastfed before or just know the value of peer support...

It's also great if you know the value of peer support, which in this case is women who are (or have been) breastfeeding supporting others who are trying to.

Women are more likely to plan to breastfeed their own babies and they're less likely to stop in the first two weeks if they have friends who breastfed (Davis, 2016). So do try to open up and share your experience of breastfeeding with the new mum, warts and all.

Here's what one mum's friend said to her:

"I was having a very bad day and a friend came up to me, put her arms around me, and told me that motherhood is hard, and that I was doing a fabulous job... Prior to that no one had told me that parenthood was hard, I believed it would all come naturally..."

Peer support is a massive help for encouraging long-term breastfeeding. If you haven't breastfed but wonder if a new mum you know would like that kind of support, you could suggest they find a breastfeeding peer support group locally.
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 support line 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.

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

Healthtalkonline.org- comprehensive library of face-to-face interviews where parents share their experiences about breastfeeding, birth, parenting and many other issues:

The NHS has information on breastfeeding in public.

Best Beginnings Bump to Breastfeeding (watch video clips online).

The Breastfeeding Welcome Scheme aims to champion the support given to breastfeeding mothers.

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How can family and friends support breastfeeding? | Baby & toddler, Feeding articles & support | NCT

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New mums need a lot of support in the early days and weeks of breastfeeding. What can friends and family do to support a mum who is breastfeeding?

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Mixed feeding (combining breastfeeding and bottle feeding)

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Mixed feeding (combining breastfeeding and bottle feeding)

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When it comes to feeding their baby, some parents decide to exclusively breastfeed and some to exclusively formula feed. Many families decide to combine breastfeeding and formula feeding; this often called combination feeding or mixed feeding (NHS, 2019).

What is mixed feeding?

Mixed feeding usually means mixing breast and bottle feeding. The content of the bottle can be either breastmilk or formula milk.

Watch our video to find out more about mixed/combination feeding.

Why do some families combination feed?

You might start mixed feeding for a variety of reasons.

If you and your baby have some difficulties getting breastfeeding established or if there are concerns about your baby's weight, you might be advised to give some formula feeds alongside breastfeeding.

You might need to leave your baby for periods of time (for example, if you are returning to work).

Your partner might want to be involved with feeding.

You might be bottle feeding and want to start or resume breastfeeding.

It can be helpful to talk to a breastfeeding counsellor, a midwife or health visitor about your options and the potential impact on breastfeeding of mixed feeding (see below). You could also call our infant feeding line on 0300 330 0700.

How do I combine bottle feeding and breastfeeding?

Some families choose to express milk and feed it to their babies through a bottle. They might do this if someone else would like to feed the baby or if the mum has to be away from their baby for a while.

Others choose to substitute some breastfeeds for formula. If you want to do this, you and your baby will adjust more easily if you reduce the number of feeds gradually (NHS, 2019).

You can offer formula feeds before, during, after or instead of a breastfeed. Talk to your midwife, health visitor or a breastfeeding counsellor about this, as different options will suit different circumstances. And will also depend on what you wish to achieve ultimately.

There are some cases when formula might be given before a breastfeed (for example, with babies who are not breastfeeding well). In other cases, the formula feed might be given instead of a breastfeed. This might happen if you're not with your baby and can't breastfeed or if someone else is sharing the feeding.

Gradually cutting down breastfeeding reduces the chance of your breasts becoming uncomfortably engorged. It will also reduce your risk of developing mastitis (NHS, 2019). It helps to reduce the number of breastfeeds slowly, starting with the one which is convenient for you (NHS, 2020). If you substitute a breastfeed with a formula feed, it may take around five to seven days for the amount of milk your breasts are producing to adjust to missing that one feed (NHS, 2017).

If you 'top up' with formula during one or more feeds, rather than replacing an entire feed, this is likely to extend the gap between breastfeeds. It will also signal to your breasts to make less milk (NHS, 2020).

On the other hand, if you've been advised to 'top up' as a temporary measure and want to return to exclusive breastfeeding, it is important to express milk between feeds to prevent a decrease in the amount of milk you make (NICE, 2017). Try and feed your baby any available breastmilk before each formula feed.

What effect will combining breastfeeding and formula feeding have?

Your baby will enjoy the benefits of breastmilk, even if you're not exclusively breastfeeding. For instance, they will still gain some of the antibodies that will protect them against infection (NHS, 2019).

If you want to feed your baby with both breastmilk and formula milk, it is recommended to wait until feeding is firmly established before introducing a bottle (NHS, 2019). This can take up to a month (La Leche League, 2019).

It's best to wait until breastfeeding is established because breastmilk supply is generally driven by frequent, effective removal of milk from the breasts. Giving your baby formula reduces your milk supply, which is particularly important when you are both getting used to breastfeeding. If your baby breastfeeds less often, your breasts produce less milk (Daly and Hartmann, 1995).

You might have heard that babies can get 'nipple confusion' but there is no evidence that this exists (Kotowski et al, 2020).

How many breastfeeds does an older combination-fed baby need?

Older babies, beyond the newborn stage, can maintain your breastmilk supply alongside formula feeding as long as you breastfeed several times a day. Much older babies - from eight or nine months - can breastfeed just a handful of times a day, and there is still a supply.

Very well-established breastfeeding, with a baby who is one year or older, can continue with as few as one or two feeds in 24 hours.

If your baby is over six months they can use a beaker or cup rather than a bottle (NHS, 2020).

Tips to introduce a bottle to a breastfed baby

You might find your baby does not want to take a bottle at first. The different sensations may confuse them and they don't know the bottle contains food. But there are lots of different things you can try to help your baby:

Offer a bottle when your baby is relaxed and happy, rather than very hungry.

Maybe ask someone else to offer a bottle so they can't smell their mother's milk.

Try softening the teat with warm, boiled water.

Hold your baby in a different position from their usual breastfeeding one. It might help your baby get used to the new way of feeding.

Try a different bottle or teat, this might make a difference.

(La Leche League, 2019)

Unicef (2016) recommend feeding responsively, which means following your baby's cues, whether breastfeeding or bottle feeding. They also recommend using paced bottle feeding. The way a baby is fed with the bottle can affect their comfort, their control of the amount of milk they drink, and the transition between breast and bottle (Kotowski et al, 2020).

Tips for paced bottle feeding

Hold your baby upright, close to your body. (If your baby is lying back, they are less able to control how much milk they swallow, so they can overfeed.)

Touch the teat against the baby's top lip to encourage them to pull it into their mouth.

Hold the bottle horizontal, so that when the baby is actively sucking, they get milk and when the baby is pausing, they don't get milk.

Give the baby several breaks by removing the bottle from their mouth.

Watch what the baby is doing, rather than how much milk they have drunk. End the feed when the baby is no longer drinking.

(UNICEF, 2016; La Leche League, 2019)

This all helps to build a close, loving relationship, a responsive feeding relationship, and avoids overfeeding your baby.

Where can I go for breastfeeding support?

If you have questions, concerns or need support, you can speak to one of our breastfeeding counsellors by calling our infant feeding line 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.

Further information

Healthtalkonline.org has a comprehensive library of face-to-face interviews where parents share their experiences about breastfeeding, birth, parenting and many other issues.

Best Beginnings has video clips from the 'Bump to Breastfeeding' DVD.

UNICEF have produced a summary guide for parents on how to responsively bottle feed babies.

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Mixed feeding: combining breastfeeding and bottle feeding | Baby & toddler, Feeding articles & support | NCT

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Here we look at mixed feeding your baby, which is combining breastfeeding and bottle feeding

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What is Ramadan?

Ramadan is a holy month in Islam, marking when Allah began to reveal the Qur'an to the Prophet Muhammed. One of the ways that Muslims show their faith is to fast during the hours of daylight, as prescribed by God in the Qur'an.

This means that during Ramadan, Muslims will get up before dawn to eat a meal, then won't eat or drink anything again until sunset.

At the end of the month, there is a big celebration called 'Eid ul-Fitr,' or 'the Festival of Breaking of the Fast.' Muslims spend time with their family, eat a meal during the daytime and give money to charity.

Should you fast if you're pregnant or breastfeeding?

While most Muslims over the age of 14 will fast, if you are pregnant or breastfeeding you are not expected to, although you can if you wish.

What should you eat if you're fasting?

If you do decide to fast, it's important to make sure that you hydrate well by drinking lots of water when you are permitted to eat and drink. Also make sure you eat foods that will release carbs slowly, like bread and brown rice, to fill you up for longer.

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Ramadan is a holy month in Islam, marking when Allah began to reveal the Qur'an to the Prophet Muhammed. One of the ways that Muslims show their faith is to fast during the hours of daylight, as prescribed by God in the Qur'an.

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Advice on drinking alcohol while breastfeeding, including how to manage social occasions and the risks of binge drinking.

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NHS - Why is "responsive feeding" so important?

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NHS - Why is "responsive feeding" so important?

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A newborn baby's stomach is only the size of a walnut, so they need to feed little and often. Your baby can have a good feed and be hungry again quite quickly. This is why "responsive feeding" – also called "baby-led" or "on-demand" feeding – is so important.

The idea is that you respond to your baby's cues. Breastfeeding is not only about your baby getting enough milk. Your baby feeds for comfort and reassurance, too.

Babies go through different patterns of feeding as they grow. Letting them feed when they need to will ensure they're content and getting the milk they need, when they need it, and will also stimulate your milk supply.

Responsive feeding is also to do with your needs. You may want to offer a breastfeed if your breasts are uncomfortably full, or if you need to fit in a feed around other commitments, or if you just want to sit down and enjoy spending some time with your baby.

(text extracted from NHS website)

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How often does my baby need to breastfeed?

All mothers and babies are different, and you and your baby will work out your own feeding pattern together. As a very rough guide, your baby should feed at least 8 times every 24 hours during the first few weeks.

Do not worry about feeding your baby whenever either of you wants to. You cannot overfeed a breastfed baby, and your baby will not become spoiled or demanding if you feed them whenever they're hungry or need comfort.

How long should each breastfeed last?

Every baby is different. Some babies want frequent short feeds, and others prefer feeding for longer, or a mixture of both. Let your baby finish the first breast, then offer the second.

If your baby feeds all the time and you're worried, speak to a midwife, health visitor or a breastfeeding specialist. You may need some help with positioning and attachment. You can also call the National Breastfeeding Helpline on 0300 100 0212.

How long should I breastfeed for?

Exclusive breastfeeding (breast milk only) is recommended for around the first 6 months of your baby's life. Breastfeeding alongside solid foods is best for babies from 6 months.

You and your baby can carry on enjoying the benefits of breastfeeding for as long as you like. Breastfeeding into your baby's 2nd year or beyond, alongside other foods, is ideal.

Lots of mothers carry on breastfeeding when they go back to work or college. Read more about breastfeeding after returning to work. You do not have to stop breastfeeding if you get pregnant again, either.

Find out more about deciding when to stop breastfeeding.

Why is "responsive feeding" so important?

A newborn baby's stomach is only the size of a walnut, so they need to feed little and often. Your baby can have a good feed and be hungry again quite quickly. This is why "responsive feeding" - also called "baby-led" or "on-demand" feeding - is so important.

The idea is that you respond to your baby's cues. Breastfeeding is not only about your baby getting enough milk. Your baby feeds for comfort and reassurance, too.

Babies go through different patterns of feeding as they grow. Letting them feed when they need to will ensure they're content and getting the milk they need, when they need it, and will also stimulate your milk supply.

Responsive feeding is also to do with your needs. You may want to offer a breastfeed if your breasts are uncomfortably full, or if you need to fit in a feed around other commitments, or if you just want to sit down and enjoy spending some time with your baby.

Can I breastfeed after a caesarean?

Yes, you can. Make sure you get a skin-to-skin cuddle with your baby as soon as you're able to. A midwife may help you have a skin-to-skin cuddle while you're still in theatre, or in the recovery room.

If you keep your baby close to you and maintain lots of skin-to-skin contact, you'll be able to put them to the breast often and this will stimulate your milk supply.

After a caesarean, you might find the "rugby hold" (where the baby's body is around to the side of your body, supported by your arm on the same side) is preferable to having them lie against your stomach. Ask a midwife about pain relief so you can feed your baby more comfortably.

Are there any reasons why I should not breastfeed?

Very occasionally, there are sound medical reasons for not breastfeeding. For example, if you have HIV or, in rare cases, you're taking a medicine that could harm your baby, such as drugs for treating cancer.

If you're not sure whether you should breastfeed your baby, speak to a midwife or health visitor for information and support.

Can I still breastfeed with more than 1 baby?

Twins, triplets and other multiples can be breastfed. In fact, because multiple babies are more likely to be born prematurely and have a low birthweight, breast milk is especially important for them.

When you start breastfeeding, you may find it easier to feed each of your babies separately. When you feel more confident, you can feed them at the same time. This may take a few weeks.

It can be really helpful to talk to other mothers who have breastfed twins, either at an antenatal group or at a twins group in your area. Triplets can be breastfed, either 2 together and then 1 after, or all 3 rotated at each feed.

Read more about feeding twins or more.

Breastfeeding help and support

If you have any questions or concerns about breastfeeding, there is help and support available. You can:

talk to a friend or family member who has breastfed

ask a GP, midwife or health visitor

call a helpline, such as the National Breastfeeding Helpline on 0300 100 0212

look at reliable websites, such as The Breastfeeding Network

join a local breastfeeding support group - ask a health visitor for details

Got a breastfeeding question?

Sign in with Facebook and message the Start4Life Breastfeeding Friend chatbot for fast, friendly, trusted NHS advice any time, day or night.

See more sources of help and support with breastfeeding.

Community content from HealthUnlocked

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All mothers and babies are different, and you and your baby will work out your own feeding pattern together. As a very rough guide, your baby should feed at least 8 times every 24 hours during the first few weeks. Do not worry about feeding your baby whenever either of you wants to.

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Start4Life and the NHS explain and offer information on several possible breastfeeding challenges, including colic, mastitis, sore nipples and more.

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There are other reasons why your baby may be crying, it's a good idea to check if they:

are hungry

have a dirty or wet nappy

have wind

are too hot or too cold

are bored or overstimulated

If your baby tends to cry during or after feeds, it's worth checking whether this could be reflux. Our guide to reflux in breastfed babies has information on the signs and symptoms.

What causes colic?

There are no known reasons why some babies get colic &ndash some doctors think it's a type of stomach cramp. But it may happen because babies find it harder to digest food when they are really young.

Constant crying could also be due to food allergies, such as cow's milk allergy. If you think this is the case, talk to your GP before making any changes to your baby's diet.

Colic remedies for breastfed babies

Sadly, there is no actual cure for baby colic, only methods to provide relief and soothe them. These are some of the tried and tested techniques that other parents use to relieve colic symptoms in breastfed babies:

Burping

Burp (or wind) your baby during and after every feed - have a look at burping your baby for techniques.

Sit your baby up

When breast or bottle feeding, sit your baby up as straight as possible. This will help minimise the amount of air they swallow. If you are bottle feeding, try to make sure the milk fills the teat and there are no air pockets - you could try using an anti-colic bottle to see if that helps.

Attachment

Check that your baby is attached (latching on) properly as this may help reduce colic symptoms. If you are unsure that your baby is attaching properly while breastfeeding, have a look at our guide to latching on.

Diet

There is no evidence that changing your diet will help &ndash however some people say that cutting down on spicy foods, caffeine and acohol has made a difference for them.

If you are mixed feeding (combining breast and bottle feeding), have a look at our guide to colic when bottle feeding.

Other ways to soothe your baby

Hold them

During bouts of crying, hold your baby to your chest so they can feel and hear your heartbeat.

Rock your baby

Sometimes the swaying motion of rocking your baby in your arms can help.

Warm bath and a massage

A warm bath can be soothing, followed by a gentle tummy massage (with gentle, circular strokes on the tummy).

Create a calming atmosphere

Babies can become overstimulated with lots of noise and activity around them. Try to quieten your surroundings, switch the TV off, dim the lights, and try to take some deep breaths yourself.

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There are other reasons why your baby may be crying, it's a good idea to check if they: are hungry have a dirty or wet nappy have wind are too hot or too cold are bored or overstimulated If your baby tends to cry during or after feeds, it's worth checking whether this could be reflux.