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Using infant formula to feed your baby - The Breastfeeding Network

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Using infant formula to feed your baby - The Breastfeeding Network

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Using infant formula to feed your baby - The Breastfeeding Network

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Many parents give their baby infant formula milk alongside or instead of breastfeeding. Giving formula alongside breastfeeding, either just for a few days or over the longer term, is called mixed or combined feeding.

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Mind- Useful contacts - perinatal mental health

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Mind- Useful contacts - perinatal mental health

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Shropshire Community Perinatal Mental Health Team

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Shropshire Community Perinatal Mental Health Team

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Mental Health Perinatal Community (Shropshire) :: Midlands Partnership University NHS Foundation Trust

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The Sea Change Trust runs community drop-in spaces for parents and carers with babies and toddlers. Thanks to our funders, all sessions are free of charge and delivered by specialist child and family psychotherapists in a supportive group setting.

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Discover psychotherapy for children in our Early Years services, offering support for parents and carers of babies and toddlers in a safe environment.

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Postnatal depression (PND) is a type of depression that many parents experience after having a baby. It can affect any parent, regardless of whether they've suffered from a mental health condition before. Postnatal depression is linked directly to giving birth and is a common problem, affecting 1 in 10 women within a year of giving birth.

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Breastfeeding at night - La Leche League GB

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Breastfeeding at night - La Leche League GB

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Breastfeeding at night is one of the most discussed topics at La Leche League meetings, both in person and online. This is often because breastfeeding at night, especially in the early days, can be so important to establishing a successful breastfeeding relationship. It is also because of its inextricable link with the topic of sleep, which can be one of the biggest changes many mothers and families experience when they have a new child.

There is no doubt that caring for a new baby can be exhausting, especially if you feel you are not getting enough sleep. Understanding why breastfeeding at night is so important can help. There is a huge amount of both reliable and rather less reliable information on the internet and in countless parenting books about what infant sleep 'ought' to be like, and therefore what infant night-time feeding 'ought' to be like. This article is designed to give mothers and parents the information and reassurance they need to inform their own night-time breastfeeding approach, including some helpful tips on how to get more rest when you can.

Breastfeeding at night in the early weeks and months is normal and important

Babies wake to feed at night in the early weeks and months (and often beyond) for a number of important reasons. Breastfeeding at night is a vital part of establishing and maintaining a good milk supply and ensuring that newborn babies get all the milk they need to grow and thrive. Breastmilk works on a supply and demand basis: the more milk that is removed, the more milk your breasts make. For the majority of mothers, this means milk needs to be removed roughly every 2-3 hours in the early weeks. Although some babies may sleep for slightly longer periods overnight, perhaps 3-4 hour stretches, newborn babies will typically wake several times a night to feed. This also helps to ensure that you don't get engorged breasts, which may lead to blocked ducts or mastitis.

Newborn babies often wake to feed because their bodies have signalled that they are hungry. However, newborns (and babies and children of all ages) also wake at night for many other reasons, including being scared or uncomfortable, being hot or cold, feeling the need for comfort and connection, and so on. As adults, we have developed ways of meeting these needs ourselves - adjusting a pillow, having a sip of water, cuddling our partner. As babies have no way of independently meeting these needs, they rely on their mother or parent to meet them. Breastfeeding at night offers mothers a way of easily and conveniently meeting the vast majority of these needs in one go.

Lots of research shows that night waking is the biological norm for babies. You can read more about it here as well as in Sweet Sleep, La Leche League International's exhaustive publication on nights and naps for breastfeeding families. Research also shows that, overall, breastfeeding mothers get more sleep than mixed- and formula-feeding mothers. This is for a number of reasons, including the impact of natural hormones and chemicals released for baby and mother when breastfeeding at night. There is also a perception that babies who have formula milk sleep longer than breastfed babies. Evidence shows this is not the case. "Despite the common perception that supplementing an infant's diet with formula milk or solid food will promote sleep, a recent study found that there was no difference in the frequency of night waking between breastfeeding and formula feeding infants aged 6-12 months old. Infants who received more milk or solid feeds during the day were less likely to feed at night but not less likely to wake."

Breastmilk at night

Research shows that breastmilk changes all the time, in response to all sorts of things, like the needs and health of your baby, temperature, and the time of day. For most mothers, breastmilk will gradually increase in fat content throughout the day. During the evening, young babies often cluster feed, taking in frequent feeds of this fattier milk, which tends to satisfy them enough to have their longest stretch of sleep. This cluster feeding in the early months may go on late into the evening when you were hoping you would be asleep, which can naturally feel exhausting.

Overnight, your prolactin levels - the hormone designed to support milk production - are at their highest. So, when your baby feeds frequently at night, the message to your body to boost milk supply is even stronger. Breastmilk at night is also high in the amino acid tryptophan, which in turn helps your baby to make melatonin, which is used by the body to develop its circadian rhythm (our internal system for recognising the difference between day and night) and to sleep better. Hormones produced while breastfeeding also help you to relax and fall more quickly back to sleep, which may be why you find yourself nodding off so easily while breastfeeding.

Given the fact that the hormones in night-time breastmilk help you and your baby to get back to sleep quickly, feeding babies to sleep is completely natural. A mother and baby's bodies are designed to work in tandem this way. Breastfeeding your baby to sleep helps baby feel calm, safe and secure. Over time, babies stop falling asleep at the breast so easily, and eventually all babies or children stop needing the breast to fall asleep. Sleep is not a taught development, and all children get there in their own time. So, while breastfeeding to sleep continues to work, many mothers find it a wonderful, loving and responsive way to help their children doze off.

Breast-sleeping / Co-sleeping

Safely sharing a bed with your baby, or having your baby sleep very close to you in a sidecar cot or similar, is one way of getting more sleep and rest. The majority of other mammals sleep with their young, and our own infants are hard-wired to expect this too. For many breastfeeding mothers, learning to feed lying down and being able to fall back asleep safely with baby is when things start to feel a lot more manageable at night. Some mothers may start out nursing their babies at night sat up in bed, but many soon find that mastering breastfeeding lying on their side can really help everyone to get more sleep, especially as baby gets a bit older and can latch on by themselves. Mums can feed from both breasts when lying on one side by simply tilting their body forwards more. The same principles for getting a comfortable, deep latch apply when side-lying as when feeding upright. It may take a little practice, but overall it's easier and less disruptive for both mother and baby at night. Research shows that breastfeeding tends to be more successful overall for mothers that co-sleep than those that keep their baby separated from them at night. You can read more about how to co-sleep or breast-sleep safely with your baby here

Breastfeeding at night after the early months

Many mothers go through patches where their baby may wish to breastfeed more or less at night, especially within the first year. This will be related to a whole host of reasons, including growth spurts, teething, illness, and learning new skills such as sitting, crawling and walking. Like so much else with babies and children, the frequency of breastfeeds at night is not a linear progression. Phases of increased night feedings are usually relatively short-lived and you may find that co-sleeping is a really valuable tool for managing those phases. Increased periods of waking and breastfeeding around four-six months are very common and are not a sign that your baby is hungry and needs formula and/or solids. You can read more about this in our article 'What happens at four months'

As your baby gets older and bigger, you may find that night feeding becomes much easier. While in the early days you may feel the need to switch on a light or sit up in bed in order to latch your baby comfortably onto your breast, as your baby gets stronger and learns to self-latch, feeding at night can be a simple matter of rolling over and putting the breast near your baby, who will manage the rest. Night feeds often become quicker too. Some mothers use breast compressions as a way of speeding up feeds. Being able to help their older baby back to sleep quickly with a breastfeed helps many mothers get the most sleep.

Coping with the challenges

Knowing that waking at night to breastfeed is positive for our supply and our baby, and that it is the biological norm, can often be reassuring for mothers and parents. Nevertheless, sleep deprivation can be really challenging for many families. It can feel especially hard if your baby is waking more than your friends' babies, or if they are an older baby still waking up more than you had expected.

New parents often get asked about their babies' sleep and their approach to feeding at night. These conversations can sometimes lead to (unwanted) comments about what is normal, what you 'should' be doing, and how to 'fix' things. And if you are feeling really tired or at a low point, you may be thinking that you do need to find a 'solution' and try some of those suggestions. The many unhelpful sources out there setting unrealistic expectations may be undermining your self-confidence as a mother. Perhaps you're wondering what a loving and respectful approach that suits both you and your baby would be?

First, it's important to say that you are not alone. At any point in time there are hundreds of thousands, if not millions, of mothers up and breastfeeding their babies - of varying ages - at night. A turning point for some of them is when they are able to relax their expectations of themselves and their babies a little. Some mothers also find that being constantly reminded of when they have been woken up is actually part of the problem, and they decide to ignore the clock and not to use their phones at night.

Being responsible for all the night-feeds can feel exhausting, or even unfair. Sometimes well-intentioned comments may suggest that a partner or other care-giver could feed the baby at night with a bottle. It can be useful to remember that the hormones in night-time milk make it easier for both you and your baby to get back to sleep quickly. And since the hormones in night-time milk are made at night-time, there is some evidence that giving your baby breastmilk expressed at other times does not always have quite the same effect. It is also sometimes easy to overlook the practicalities of another care-giver taking care of night-feeds. Mothers will often wake up when their baby does anyway, and may struggle to get back to sleep if they can hear their baby being upset while waiting for a bottle to be warmed up. Most mothers will also need to pump or hand express milk during the night to protect their supply and avoid engorgement, so they are often awake anyway during the time their baby is being fed by their partner.

Even though breastfeeding at night may be the responsibility of the mother alone, there are lots of ways to get supported so that things feel easier. For example, sometimes dads and partners get up with the baby first thing in the morning to give mums some extra time in bed, which can make a big difference to how tired they feel. Good communication is really helpful - ask for help with other things where you can and be clear about the kind of support you need. It's OK not to enjoy breastfeeding every second, and it's OK to complain about being tired: that doesn't mean you don't want to do it, so you can explain that asking 'Why don't you just stop?' is not helpful and that you'd rather be asked 'How can I help you find time to rest today?'

If you are really struggling with tiredness, you may want to think of ways to adapt your own routines for a short while to help you get more rest - perhaps sleeping more during the day, or going to bed earlier when your baby has her first 'longer' stretch of sleep. It can also be a great time to join an LLL group meeting with other breastfeeding mothers, as hearing that they are experiencing the same challenges can be really reassuring. Mothers often get bombarded with unrealistic expectations of infant sleep, and it's precisely this misalignment of expectation and reality that can cause stress.

Another challenge that mothers may experience (usually once their baby is a bit older) is a feeling of nursing aversion or irritability, particularly during night-time feeds. These feelings can be very normal and are often linked to tiredness or feeling 'touched out'. You may experience them more when your baby is waking or feeding a lot more frequently, for example when teething or feeling ill. You may also experience these feelings when there is a change in your own hormones, for example, during ovulation or your period. There is some anecdotal evidence that taking magnesium supplements can be helpful. Many mothers describe these feelings as irrational and usually short-lived; they can be a sign that you need to give yourself a little 'self-care' - perhaps asking for some more help during the day so that you can rest or focus on yourself.

Nursing aversion can sometimes lead to feelings of guilt about not enjoying breastfeeding, and make you wonder whether it is a sign you need to stop. There are some helpful information groups on social media where mothers share their nursing aversion experiences, as well as tips and tricks that helped them overcome those feelings. Like anything in life, you may not enjoy breastfeeding every moment of every day; that's OK. Take things one day at a time, listen to your body and your baby.

Stopping breastfeeding at night

Breastfeeding at night meets a baby's needs in a variety of ways. For many mothers, it's the easiest way to settle their baby back to sleep when they wake at night, and they continue to use it for as long as it continues to work. It is not a bad habit and all babies eventually fall asleep and stay asleep without the breast. You may decide that you are happy with breastfeeding back to sleep, but you are feeling pressured by others' expectations about what your baby 'should' be doing.

Some books suggest that after six months babies no longer need night feeds. Not only is this an arbitrary figure, taking little account of the different circumstances of different babies and families, but it also has no evidence to back it up. Sometimes, mothers worry that breastfeeding at night is what is causing their baby to wake up several times. This is not the case. Babies wake for lots of reasons and it is better to think of breastfeeding as a tool that meets the vast majority of those needs. Some sources claim that babies after a certain age don't 'need' breastmilk at night any longer, but breastfeeding goes on meeting a baby's needs for a long time. Many babies will continue to need the calories from night-time breastmilk, as well as all the other comforts that it brings, for some time after six months, and sometimes well beyond.

Some families may feel that their baby is ready to cut some breastfeeds at night or stop breastfeeding at night altogether. Generally speaking, the evidence seems to suggest that night-weaning is best left until after around 18 months. Many mothers find that gently cutting down feeds at this point is much easier, as the baby is learning to talk and the mother can help to explain any changes. There is helpful information about approaches to cutting down night feeds here. Any changes are best approached gradually and respectfully, so that you can preserve the important close connection to the baby at night-time. As your baby gets older, you will discover ways of being responsive to their needs at night that might not include offering your breast every time. For example, you may find that you are able to try other things like rocking, patting and shushing before offering the breast. These may not work initially, but over time, as your baby develops, you may find that in some cases these soothe him back to sleep. As always, you are the expert on your baby and you'll be able to assess whether your child is ready to stop breastfeeding at night, or whether it would be easier to try night weaning later on.

Conclusion

Having a baby, and eventually a toddler, can of course be exhausting. Since responding to your baby's intense needs at night can feel overwhelming, being able to access reliable information about infant sleep and night-time feeding behaviour can help you adjust your expectations. You may be happy breastfeeding your baby back to sleep as often as needed, yet you may feel pressured by well-meaning comments from friends and family about what your baby's sleep 'should' be like. Sometimes spending time with others who understand what you're going through, and who are supportive or your choices, can help you feel confident to make the decisions that work for you. Chatting with other mothers at a La Leche League meeting, in person or online, about what they found helpful, and exchanging ideas for getting more sleep may help you decide what's right for you and your baby. Never forget that you know your baby best!

Written by Rhiannon Butterfield, LLL Cambridge. February 2021

Endnotes:

i Baby Sleep Info Source (BASIS) - Durham University

ii Brown A, Harries V. Infant Sleep and Night Feeding Patterns During Later Infancy: Association with Breastfeeding Frequency, Daytime Complementary Food Intake, and Infant Weight. Breastfeeding Medicine. 2015;10(5):246-252.

iii https://gpifn.org.uk/sleep-and-safe-sleeping/

Further reading:
Safer Sleep and the Breastfed Baby
I need some sleep!
LLLI: Safe Sleep Seven
The reasons why nightwaking is the biological norm
Letting babies cry: the science behind the studies
Sweet Sleep available in our LLLGB Shop

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Breastfeeding at night - La Leche League GB

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Breastfeeding at night is one of the most discussed topics at La Leche League meetings, both in person and online. This is often because breastfeeding at night, especially in the early days, can be so important to establishing a successful breastfeeding relationship. It is also because of its inextricable link with the topic of sleep, [...]

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Feeding your baby on the neonatal unit can be different to what you had planned, but you can still find the best way of feeding for you and your baby. Find out more here.

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How to bottle feed including how to make up formula.

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Shropshire: 0800 229 4066

Helpline opening hours are 7am-10pm weekdays and 9am-5pm on weekends and bank holidays.
If you need Domestic Abuse support when the helpline is closed please contact the 24hr National Domestic Abuse Helpline on 0808 2000 247.

We also have Livechat available from 9am until 5pm, Monday to Friday for those who want to contact our helpline silently or who prefer to text rather than talk.
If you are in immediate danger please call 999

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 Domestic Abuse Helplines: 0800 783 1359 0800 229 4066 0800 840 3747 0800 980 3331 Helpline opening hours are 7am-10pm weekdays and 9am-5pm on weekends and bank holidays

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Information to help families in Shropshire - Shropshire Together Community Directory

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Welcome to the Family Information Service (FIS) page, helping you to find information on childcare, things to do, plus local and national organisations and

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Safe Breast and Bottle Feeding in a Sling - Carrying Matters

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Safe Breast and Bottle Feeding in a Sling - Carrying Matters

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Safe Breast and Bottle Feeding in a Sling - Carrying Matters

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Rosie discusses how to use various common slings for safe breast and bottle feeding of your child. It's all about the airway!

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Importance of relationship building- UNICEF

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Importance of relationship building- UNICEF

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Unicef UK Baby Friendly Initiative | Importance of relationship building

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Building A Happy Baby: A Guide for Parents by UNICEF

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Building A Happy Baby: A Guide for Parents by UNICEF

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Breastfeeding Grief- Professor Amy Brown

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Breastfeeding Grief- Professor Amy Brown

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Whether you're experiencing breastfeeding grief, supporting someone through it, or simply want to know more, I hope this page helps.

Breastfeeding grief, loss, or trauma exists. It matters and it's real. You might feel many different emotions and no two experiences are exactly the same. It doesn't mean you aren't grateful that your baby is being fed. It doesn't mean that you prioritise your own feelings over your baby's needs. It is possible to feel many emotions at the same time.

Breastfeeding grief can be caused by many things. Maybe you had to stop before you were ready. Maybe you had a really difficult experience that looked nothing like you hoped. Maybe you weren't given the support you needed, or others tried to damage your experience. Most likely you were trying to breastfeed in a system that told you it was great but then didn't provide you with an environment that actually made that possible.

On this page you'll find a collection of everything I have written over the years about breastfeeding grief, loss and trauma including my social media posts, articles and interviews. There are ideas for what might help, where to find more support and further reading.

My work is based on twenty years of research exploring experiences of infant feeding, and particularly how this can affect mental health and wellbeing. Specifically my breastfeeding grief research stems from a large study of over 3000 women who struggled with their breastfeeding experiences. I hope some of it resonates with your experience.

My book 'Why breastfeeding grief and trauma matters' is available from my website, via Amazon / Wordery / most bookshops and there is an Audible and Kindle version.

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Whether you're experiencing breastfeeding grief, supporting someone through it, or simply want to know more, I hope this page helps. Breastfeeding grief, loss, or trauma exists. It matters and it's real. You might feel many different emotions and no two experiences are exactly the same.

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Maternity - BSL Infant Feeding from Mid Cheshire Hospitals

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Maternity - BSL Infant Feeding from Mid Cheshire Hospitals

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Share your videos with friends, family, and the world

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You'll probably spend a large part of the first few days after birth looking at your baby.
If you notice anything that worries you about your baby, however small, speak to your midwife.

Within the first 24 hours, a health professional will offer to give your baby an injection of vitamin K. This is to prevent a rare but serious blood disorder.

You will also be offered a newborn physical examination for your baby in their first 72 hours. Among other things, their eyes, heart, hips and testicles (if they have them) will be checked for possible problems.

In their first few weeks, you baby will also have the:

Umbilical cord care

Your newborn's umbilical cord takes about a week to dry out and drop off. Keep it clean and dry until it does. If you notice any bleeding or discharge, tell your midwife, health visitor or GP.

Fontanelles (soft spots)

On the top of your baby's head, near the front, is a diamond-shaped patch where the skull bones have not fused together yet. There is another, smaller, soft spot towards the back of their head. These are called the fontanelles.

It will probably be a year or more before the bones close over. Do not worry about the fontanelles as they are covered by a tough protective membrane.

Your baby's skin

At birth, the top layer of your baby's skin is very thin and easily damaged. Over the first month, or longer for premature babies, your baby's skin matures and develops its own natural protective barrier.

Vernix, the white sticky substance that covers your baby's skin while in the womb, should always be left on the skin. It's a natural moisturiser that also protects against infection in the first few days.

It's best to bath your baby with plain water only for at least the first month. Do not add cleansers to your baby's bath water or use skin lotions or medicated wipes.

Premature babies' skin is even more delicate. Staff in the neonatal unit will advise you on skincare.

Find out more about babies who need special care.

If your baby is overdue, their skin may be dry and cracked. This is because all the protective vernix has been absorbed before they were born.

Eyes in newborns

Your newborn's eyes will be checked shortly after birth as part of their newborn physical examination. New babies can see, but their vision is not very focused. Their eyesight develops gradually over the first few months.

By the time your baby is 2 weeks old, you'll probably notice their eyes following your face. If they do not seem to be doing this, mention it to your health visitor or GP.

Your newborn's eyes may roll away from each other occasionally. This is called a squint and is normal in a newborn. It should go away by 3 months. Talk to your health visitor or GP if it does not.

Bumps and bruises

It's common for a newborn baby to have some swelling and bruises on their head, and perhaps bloodshot eyes.

This is caused by squeezing and pushing during birth, and is particularly common in babies who have been delivered by forceps or ventouse. It will soon disappear but, if you're worried, you can ask your midwife about it.

Birthmarks

The most common birthmarks in newborns are little pink or red V-shaped marks on the forehead, upper eyelids or neck. Some people call these stork marks or salmon patches. They gradually fade, but it may be a few months before they disappear completely.

Dark red and slightly raised strawberry marks (infantile haemangioma) are quite common. They sometimes appear a few days after birth and gradually get bigger. They may take a while to go away, but they usually disappear gradually.

See more about birthmarks.

Newborn spots

Spots and rashes are very common in newborn babies. They may come and go, but if you also notice a change in your baby's behaviour - for example, if your baby is not feeding well, or is very sleepy or very irritable - tell your midwife or GP immediately.

Breasts and genitals in newborns

Quite often, a newborn's breasts are a little swollen and ooze some milk, whether they are a boy or a girl.

Your newborn's genitals may appear swollen initially but will look normal within a few weeks. Baby girls also sometimes bleed a bit or have a white, cloudy discharge from the vagina.

All this is caused by hormones passing from you to your baby before birth. Do not be concerned.

Boys' testicles develop inside their body and sometimes take a while to descend into the scrotum. A health professional will check whether they have descended as part of the newborn physical examination.

Jaundice in new babies

When they're about 2 to 3 days old, some babies develop mild jaundice. This will make their skin and the whites of their eyes look a bit yellow. It's caused by pigments released during the breakdown of old red blood cells.

It's more common in babies delivered by forceps or ventouse. It usually fades on its own within about 10 days, but more severe jaundice may need treatment.

Find out about newborn jaundice.

If your baby develops jaundice in their first 24 hours, they should be checked by a health professional straight away.

Instincts in new babies

Babies are born knowing how to suck. During the first few days they learn to co-ordinate their sucking with their breathing during feeding.

Newborn babies also automatically turn towards a nipple or teat if it's brushed against their cheek, and they'll open their mouths if their upper lip is stroked.

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What to expect in the first few days after birth, including your baby's appearance, birthmarks, tests and fontanelles.

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Eating Well resources - First Steps Nutrition Trust

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Eating Well resources - First Steps Nutrition Trust

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Breastmilk is the bespoke food for a human infant. Breastfeeding ensures all the infants' nutrient needs are met, encourages optimum infant development, facilitates mother and child bonding, and protects the infants' and mothers' health in the short and long term.
In order to protect breastfeeding and support families who use formula it is important that all those who offer advice to families have accurate and unbiased information about infant feeding, including clear information about infant formula.

We also provide information and advice on eating well for new mothers, particularly those who are breastfeeding, and information and practical advice on introducing solid foods to babies, with recipes and photos to show the sorts of foods, and amounts of foods, that will give them a good start to their eating journey. On this webpage you can also find our eating well guide for vegan infants and under 5s, a recipe book with simple, cost-effective ideas for the whole family and a poster which provides a simple guide to eating well for infants.

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Eating Well resources - First Steps Nutrition Trust

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The resources produced by First Steps Nutrition Trust provide help and support for pregnancy, infants and new mums, and young children up to five years.

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Baby bottles and teats: choosing and sterilising- NCT

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Baby bottles and teats: choosing and sterilising- NCT

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Our NCT Infant Feeding Line provides a listening ear for all questions about feeding your baby. It's open every day of the year, from 8am to midnight. Call 0300 330 0700.

How many bottles and teats do I need?

This will depend on how many times the baby is fed.

Newborn babies generally feed between 10 and 14 times in 24 hours, with feeds becoming less frequent as they grow.

If exclusively bottle-feeding, whether formula or expressed milk, four to six bottles and teats is a good starting point.

If bottle-feeding is planned once a day, only one bottle might be needed.

What bottle size will I need?

Bottles come in two sizes, small ones which hold 150mls (5 fl oz) and large ones which hold 250mls (9 fl oz).

Newborns feed little and often as their stomachs are so small, so the smaller size is more suitable.

Parents might then find they need to move onto bigger bottles as their babies grow and their milk consumption increases. Every baby is different so there isn't a set age when this should happen.

It's important to follow the baby's feeding cues and signs they need more milk. These include:

Finishing a feed

Seeming to want more

Which type of feeding bottle is best?

There's no one 'best' brand of bottle - it depends on what works for you and your baby. One that has a simple design and is easiest to clean and sterilise is probably the best option (NHS, 2024).

Basic bottles

These are the standard bottles, often narrow and cylindrical in shape. They'll usually come with their own teats and lids and are reasonably priced. They are readily available but it can be harder to fill these narrow-necked bottles.

Anti-colic bottles

These are pricier bottles and their design is supposed to reduce the likelihood of colic symptoms. There is no evidence that this is the case, but they may reduce wind (Maxwell et al, 2025).

Wide-necked bottles

These bottles are shorter and fatter than the basic ones, but you can put the same amount of milk in them. The wider neck can make it simpler to put formula milk powder in. These bottles can be easier to clean, but take up more space in the steriliser.

Ready-to-feed bottles

'Ready to feed' bottles contain formula milk that is already sterilised. These can be a convenient short-term solution for one-off or occasional use.

They are more expensive and because they are single use, they are not good for the environment.

BPA and microplastics

Since 2011, the European Commission has banned the use of Bisphenol A (BPA) in baby bottles. This was because chemicals could leach out of the plastic and be absorbed by babies. None of the bottles for sale in the UK should have BPA.

More research is needed into whether cleaning baby bottles made from polypropolyne at the high temperatures needed to sterilise them releases microplastics (iHV, 2020).

Glass bottles

Glass bottles can be easier to clean and are longer lasting than plastic bottles (Chen and Kuan, 2014). So although more expensive to buy, they can save money in the long run.

However they are usually heavier than plastic bottles.

Which teat should I use?

Teats are made from silicone or latex. Silicone is less flexible but longer lasting than latex, which needs to be replaced regularly when it becomes sticky, cracked or shows signs of wear.

Teats vary in the width of the base and the length of the nipple. Some are marketed as being more breast-like, or as mimicking the breastfeeding experience, but there is little evidence to support this (Maxwell et al, 2025).

Consider using a teat that is more suited to paced bottle feeding. This means it will hold enough milk when held in a horizontal position, rather than having to be tipped. When a bottle has to be tipped more steeply, the milk flows faster, giving the baby less control over the pace of feeding.

Which flow rate is best?

Flow rates of teats refer to the size or number of holes in the teat. This affects how quickly milk 'flows' from the teat to your baby's mouth. The main categories are slow, medium and fast, with some extra variations depending on the brand (such as extra slow).

Slow flow is generally preferable for newborns, while you're both learning how to feed.

If the flow rate is too fast:

it makes paced feeding more difficult

babies have very little control over how they feed as milk flows into their mouth faster than they can swallow it

this might make your baby cough or splutter, or struggle to keep up with the flow of the milk so it dribbles to the side of their mouth

this could also mean they get upset, get indigestion and bring up lots of milk (NHS, 2024)

it can lead to overfeeding (NHS, 2024)

However, some research has shown that there is a lot of variability over teats marked 'slow' or 'extra-slow' even within the same brand (Marshall et al, 2021). So you may need to try different teats to get the flow which is right for your baby.

Read more about making up a feed and bottle feeding.

It is important to wash then sterilise bottles and teats after they've been used, to make sure any bacteria is killed before they're used again (NHS, 2023). A baby's immune system is not as developed as an adult's, so they could become ill if they drink milk contaminated with bacteria.

First, wash bottles and teats in hot soapy water to clean away any milk residue. Do this with a bottle brush that you only use for this (NHS, 2023). Then sterilise the bottles and teats (details below).

Sterilising a baby's bottles and teats until they are 12 months old will reduce the risk of infections, especially diarrhoea and vomiting (NHS, 2023).

Is a dishwasher enough to sterilise bottles and teats?

Washing bottles and teats in a dishwasher may clean them, but it won't sterilise them. They will need to be sterilised afterwards. If using a dishwasher, make sure bottles and teats are facing down so water doesn't collect in them (NHS, 2023).

There are three main ways to sterilise bottles and teats, below.

Cold water sterilising

Cold water sterilisers use chemicals, which are mixed with cold water, to sterilise feeding equipment. They can be bought in tablet or concentrated liquid form, which are added to cold water. They are also available as a ready-to-use sterilising solution.

Items being sterilised need to be submerged in the cold water solution for at least 30 minutes before use (NHS, 2023).

It's important that there aren't any air bubbles trapped in the bottles and teats when they're under the water as this will stop them being properly sterilised. Most cold water sterilisers have a cover to make sure the bottles and teats are kept under water (NHS, 2023).

After sterlising, rinse the bottles with cool boiled water. Always use cold water sterilisers in accordance with manufacturer's instructions, as these may vary.

Boiling

The majority of bacteria are killed at 100°C (the boiling point of water) for 10 minutes. This method is particularly useful if only sterilising occasionally as specialised equipment isn't needed.

If this method is used regularly, some items may be damaged by the heat so may need replacing more regularly (NHS, 2023).

How to sterilise baby-feeding equipment by boiling (NHS, 2023)

Check that the item is safe to boil.

Bring a saucepan of water to the boil.

Submerge the items to be sterilised in the boiling water, making sure they are completely covered. Don't put fingers into the water - a pair of sterile tongs used just for this purpose is ideal.

Continue to boil for 10 minutes. After 10 minutes, turn the heat off and cover the pan.

Keep the items covered and remove them just before use.

Steam sterilising

This works on the same principle as boiling. Water is added to the sterilising unit and the water boils, creating steam that kills the bacteria.

Several different types of steam steriliser are on the market. Some steam sterilisers are used in the microwave, while others are stand-alone units that plug into the mains. Some microwave steam sterilisers can also be used as cold-water sterilisers.

How to steam sterilise baby-feeding equipment

Follow the manufacturer's instructions, which normally involve adding a specific amount of water to the unit and running it for a given period of time.

The length of time can vary from one steam steriliser to another.

Make sure the openings of the bottles and teats are facing downwards in the steriliser.

Check the manufacturer's instructions for information about how long items can be left in the steriliser before using them.

Self-sterilising bottles

Some parents find self-sterilising bottles are useful when using the occasional bottle or when out and about. However, there is currently no independent research to suggest that this sterilisation method is as effective as the methods above.

Sterilising breast pumps (CDC, 2024; NHS Start for Life, no date)

Wash hands before expressing milk, and always store expressed milk in a sterile container with a lid (Breastfeeding Network, 2019).

As soon as possible after using the pump, take apart the pump kit.

Wash all the parts that have come into contact with the breast or breastmilk (including the bottle, valves and funnel) in warm soapy water, in a clean wash basin with a clean bottle brush.

Sterilise the parts in the same way that you sterilise bottles and teats. Sterilising after each use is especially important if the baby is less than two months old or premature.

After sterilising, leave parts on a clean tea towel or piece of kitchen towel to air dry thoroughly.

If the breast pump has tubing:

Replace tubing if some milk has got into it, as it is hard to clean properly.

If there are some condensation bubbles in the tubing, turn on the pump for a few minutes until it dries.

Check that tubing is not mouldy before each use, and replace immediately if it is.

What to do after sterilising (CDC, 2024; NHS, 2023)

Sterilised items can be left in the steriliser or pan until needed, but the majority of manufacturers advise using or re-sterilising after 24 hours.

Hands should be washed and dried before handling sterilised equipment.

Sterile tongs can also be used.

If sterilised items are taken out, the teats and lids will need to be put on the bottles immediately.

Don't use a tea towel to dry items, as this might transfer germs. They can be left on a clean tea towel to air dry.

The area being used to prepare the feed or assemble the pump will need to be cleaned and disinfected, or the upturned lid of the steriliser can be used.

See our articles on preparing a feed with expressed breastmilk or formula milk.

When should I throw away the bottle and teats?

Make sure you change the teats regularly and check them for damage. Once the baby's teeth start coming through, they can damage teats by chewing them which is a potential hazard.

In the same way, if you notice that the baby's bottle is damaged, scratched or cracked, it should be replaced.

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Baby bottles and teats: choosing and sterilising | NCT

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We give an overview of what bottles and teats you might need, and information on how to wash and sterilise them.

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"Fussy evenings" with a newborn - La Leche League GB

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"Fussy evenings" with a newborn - La Leche League GB

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My baby feeds all evening, and my breasts feel empty - have I run out of milk?

Every time I try to put my baby down to sleep, they cry! What am I doing wrong?

Why does my baby cry at the breast sometimes, even though they still seem hungry?

If you've ever asked questions like this during the rollercoaster weeks of new parenthood, you're in good company! Most new parents, unless they have been around newborn babies a lot before, are surprised and sometimes confused by how intensely their baby needs to be held and comforted. At times, it can feel like very hard work, or even as if, whatever you try, nothing quite works. Babies on the TV might sleep quietly in their beds between feeds, but real babies often don't!

Here is some information that may help you make sense of your baby's behaviour and work out whether there is a problem that needs fixing, or whether your baby is just doing what normal babies do. If you haven't had your baby yet, reading ahead can help prepare you for what to expect, so that you take this stage in your stride!
This article about normal newborn behaviour assumes that your baby is full-term, healthy, feeding well and growing normally. If your baby was born early, is unwell, or if you are not sure whether your baby is feeding or growing well, please check with your midwife, health visitor, doctor or breastfeeding supporter. Here is a (non-exhaustive) list of signs that more could be going on than just normal newborn behaviour:

your baby's poo output is less than expected (What's in a nappy);

your baby loses more than 7% of birthweight by day 5 or keeps losing weight after day 5;

your baby grows at an average of less than 20-30g per day after day 5;

your baby doesn't wake at least 8-12 times in 24 hours to feed;

your baby seems to be in pain;

your baby cries inconsolably for hours, even in your arms;

your baby develops patches of dry skin/eczema or a wheeze;

your baby has green/mucousy stools or blood in their stool;

breastfeeding is painful for you and not getting any better;

your baby is often unhappy or frustrated at the breast;

your baby often feeds for more than 40 minutes per breast or doesn't stop breastfeeding until you take them off the breast.

If any of these apply to you, please seek further help from your healthcare provider or a breastfeeding supporter.
"Fussy periods"

When they aren't feeding, many babies sleep most of the time during the first few days after birth. This may be nature's way of letting both mother and baby recover from their birth experience.

Around 10-14 days old, though, your baby may "wake up", sometimes quite suddenly, and you may be shocked by the change! From now on, your baby will spend increasing amounts of time awake. At times, it can feel like hard work to make sense of what they need and to help them get back to sleep when they have had enough of being awake.

Many young babies have a "fussy period" of a few hours each day, when they especially need lots of calming and soothing. This is most commonly, though not always, in the evening and first part of the night, and tends to build in intensity over the next few weeks. The peak age for crying is around 6-8 weeks.

Why babies need so much help in the evening

Many pregnant women notice that their unborn baby seems most active when they lie down at bedtime. This could be because they have stopped walking around and lulling their baby back to sleep!

It is common for newborn babies to continue this pattern of evening wakefulness during the first few weeks after birth. By about 6 weeks, most babies are learning that the night is for sleeping, and (though they may still need to feed at night for many months) will begin to settle to sleep more quickly after a feed. You can gently help your baby learn the difference between night and day by taking them out in the daylight, especially in the morning, and keeping the lights low at night.

Another reason for babies to be unsettled by the end of the day is that their brains feel like they are on fire! Babies' brains are growing amazingly fast - they double in size in the first year. Every day, they take on lots of new information and experiences, and by the evening they are so excited by the day's learning that it takes them a long time to wind down towards sleep.

In busy households, with other adults and children coming back at the end of the day, some babies may find all the extra activity overwhelming, too. And if it's been just you and the baby all day, by the evening you may be feeling frazzled yourself, and in need of nurture and care, just like your baby! Unlike adults, babies can't just "switch off" and relax; they need lots of help from calm, loving adults.

Breastfeeding - more than just milk

Breastfeeding provides babies with much more than just milk. A frazzled baby seeks the breast because the rhythm of sucking, the closeness and security of being held, and the feel and smell of their mother's body help them to feel safe and calm.

Most babies like to feed more often in the evening. Milk flow might be a bit slower than it is first thing in the morning, but this isn't a problem; it means that babies can do lots of calming, soothing sucking at the breast without getting uncomfortably full. If your baby cries when you offer the breast yet again, it won't be because the breast suddenly doesn't work! It's much more likely that they've just had enough for the moment. The signals for "I'm hungry" are very similar to "I'm bored/tired/sad/uncomfortable/need a cuddle". Your baby still needs help, they just don't want the breast again right now.

You can find some ideas below of other ways to soothe a frazzled baby. If you're not sure what your baby wants, try offering the breast first, but if it seems to make things worse, try something else, and offer again when they are calmer.

The "fourth trimester"

Some experts talk about the "fourth trimester" of pregnancy; the first few months after birth, when babies' brains are still in an "unfinished" state. Human babies have to be born while their brains are still relatively immature, in order to fit through their mother's upright, restricted pelvis.

Your baby will learn to calm down and manage their own emotions when they are ready, but a young baby can't do this yet. You don't need to be worried that, by giving them the help they need now, they will be "clingy", "spoiled" or more dependent later. In fact, the opposite is true. Psychologists know that babies whose needs are met promptly early on are more likely to develop into trusting, confident children, because they find the world to be a safe place and know that they can always find help if they need it.

In the early months, if you are managing to keep your baby safe, fed, comfortable and reasonably happy, you are doing a great job.

A typical evening with a newborn

You feed your baby until they look fast asleep. You carefully put them down in their bed. Either immediately or soon afterwards they wake up and cry. You think they must be hungry... maybe breastfeeding isn't working? You feed them again until you think they can't possibly fit in any more milk, and put them down.... and so on, until the early hours of the morning.

Although (especially if you haven't breastfed before) you may worry that your baby cries at the breast because there's a problem with feeding, as long as the signs of milk intake (weight, wet & dirty nappies) are OK ( What's in a nappy and My Baby needs more milk) , and your baby is happier the rest of the time, it's probably nothing to do with hunger, or a breastfeeding malfunction! Your baby is most likely to have woken up because they were put down.

The conditions that adults might prefer for sleep - quiet, dark, being left alone - are scary for babies, who fear being abandoned more than anything. For our ancestors, a baby who was left alone was a baby who probably wouldn't survive. Your baby has an "alarm", carefully developed over thousands of years of human evolution, that is programmed to go off if they sense that they have been left alone.

What can you do about it?

Here are some ideas you might like to try:

Babies, like other small primates, feel safest held closely against an adult body, especially an adult who is moving around. Try swaying or gently dancing with your baby.

If you want to put your baby down, try to help them feel they are still with you: warm their bed, put something in it that smells of you, rock the crib, leave your hand resting on them while they fall asleep, etc.

Wait about 20 minutes until they are in deep sleep before putting them down. If you put them down too soon, they are more likely to wake up, perhaps quite upset, because they wanted to be asleep.

Carrying your baby in your arms or a sling meets most of the same needs as breastfeeding, and can be done by another adult. Dads or other close care-taking adults are often brilliant at this. A baby who is not hungry will still head towards a milky breast if they smell it close by. If they really don't want to nurse again, they might protest when they get there, which can be confusing for everyone!

You don't need to put your baby down if you don't want to.

If you do want to, enlist the support of other people who can get to know and love your baby. If you don't have another adult living with you, could a family member or friend come and stay for a while? Do you have an older neighbour who misses their grandchildren? A teenager who is brilliant with babies? Even very young babies can have close relationships with several adults (and older children) at once, and another pair of arms can be helpful to both you and your baby at the end of a long day.

Try going outside - babies are often happier outdoors.

Babies often seem more relaxed when you are surrounded by other adults; they know the sabre-toothed tiger can't get them! Visiting a pub garden can work really well on summer evenings. If you are at home and don't have company, try the radio or TV on a channel with people talking.

Experiment with singing, dancing, music, massage, bathing, rocking, walking.

Try turning the lights and the noise down. Some babies are more sensitive to lights and noise than others.

If you can do so safely, (Safe sleep and the breastfed baby) you might want to experiment with sharing a bed with your baby. Learning to feed lying down in a safely prepared bed means that you won't have to move your baby once they are asleep, and you can get some rest while you feed. If you are worried about whether your baby will be safe in bed with you, you might want to try it in the daytime first, with another adult keeping an eye on both of you.

Make sure you get something to eat (prepare a meal/snack in advance) and get a nap or at least a rest earlier in the day if you can, to prepare for the time of day when your baby needs you the most.

Sometimes nothing works; you can still let your baby know you are there with them in their distress.

If your baby is crying as if they are in pain, check with your doctor. There is more information here about possible reasons for crying. (Unhappy baby)

If you feel overwhelmed by your baby's needs, get help & support. Looking after a crying baby is really hard, but much harder if you feel unsupported. Your midwife, health visitor, GP or a parent support group can all help.

Although attending a La Leche League meeting will not guarantee you more sleep, knowing that this phase is normal and will pass can really help. Other mothers who have experienced the intensity of the early weeks with a baby will welcome and encourage you. Many LLL groups offer support on Facebook too. (Find a group)

You are working enormously hard to understand and meet your baby's needs. Every baby is different, and you are becoming an expert on your baby. There is no "right" or "wrong" way to be with your baby (any more than there is a right or wrong way to be with a partner or friend); there is only what works for you both, today.

This can feel scary at first (if only babies came with an instruction manual!), but as time goes on, you will feel able to try different ideas for calming your baby, and come up with some new ones. As the weeks go by, you will learn more about what helps your baby (and what doesn't!) and become more confident about knowing when they are OK, and when to get help. As your baby gets older and more experienced, they will find the world, and their own bodily sensations, less alarming.

These early weeks, which can feel like "forever", will pass. Before you know it, you will be able to support a newer parent who is wondering how on earth they will get through it, because you did!

Written by Jayne Joyce, on behalf of LLLGB, January 2019

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"Fussy evenings" with a newborn - La Leche League GB

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My baby feeds all evening, and my breasts feel empty - have I run out of milk? Every time I try to put my baby down to sleep, they cry! What am I doing wrong? Why does my baby cry at the breast sometimes, even though they still seem hungry?

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Exclusively Expressing Breastmilk for Your Baby - La Leche League GB

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Exclusively Expressing Breastmilk for Your Baby - La Leche League GB

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When babies cannot feed at the breast comfortably and effectively, and breastfeeding support is hard to find or not able to help, mothers may choose to use a breast pump to express all the milk their baby needs, and then feed via a bottle or feeding tube. This is known as exclusive pumping. While this is often a temporary solution to protect milk supply until the baby is able to nurse directly at the breast, some mothers may find themselves exclusively pumping long term. Some mothers may also actively choose to exclusively pump and some mothers may be unable to feed their baby directly at the breast because their baby is poorly or has medical difficulties.

The decision to exclusively express breastmilk usually stems from an awareness of the irreplaceable qualities of breastmilk. Mothers also find that providing their babies with breastmilk can help with the grief from not being able to nurse directly at the breast. If their baby has medical difficulties, many mothers feel strongly that providing human milk will give their child the best possible start, particularly if their baby is in hospital. Yet, exclusive pumping is a significant undertaking which requires dedication, information and support.

You might find the decision to exclusively express feels difficult, and that you don't feel you fit with breastfeeding mothers or with those using formula. Please be sure that you will receive a warm welcome and support at LLL meetings and from your local Leader, and that we understand the lengths you're going to, to make sure your baby has your milk.

This page concentrates on the practicalities of how and when to express your milk and feed it to your baby, to establish exclusive expressing as your feeding method. Sometimes it can help to focus on all these practicalities and, once you have a workable plan, to give yourself time too to process how you're feeling about it, as you settle into life with your new baby. If you have a partner or supporter at home with you, all the things that are useful in supporting a breastfeeding mother will apply to you too!

Getting Started

If you have recently given birth and your mature milk has not yet come in, hand expressing is the most effective way of collecting colostrum to feed to your baby. It is important to start expressing colostrum within six hours (ideally after one hour, if possible) of giving birth, though if this doesn't happen for you, it is still possible to get started.

A newborn would expect to feed 8-12 times in 24 hours, and the feeds might not be evenly spread over that time, though they do need to include some feeds in the night; it is important to try to express breastmilk just as frequently in order to lay the groundwork for a robust milk supply later on. If you can have skin to skin contact with your baby while you're expressing, it can really help, and a photo or something that smells of your baby can be a substitute. You can collect your colostrum in a syringe, a small clean cup or a spoon. See our article on Hand Expression of Breastmilk for more information on hand expressing, and you might also find this video on hands-on pumping helpful. This technique can be tricky to get the hang of, so please do ask your midwife or other breastfeeding supporter to help. It's very common to need an extra pair of hands to collect the drops of colostrum.

Equipment

As your milk starts to transition, you will probably notice it start to change colour and spray out as you are expressing; this is a good time to introduce a breast pump. Although some women respond better to hand expressing, using a hospital grade double electric pump is the most effective way of removing breastmilk when a baby isn't latching or is not nursing adequately. If you are planning on exclusively expressing for your baby long term, then it will be worth investing in a hospital grade double pump. If you would like to try one before deciding whether or not to buy it, your hospital or midwife may be able to provide you with one on a short-term loan. Alternatively, you can hire a pump, although it may turn out to be rather expensive if you are exclusively expressing long term.

A breast pump usually comes with a collection set and the part that sits over your nipple/areola, which is called a flange. As women's nipples and skin elasticity differ, flanges are available in different sizes. It's important to ensure you have the right size for your nipples, as flanges that are too large or too small may cause pain or nipple damage and reduce the amount of milk you are able to express. Finding the right flange size may be a bit of a trial and error process; you may want to start by trying the standard size that comes with the pump (which varies for different pump brands) and see how you respond. If the standard flange sucks in too much areola, or if your nipple is at the back of the pump, you may need to go down a size. If, instead, you are left with a white ring around your nipple, you may need to go up a size.

Many mums find being able to express handsfree invaluable in terms of allowing them to fit regular pumping sessions into their day. There are a small variety of pumps that provide milk collection cups that sit inside your bra, freeing you up to cuddle your baby without fear of spilling your milk. However, they tend to have a limited range of flange sizes. Alternatively, you can buy special bras designed to hold your pump flanges against your breasts, or you can even DIY your own by cutting holes in a stretchy bra that line up with your nipples.

There are several other things to consider when choosing which hospital grade double pump to purchase or hire:

- How often will you use it? If you are planning to exclusively pump long term, you may need to consider motor life, to make sure the pump you purchase will live up to its use.

- How portable is it? If it uses a battery, then it can be carried around the house or out and about with you. Some pumps have built-in rechargeable batteries, while others offer the option to purchase a power pack or a car charger. Some pumps use removable batteries which are easy to replace if you unexpectedly run out of charge while away from a plug socket. However, using removable batteries may end up being rather expensive long term. You might find you end up using two different pumps - an efficient hospital grade one when you're at home and a hand pump or battery pump when you're out and about.

- Can you purchase spare collection sets? Having a spare collection set or two can come in handy, as most mothers find that it is easier to stick to their pumping schedule if their pump is set up and ready to go at a moment's notice, especially at nighttime.

Setting your schedule

For the first three-four months, you will need to express regularly to build a robust milk supply, ideally 8-12 times in 24 hours. Although you do not always need to pump at regular intervals, it is best not to go more than two to three hours between pumping sessions, with one longer stretch of four-five hours at night if you can take this break without damaging your milk supply. You will need to have at least one pumping session overnight, ideally between 2am and 5am when prolactin levels are highest. If you are able to pump when your baby wakes up for a feed, you may find it easier to do so than setting an alarm. If you need to set an alarm, but are having difficulty waking up, it may be worth experimenting with setting it for different times to try and coincide with the periods in your sleep cycle where you are in a lighter sleep. Many mothers find that they are able to express the most milk first thing in the morning, and less as the day goes on. You will notice your own patterns. It's also common for one breast to produce more milk or have a faster flow than the other side.

Working out ways to fit pumping sessions into your routine is key to long-term success. Some mothers will express while cooking, or holding a sleeping baby, or while travelling; sometimes before they feed their baby, sometimes afterwards. Experiment to find out what works best for your family and your daily rhythms.

In the early days, you may find that you are producing more milk than your baby needs; this is common and it will settle down in a few weeks. It can be useful to freeze any excess milk in small portions for later on, should your baby suddenly require more milk, such as during a growth spurt or period of illness.

Once your supply has established, usually between three and four months, you may decide to slowly reduce your number of daily pumping sessions. If you are planning to exclusively express long term, however, you may decide not to make any changes to your pumping schedule. If you start to reduce your expressing sessions, you may like to keep a record of your daily pumping outputs so that you can monitor what effect it has on your overall milk supply. You could start by increasing the intervals between your overnight pumping sessions, although it will still be important to express once at night. After doing this for about three-four weeks, you may consider dropping one daytime session. This may require you to adjust the time of all your other pumping sessions, in order to avoid leaving a big gap in between them, which could make you vulnerable to experiencing blocked ducts or mastitis.

Once your baby starts eating solids reliably, around eight-nine months, you may start to notice a change in their milk requirements and can adjust your pumping schedule and milk supply accordingly. However, many mothers find that introducing solids does not affect milk intake for a lot longer (in some cases, 18 months). When your baby is sat in a highchair, it can be a good time to express your milk without them pulling on the pump tubes.

How long is an expressing session?

The length of each expressing session will vary for each mother, based on her breast storage capacity and the type of pump she uses. If you are able to express milk from both breasts at once, then you will find it much faster.

While some experts recommend pumping for about 15-20 minutes, others believe that specifying the duration of a pumping session may not be helpful, as some mothers may take up to 45 minutes. In her book Exclusively Pumping Breastmilk, Stephanie Casemore suggests spending two hours over the course of 24 hours expressing. However, this total pumping time may need to be adjusted for mothers who need long individual expressing sessions. Also, other experts believe the total number of separate sessions to be more important than total pumping duration, with shorter, more frequent expressing sessions usually being more effective than fewer, longer sessions.

As a general rule of thumb, you can express until your milk stops spraying, and then for an additional five minutes to stimulate another let-down. If you need to increase your supply, you can pump for 10 more minutes and use hand expression right after to remove as much milk as possible. Breast compressions and massage during sessions ( hands-on pumping) also help to stimulate let-downs and maximise milk output. Some mothers find that it helps to experiment with "power pumping", where they pump frequently for short periods, to mimic cluster feeding. This might be something to use on occasion rather than as part of a daily routine as it can be quite time-intensive.

If, on the other hand, you need to decrease your supply, then slowly reduce the length of time you are expressing for. In both cases, many of the techniques discussed in our articles " My baby needs more milk" and " Too Much Milk and Oversupply " can be adapted for use with a breast pump.

If you are worried that you do not have enough time to do a full session, then it is better to pump less time and have a longer session later, than to miss one entirely.

Over time, as you reduce the number of pumping sessions, you may find that you will need to express for longer to obtain the same amount of milk. Many women find that if they cycle through their pump settings again, they can trigger a second or even a third let-down over a period of 30-45 minutes.

The importance of Oxytocin

Oxytocin is the hormone that triggers your letdown (milk ejection reflex). It is especially important to be mindful of this when expressing, as even mildly stressful situations of feeling rushed can make it difficult to trigger a letdown when using a breast pump. Many mothers find looking at their baby - or at pictures of their baby if they are separated - while expressing helpful. Gently massaging your breasts before and during your pumping session, as well as applying warm compresses or taking a warm shower before expressing can also trigger a let-down. Other ways to boost your oxytocin might include listening to music, watching a comedy on TV, reading a book, or browsing social media on your phone.

If you are able to cuddle your baby while expressing, you may see an increase in your normal milk output! It is even possible to express while carrying your baby in a sling or baby carrier. As your baby gets older and more mobile, you may find it easier to remove yourself to a different room where you can relax without worrying about them pulling on your tubes, or getting into things they shouldn't.

It can feel disheartening if you are watching your collection bottles and feel that they are not filling up quickly enough. Covering the bottles with socks, or distracting yourself so that you are not watching, can be helpful. If you are struggling to get a let-down, it is ok to put your pump away and come back to it 10-20 minutes later and try again. If it is a persistent problem at certain times of day, try to remember that the stimulation you are giving your breast still has a valuable purpose.

How to pump

In order to keep pumping comfortable and avoid nipple damage, you may want to consider using lubrication, such as lanolin or olive oil, inside the pump flange to reduce friction. The flange needs to make a comfortable seal around the breast.

Pumps have different suction and cycles settings. You may want to start with a low suction and high number of cycles to stimulate your let-down. Once your milk starts flowing, you can decrease the number of cycles and increase suction. In order to avoid getting sore, it is a good idea not to use the same suction setting for long periods of time. Switching between low and high suction also helps to trigger more let-downs.

Once you are done pumping, you can massage both breasts and hand express to make sure your breasts are completely drained.

How much milk to pump

As breastmilk is highly digestible, breastfed babies tend to feed little and often. When babies nurse directly at the breast, milk intake varies from feeding to feeding, so the amount of breastmilk taken per bottle may also vary throughout the day. On average, babies need 750-1035ml of breastmilk per day between one and six months of age. You may want to pump slightly more than this to make sure you have enough milk when your baby goes through a grow spurt.

Feeding your breastmilk

Babies drink from a bottle and nurse from the breast in a completely different way. When drinking from a bottle, babies cannot control the flow of milk, which can be uncomfortable for them and can lead to overfeeding. In order to minimise this problem, you may want to feed your baby your expressed milk in a way that is as close as possible to nursing. This is often referred to as paced bottle feeding.

Rather than feeding your baby bottles of expressed milk according to a strict schedule, you may want to feed on demand, as you would if they were nursing at the breast, being aware of early hunger cues. Holding your baby upright and keeping the bottle in a horizontal position allows the baby to suck actively, as he would at the breast, and to control the flow of milk, taking a break whenever he needs to. Offering the bottle teat gently, letting the baby draw it into their mouth, and feeding to satiation also allow the baby to be more in control of his feed. You can find more information on how to feed your baby your expressed milk in our article ' Bottles and other tools '.

It's important to remember that breastmilk should not be warmed up in a microwave or in a pan on the hob, in order to avoid damaging its nutrients. Shaking breastmilk is also not necessary.

Storing your breastmilk

Breastmilk's antibacterial properties help it stay fresh, so it can be safely stored at room temperature for four-six hours and in the fridge for up to a week. If away from home, you could use a cool bag with ice packs. Our page Storing Your Milk has comprehensive details on safe periods for storing expressed milk for healthy babies. If your baby is unwell or premature, then follow hospital guidelines. Your baby will benefit more from fresh than frozen breastmilk because its living properties will help him fight off possible infections, however all human milk is beneficial for you baby.

You may well see that your expressed milk is not always the same colour, and that it separates into layers when it has been stored for a while. Neither of these is a cause for concern, and a gentle swirl of the container before you feed your milk to your baby should make the layers mix again.

If you find that you are producing more milk than your baby needs, you might like to consider donating your milk by registering as a donor for your local breastmilk bank.

Stopping exclusively pumping

When you feel ready to stop expressing milk for your baby, it's important not to rush into dropping pumping sessions, in order to avoid the risk of experiencing blocked ducts or mastitis. Your breasts need time to adjust, so it's best to adopt a gradual approach. You could try to reduce the length of your pumping sessions by a few minutes over a few weeks, or you could try slowly increasing the intervals between sessions.

Exclusive pumping, while also doing the day to day work of looking after your baby, can be exhausting, and sometimes mothers and parents wrestle with feeling guilty about having stopped "too soon". By taking on the work of exclusive pumping, though, you gave your baby a wonderful gift.

Written by Nicola Sheldon (LLL Berkshire and Oxfordshire) and Eva Williams (LLL Oxfordshire), May 2020.
Thanks to Harriet Valentino for her input and to Lois Rowlands, Rae Vacher Lowe and Laura Loasby for the photos.

Further reading

https://laleche.org.uk/hand-expression-of-breastmilk/
https://laleche.org.uk/my-baby-needs-more-milk/
https://laleche.org.uk/too-much-milk-and-oversupply/
https://laleche.org.uk/bottles-and-other-tools/
https://laleche.org.uk/expressing-your-milk/#Pumps
https://laleche.org.uk/storing-your-milk/
A mother's story from our members magazine breastfeeding matters
https://kellymom.com/category/bf/pumpingmoms/pumping/
Exclusively Pumping Breastmilk, Second edition. Casemore, S. Gray Lion Publishing, 2014

i Exclusively Pumping Breastmilk. Second edition. Casemore, S. Gray Lion Publishing, 2014

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Exclusively Expressing Breastmilk for Your Baby - La Leche League GB

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When babies cannot feed at the breast comfortably and effectively, and breastfeeding support is hard to find or not able to help, mothers may choose to use a breast pump to express all the milk their baby needs, and then feed via a bottle or feeding tube. This is known as exclusive pumping.

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My baby won't latch on - The Breastfeeding Network

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My baby won't latch on - The Breastfeeding Network

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Sometimes, it can be hard to convince your baby to latch on to your breast. This can be stressful but there are lots of things you can try to make it easier. If you are struggling to get your baby to latch on, first try following our guide on how to breastfeed.

You might find that it helps to hand express some drops of milk onto your nipple so your baby can smell and taste it.

If possible, try breastfeeding as soon as your baby shows any signs of hunger. A very hungry baby may become distressed and this can make latching more difficult.

If your breasts have become very full and hard, it may be hard for your baby to latch. You can try expressing just enough milk to soften your breasts, so you feel more comfortable and to make latching easier for your baby.

Reverse pressure softening may also help if your breasts are very full or engorged.

It might help to spend some time in skin-to-skin contact, with the baby close to your breast and with access to your nipple, but without pressure to latch on and feed. You could try a laid-back position with your baby laid on your tummy/chest, so they can root and seek out the breast themselves.

Sometimes it helps to take a 'Babymoon'. Sometimes families can have lots of visitors in the first few days and end up being busy making cups of tea and looking after visitors. This can impact on you as a breastfeeding parent, as you don't have the time to sit and really spend time getting to know your new baby and work together on getting breastfeeding established. This is especially true if you are worried about feeding with people around. You are also less likely to be spending time in skin-to-skin contact with baby if you have lots of visitors around!

Sometimes when you are finding feeding isn't working that well in the first weeks (or even later on) it could help to spend 24 hours or so just focusing on your little one and on feeding, especially if you have been busy. Some breastfeeding parents head to bed for lots of skin-to-skin and others just ask for no visitors (except those who are willing to look after you so that you can focus yourself and your baby!) This is sometimes called a babymoon.

If you are still having trouble with latching or breastfeeding, speak your midwife, health visitor or a breastfeeding supporter. You can visit a local support group or contact the National Breastfeeding Helpline as well.

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My baby won't latch on - The Breastfeeding Network

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Sometimes, it can be hard to convince your baby to latch on to your breast. This can be stressful but there are lots of things you can try to make it easier. If you are struggling to get your baby to latch on, first try following our guide on how to breastfeed.

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Getting started with breastfeeding - The Breastfeeding Network

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Getting started with breastfeeding - The Breastfeeding Network

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Getting off to the best possible start can play a key part in your breastfeeding journey.

Four key factors have been identified by WHO and UNICEF as being important in establishing and sustaining breastfeeding:

A breastfeed within the first hour of life - skin-to-skin contact after delivery can help to get this started.

Exclusive breastfeeding - breastfed babies do not need any other food or drinks, including water for at least the first six months.

Breastfeeding when your baby displays signs of being hungry, such as sucking fingers and licking lips, and for as long as your baby wants i.e. until your baby comes off the breast by themselves and has completed the feed.

Avoiding the use of bottles, teats or dummies, including nipple shields.

Some ideas to help you find more information include:

Read and download the NHS and UNICEF leaflet Off to the Best Start or the NHS Health Scotland leaflet Off to A Good Start for good general information including skin to skin and the first feed.
Think about going along to a local drop-in group where you can talk to other breastfeeding mums about their experiences. Find out here if there is a group near you.
Bookmark or favourite the BfN and National Breastfeeding Helpline websites on your phone, laptop or tablet so you can always find our helpline numbers or access our online chat facility. You could even give them a call if you would like to speak to someone while you are pregnant.

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Getting started with breastfeeding - The Breastfeeding Network

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Getting off to the best possible start can play a key part in your breastfeeding journey. Four key factors have been identified by WHO and UNICEF as being important in establishing and sustaining breastfeeding: Some ideas to help you find more information include: Read and download the NHS and UNICEF leaflet Off to the Best [...]

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Breast Compressions- Kathryn Stagg IBCLC

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Breast Compressions- Kathryn Stagg IBCLC

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

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

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

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

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

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

Two things that are normal:

1.Babies want to be close to you.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Breastfeeding after a Caesarean Birth - The Breastfeeding Network

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Breastfeeding after a Caesarean Birth - The Breastfeeding Network

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Breastfeeding after a Caesarean Birth - The Breastfeeding Network

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As part of caesarean awareness month in April, we’re sharing some information on breastfeeding after a caesarean section. Your caesarean may be planned or unplanned, but either way it needn’t derail your breastfeeding journey – the key is to be informed so you can be as prepared as possible. First,…

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As new parents, we suddenly find ourselves examining our babies' poo more closely than we could ever have imagined. We pay attention to the colour, quantity, texture and smell, and notice the slightest changes. We then go to the internet looking for answers and fear the worst. There are many versions of normal, and we will share some of these below.

When your baby is born, your colostrum (first milk) has laxative and diuretic compounds in it to make your baby wee and poo. In the first few days your midwife and health visitor will ask how many wet and dirty nappies your baby has had, so you may find it helpful to take note of how many nappies you change.

Your baby may not poo much at first but this will increase as your milk comes in. For an idea of how many poos to expect, see https://laleche.org.uk/is-my-baby-getting-enough-milk/#dirtynappies

It can be tricky to tell if disposable nappies are wet - after five full days, when copious milk comes in, they should be heavy.
Many disposable nappies have a faint line down the middle of the nappy which changes colour when wet.
You can feel what a properly wet nappy should feel like by putting three tablespoons (45ml) of water onto a clean, dry one. Urine should be pale and mild smelling.
This post on signs of effective feeding has more information.

Pictures 1-9 below show the contents of one baby's nappy in the first few days of their life, to give you an idea of what to expect from a healthy, full-term baby. If you have any concerns about your baby's poo, or if you see blood in the nappy (beyond the first few days, when baby girls can have a mini period caused by birth hormones), don't hesitate to contact your midwife, health visitor or GP.

Picture 1
Baby's first bowel movement, called meconium, is tar-like, sticky and hard to remove.

Picture 2
Baby's second bowel movement.

Picture 3
Poo from the first day of baby's life. Reddish pink urate crystals are visible in this nappy; see picture 10 for more about urates.

Picture 4
Bowel movement on day two. Your baby's poo will gradually change colour, from black to green to brown. It becomes a lot easier to wipe off as your baby begins to drink more milk.

Picture 5
Day three bowel movement. Looking a lot paler, heading towards a yellowish colour, and much less sticky.

Picture 6
Day four bowel movement.

Picture 7
Day five bowel movement.

Picture 8
Day six bowel movement.

Picture 9
Day ten bowel movement. By this age most fully breastfed babies' poo will be this pale yellow colour. It is common for babies to have what are described as "explosive" poos, which may take you by surprise if your baby poos while you are changing their nappy!
The following pictures show some ways in which your baby's poo may look different from the typical pattern shown above.
Picture 10
In the first few days, you may see reddish pink crystals called urates in your baby's nappy. They are often described as looking like brick dust. As your baby begins to take more milk, the urates should stop appearing in her nappy.

Picture 11
Sometimes your baby's poo may be light green rather than yellow, and have small lumps in it like cottage cheese. This is common and not significant by itself, unless your baby has other symptoms that you are worried about.

Picture 12
This poo came from a three-week-old baby who was given Gaviscon because of reflux. When the medication was stopped, the baby went back to having runny yellow stools.

Picture 13
After the 12-week injections this baby had green poo, which went back to being yellow after a few days.

Picture 14
This dark green poo came from a baby who was later diagnosed with cow's milk protein intolerance.

Picture 15
This poo, containing mucus, came from a baby diagnosed with allergies. Mucus in the poo is also common when a baby has a heavy cold, but this should be temporary and should stop when the baby is well again. If your baby's nappy has persistent or unexplained mucus in it, seek medical advice.

Picture 16
As your baby starts to eat solid foods, you will see the results in his nappy. It is common for your baby's very first foods to come out looking almost exactly as they did when they went in, as his digestive system is not used to dealing with these other foods yet. This is much easier to spot if your baby is eating finger foods rather than mashed food; the mashed foods are passing through semi-digested in the same way, but are less obvious in the nappy.

With time, your baby's poo will gradually change from yellow liquid to soft brown lumps, and you won't generally see pieces of food. However, some foods are hard to digest and tend to pass through the body unchanged (even for older children or adults). This picture shows an 11-month-old's nappy with partially digested grapes visible in it. Strongly coloured foods (like blackberries or beetroot) can also affect the appearance of your baby's wee and poo.

Written by Amanda Dunbar and Emma Taylor for LLLGB, 2017

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As new parents, we suddenly find ourselves examining our babies' poo more closely than we could ever have imagined. We pay attention to the colour, quantity, texture and smell, and notice the slightest changes. We then go to the internet looking for answers and fear the worst.

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La Leche League: Breastfeeding beyond infancy

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La Leche League: Breastfeeding beyond infancy

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UNICEF 'Busted: 14 myths about breastfeeding' article

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UNICEF 'Busted: 14 myths about breastfeeding' article

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1. Myth? Breastfeeding is easy.

Babies are born with the reflex to look for their mother's breast. However, many mothers need practical support with positioning their baby for breastfeeding and making sure their baby is correctly attached to the breast. Breastfeeding takes time and practice for both mothers and babies. Breastfeeding is also time intensive, so mothers need space and support at home and work.

2. Myth? It's usual for breastfeeding to hurt - sore nipples are inevitable.

Many mothers experience discomfort in the first few days after birth when they are learning to breastfeed. But with the right support with positioning their baby for breastfeeding and making sure their baby is correctly attached to the breast, sore nipples can be avoided. If a mother faces breastfeeding challenges like sore nipples, support from a lactation consultant or other skilled professional can help them overcome the issue.

3. Myth? You should wash your nipples before breastfeeding.

Washing your nipples before breastfeeding isn't necessary. When babies are born, they are already very familiar with their own mother's smells and sounds. The nipples produce a substance that the baby smells and has 'good bacteria' that helps to build babies' own healthy immune system for life.

Did you know? Breastfeeding protects your baby from ear infections, diarrhoea, pneumonia and other childhood diseases.

4. Myth? You should separate a newborn and mother to let the mother rest.

Doctors, nurses and midwives often encourage the practice of 'skin-to-skin' - also known as kangaroo mother care - immediately after birth. Bringing your baby in direct contact, so their skin is against yours, is a very important practice that helps them to find and attach to the breast. If you can practice this within one hour after birth and then frequently after, it helps to establish breastfeeding. If the mother cannot do this, then the partner or another family member can step in.

5. Myth? You should only eat plain food while breastfeeding.

Like everybody else, breastfeeding mothers need to eat a balanced diet. In general, there is no need to change food habits. Babies are exposed to their mothers' food preferences from the time they are in the womb. If a mother perceives that her baby reacts to a specific food she eats, it is best to consult a specialist.

6. Myth? Exercise will affect the taste of your milk.

Exercise is healthy, also for breastfeeding mothers. There is no evidence that it affects the taste of your milk.

7. Myth? You won't be able to breastfeed unless you do it straight away.

It is easier to get breastfeeding started if you begin in the first hour after birth because a baby's reflexes are very strong at that time. They are ready to learn to feed at the breast. If you do not latch your baby on right after birth, do it as soon as possible in your situation. If you need help putting your baby to the breast, ask for support from a qualified lactation consultant or other skilled professional. Frequent skin-to-skin contact and putting your baby to the breast will help to get breastfeeding going.

Did you know? Breastfeeding protects the mother from diabetes, breast and ovarian cancers, heart disease and postpartum depression.

8. Myth? You can never use formula if you want to breastfeed.

Mothers may decide they need to use formula on some occasions, while continuing to breastfeed. It is important to seek unbiased information on formula and other products that replace breastmilk. To keep breastmilk production going, continue offering the breast to your baby as often as possible. It can be useful for mothers to consult a lactation specialist or skilled professional to help with a plan that works best for them to continue breastfeeding.

9. Myth? Many mothers can't produce enough milk.

Almost all mothers produce the right amount of milk for their babies. Breastmilk production is determined by how well the baby is latched on to the breast, the frequency of breastfeeding and how well the baby is removing milk with each feeding. Breastfeeding isn't a 'one woman' job and mothers need support. Support like ongoing breastfeeding guidance from health care providers, help at home, and staying healthy by eating and drinking well.

10. Myth? You shouldn't breastfeed if you're sick.

Depending on the kind of illness, mothers can usually continue breastfeeding when they're sick. You need to make sure you get the right treatment, and to rest, eat and drink well. In many cases, the antibodies your body makes to treat your disease or illness will pass on to your baby, building his or her own defences.

11. Myth? You can't take any medication if you're breastfeeding.

It's important to inform your doctor that you are breastfeeding and to read the instructions with any medications you buy over the counter. It might be necessary to take medications at a specific time or in a specific dosage, or to take an alternative formulation. You should also tell the baby's doctor about any medications that you're taking.

Did you know? The 'first milk' - or colostrum - is rich in antibodies and gives newborns an immunity boost while their own immune systems are still developing.

12. Myth? Babies who have been breastfed are clingy.

All babies are different. Some are clingy and some are not, no matter how they are fed. Breastfeeding provides not only the best nutrition for infants, but is also important for their developing brain. Breastfed babies are held a lot and because of this, breastfeeding has been shown to enhance bonding with their mother.

13. Myth? It's hard to wean a baby if you breastfeed for more than a year.

There's no evidence that it is more difficult to stop breastfeeding after one year, but there is evidence that breastfeeding up to two years is beneficial for both mothers and children. All mothers and babies are different and need to determine together how long they want to breastfeed.

14. Myth? If you go back to work, you'll have to wean your baby.

Many mothers continue breastfeeding after going back to work. First, check the policies in your country and your own workplace. If you have the right to time and a place to breastfeed during working hours, you may be able to go home and breastfeed, ask a family member or friend to bring your baby to you, or to express your milk and take it home. If you don't have the option to breastfeed during working hours, look for moments during the day to express your milk and then feed your baby directly when you are at home. If you decide to give your baby a breastmilk substitute for some feeds, it still very good to continue breastfeeding whenever you are with your baby.

This article was developed in collaboration with Dr. Michele Griswold PhD, MPH, RN, IBCLC. Dr Griswold is a lactation consultant, registered nurse, breastfeeding researcher and advocate. She represents the International Lactation Consultant Association to the WHO/UNICEF Global Breastfeeding Collective, which calls on governments and society as a whole to provide mothers the support they need to breastfeed.

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Expert advice, interesting insights and fun facts.

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1. Myth? Breastfeeding is easy. Babies are born with the reflex to look for their mother's breast. However, many mothers need practical support with positioning their baby for breastfeeding and making sure their baby is correctly attached to the breast. Breastfeeding takes time and practice for both mothers and babies.

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You have two babies, you have two breasts. Many twin mums like to feed their babies together to save time and to try to maximise sleep!

But should you try straight away or should you single feed first whilst you are all practising? The answer is it really depends on your babies and you. Some babies struggle to latch in the early days so trying to juggle two babies and latching both on with one hand each can be quite stressful. And they often take a few goes each to latch. So sometimes its preferable to wait until they have practised a bit feeding singly. Other babies, especially if they are full term, a good size and nice and alert, can tandem feed straight away. So you will really have to wait and see. Some mums try tandem feeding and just don't enjoy it. And that's fine too. But I think its always a good idea to be able to tandem feed if you need to, even if you don't do it all the time.

So how do you go about tandem feeding? The most popular position is the "double rugby hold", or "double football hold" if you are American. The babies lie one down each side of you. Start nose to nipple, so the babies need to be quite far back with their legs curled round your waist; you may need an extra cushion or two behind you to make room for their legs, especially as they grow longer! Support the baby with your hand behind their shoulders with thumb and fingers round the neck behind the ears. Tickle top lip with your nipple to stimulate baby to open her mouth wide, and bring on to the breast chin first with nipple going up into the roof of the mouth. A twin feeding pillow can help to support the babies in a good position. You can read my blog about different twin feeding pillows here. If you have your feeding pillow set up well you should be able to let go of the babies and feed hands free (meaning you can eat ice-cream!).

Many mums are worried about how they will be able to tandem feed without help when their partner goes back to work. The most important thing is to keep everything nearby within reach. Then get your feeding pillow ready. Pick up one baby and put on sofa or bed next to you. Ensure baby cannot roll or push themselves off. It is surprising how early babies can move themselves! Then pick up the second and place next to the first. Get settled and make sure the feeding pillow is in position. Lift one baby onto the pillow, ensure they can't roll off, you can either use your arm to support it or some prefer to roll up a muslin and just prop them up. Lift second baby onto the cushion. I usually advise mums to start with the fussier feeder as you can concentrate more on the latch and use both hands. Then once the first baby has settled into a deep feeding rhythm and the milk is flowing, latch on the second baby. Sometimes this knocks the first baby off the nipple and you have to start again! But with practice, you will get there.

But you don't have to be constrained by the double rugby hold and needing to use a pillow to tandem feed. There are several other positions you could try. And especially as the babies get older, more able to control their heads, and faster at feeding, you really can be quite creative.

Commonly called "The Stack" you can feed one baby in cradle hold and one in rugby hold. This is quite a good position for feeding out and about as you can do it either without a feeding pillow or with just a couple of cushions to support your arms. Or you can sit cross-legged on the floor and have your legs support the babies.

The "double clutch" can be another good way of tandem feeding without a pillow. It is especially useful when babies are a bit older and can feed in a more sitting up position.

You can even tandem feed in the car. Just make sure you are not actually driving at the time!

And you can feed walking around if you can master the "tandem twin sling feed". The ultimate food on the move.

And most importantly, there are ways you can tandem feed lying down, so you can lie back and relax whilst you feed. These positions can be used from birth when babies like to feed very frequently, or later on during the long, cluster feeding sessions during growth spurts.

And when the babies become toddlers, they can feed any old how.

Kathryn Stagg, IBCLC, Jan 2018

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You have two babies, you have two breasts. Many twin mums like to feed their babies together to save time and to try to maximise sleep! But should you try straight away or should you single feed first whilst you are all practising? The answer is it really depends on your babies and you.

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Breastfeeding in public - The Breastfeeding Network

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Breastfeeding in public - The Breastfeeding Network

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Breastfeeding in public - The Breastfeeding Network

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

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After weaning - what next? - La Leche League GB

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After weaning - what next? - La Leche League GB

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Breastfeeding always comes to an end - at some point, every breastfed baby or child stops breastfeeding. This article looks at what happens after your toddler or older child weans, how it feels for you and what it might mean for you going forward.

Sometimes, because of difficulties, breastfeeding your baby comes to an end much earlier than you thought it would or than you had hoped for. And with that can come feelings of anger, guilt, sadness, hurt and disappointment. If you are currently struggling with breastfeeding ending earlier than you had hoped, we would encourage you to talk to someone - your local LLL Leader would be pleased to support you. You may also find this article of interest: Five ways to help when breastfeeding doesn't go as expected. Amy Brown's book Why Breastfeeding Grief and Trauma Matter which explores the deep feelings women have when breastfeeding doesn't go to plan, may also be helpful.

Will weaning happen?

What is certain is that all children stop breastfeeding eventually. Children outgrow breastfeeding on their own, just as they outgrow other toddler and young child behaviours. For many families, taking the approach of being led by your child works well and the transition from breastfeeding to no longer breastfeeding is uneventful. It may all feel less noticeable if weaning takes place slowly and gently.

This process of 'natural weaning' allows a child to develop at their own pace, giving up breastfeeding according to their own natural timing. Rather than choosing a specific time to stop breastfeeding, many mothers just continue nursing while it is working well for them and see how it goes. That might mean breastfeeding for years beyond what you expected as you first breastfed your newborn.

Once weaning has happened

If you are following your child's lead, it is unlikely they will wean suddenly or overnight, especially if they are under one year old (see our article on Nursing Strikes if you are concerned this is happening). It is really common for the natural weaning process to take a long time and feel like a few steps forward and a few back. This can feel confusing at times.

It's not uncommon for children to look like they are weaning, only to come back - often with renewed energy - to breastfeed when you least expect it or when you thought they had weaned. A new baby, an unsettled family time, a change in their days such as whenstarting preschool or school, or illness can often lead to an increase in breastfeeding just when you thought they were stopping. That can be unsettling if you are trying to decide if you are still breastfeeding or not - one day you might not be, and then the next you are again. One mother said: "I thought she was weaning and I was starting to feel the grief of it around three years old, but we are still going at four.".

'The Last Breastfeed' might not be a significant event. For some, weaning happens so gradually, that suddenly you realise your child hasn't asked to nurse for a while, and you can't remember your last breastfeed - or at least, you didn't know it was the last time.

This is often the time mothers wish they had captured more photographic memories of their toddler or child breastfeeding, not realising that soon it might be the last breastfeed. Taking photos of you and your child nursing can be really special, so you may want to consider taking more at this stage.

Emotional change

The topic of what it feels like after weaning isn't talked about much and so you might be wondering if what you are feeling is normal. It almost always is.
For many, weaning is an emotional adjustment
As breastfeeding comes to end it can be an emotional time and mothers can experience a wide range of feelings. For some it might be a time of sadness - a sense of loss for the time that's gone before and a sorrow that your special 'baby days' are passing and behind you. For others it might be a huge relief and a time you had longed for and thought would never come.
Or it might be a mix of both.
Perhaps one moment you may feel a sense of relief that the intensity of breastfeeding is passing and the next moment sad that this stage of motherhood is drawing to a close when it has been so important to you.
The Womanly Art of Breastfeeding says: "You may revel in your non-nursing status but also feel weepy or supersensitive for a time."

One mother described the time of her two year old weaning as a confusing time of feeling a sense of loss but also happiness: grief and relief. Another, as her four year old weaned, said that she was completely ready to stop (and was desperate to), but then realised it meant she had to redefine how she viewed herself as she always thought of herself as a breastfeeding mother.

This huge mix of emotions around your breastfeeding journey coming to an end is common. Especially if you worked so hard to make it happen in the early days. When breastfeeding has been such a central part of how you have mothered your child, it can feel like a new and perhaps uncertain stage.

Distress around weaning is more likely the earlier it happens, or where it happened before you wanted or had intended. Where weaning has happened very early on, mothers can be left with deep feelings of anger, grief, sadness and disappointment. Where weaning has happened suddenly, or has been stressful, it is more likely that the emotional impact may be greater. How old your child is when they wean may not be as important to how you feel about weaning, rather the sense that things ended well. As Diane Bengson says: "Mothers who wean gradually, or who feel that weaning happened at a time when both they and their child were ready, often feel peace and contentment when weaning is complete

But even if you initiated weaning or encouraged your child to wean, you may still find moments of sadness. Even when weaning is a positive experience for both of you, 'letting go' can still feel emotional. Some mothers and parents describe it as nostalgia for the early times of breastfeeding your baby. Perhaps this is even more apparent if you know this is your last baby and you know you won't be a nursing mother again.

If you felt that your child initiated weaning rather than you did, and it was sooner than you had hoped for, those feeling of sadness can be stronger. Or if your toddler or older child weaned quickly, you may feel a sense of hurt or rejection. In The Nursing Mother's Guide to Weaning, Kathleen Huggens says:" Even if you had planned to wean soon, you may feel surprised and a little disappointed when your child rejects you in favour of a cup or bottle."

Or you may actually feel nothing but relief - that you are pleased to be moving on from the intensity of the early days and years and enjoying a sense of having your body back. You might be relieved to finally ditch your nursing bras and look forward to wearing clothes that no longer need easy access. You may find a sense of relief that you can sit down without being asked to nurse, and that maybe that intense need for you is easing a little - and that feels good.

The key is that whatever you are feeling emotionally about weaning - it's normal. What one mother experiences won't necessarily be the same as another. Talking about it with others who have weaned at LLL groups (in person or online), might help.

Hormonal Changes

When weaning happens, there is also a physical and hormonal adjustment which, despite limited studies on the subject, seems to reflect across the experience of many. This adjustment can lead to a short time of feeling quite low, as your hormones settle down.

It can be really common to feel down or weepy - or even depressed - after weaning. And for some, the feelings are strong and may mean there is a sense of anxiety, insomnia, anger, swings between high and low moods. In part, this is because of hormonal changes happening in your body as you adjust to reducing, and then no longer, making milk or having the repeated closeness of your child at your breast. Your breasts may still continue to produce milk, but gradually they will stop and for some mothers it might be months before they can no longer squeeze a few drops out.

There is little research on the topic, but we know that the hormones so important in breastfeeding - prolactin (milk making hormone) and oxytocin (the hormone of love and responsible for the milk ejection reflex) - play an important role in how we feel emotionally. Both oxytocin and prolactin contribute to feelings of calm, love, relaxation, closeness and contentment. As breastfeeding ends, both prolactin and oxytocin levels will lower - and so may your mood and sense of wellbeing. It may last a few days, or it may go on for longer.

So if you are feeling low or weepy after weaning, it can be reassuring to know that it is likely that your body is also dealing with hormonal changes, as well as any emotions you may have around weaning. Even if you are totally at peace with weaning and know the time is right for you both, there are changes happening in your body that might have an impact on how you feel.

It has often been described as similar to how you feel hormonally as part of your menstrual cycle, but more intense and more long lasting. Others may go further and say that they feel really sad and depressed for a few weeks after weaning. Often your hormones settle within a few weeks and you and your child adjust to a new rhythm where breastfeeding is no longer part of your current story.

These feelings of sadness and general lowness that can happen after weaning are normally temporary. Being gentle and patient with yourself is important. If you have ongoing low mood or depression after the initial weeks, it may be helpful to talk to your GP.

How do I do 'this' without breastfeeding?

If your child has stopped breastfeeding gradually or they have led the weaning process, you may see this as all part of the bigger picture of watching your child grow into an independent little person. Your role of mothering 'your baby' is changing. Perhaps your child is spending longer away from you, may be sleeping longer or on their own, and maybe there is a sense that their need for you isn't quite so intense. That can be both a relief and an adjustment.

You may feel proud of how they have grown and how much you have learnt about parenting through breastfeeding, but perhaps wonder what it means for you if you no longer have breastfeeding in the picture. Perhaps you are relieved that your breasts are no longer the focal point of your child's day?

Where breastfeeding has been important to you both, it can sometimes feel a bit uncertain about how things might go without nursing as a go-to or back-up for when parenting is tricky. How will you get them back to sleep if they wake with a bad dream in the middle of the night? How will you calm them down when the emotional whirlwind takes over them? What will you do when they bump themselves? How will you get some extra time in bed in the morning if your breast no longer offers the oasis of calm it once did?

Often looking back at all your breastfeeding relationship gave you and your child, can help shape your 'new' picture of parenting without breastfeeding. Many mothers would say that breastfeeding their baby beyond babyhood is one of their proudest and greatest achievements. If that is the case, it might feel right to celebrate or mark the event in some way for you that feels significant - for both you and and your child. Be proud!

And if you are feeling low, or missing that physical closeness, sometimes finding other ways to connect on a physical level with your child can help. If your arms are feeling "empty" without your child nursing at the breast, cuddling lots, having baths together and playing physical games with them climbing on you or rolling around together, can help with getting a hormone boost. Simple cuddles and touch, or sniffing or nuzzling your child's head, can work wonders for having a surge of oxytocin.

It's likely your breasts and chest will be a special place for your child for a long time. Many mothers have commented how their older child still likes to place their head or hand near their breast, or when upset, will cuddle into a breastfeeding position without actually breastfeeding.

Looking ahead

As you watch your child wean - be it entirely on their own, or with some gentle encouragement from you - you may find that you swing between various emotions and thoughts. Whether weaning passed uneventfully and feels like a natural end to your breastfeeding journey, or you found it an emotional and challenging time, looking back and acknowledging what you achieved and what you have given your child is something you can be rightly proud of.

Breastfeeding has taught you so much about recognising your child's needs and emotions, their demands and their wants. Your ability to nurture them, to read their cues and respond to them hasn't changed, but it might be that instead of offering the breast, you now meet those needs in different ways. And while your baby may no longer need comfort at your breast, they still need you.

Many mothers and parents look at their older children, even grown-up children, and know that the shape of their relationship has its foundation back in their nursing days. The closeness, understanding and connection that you grew together at the breast over the years, will continue - in new and different ways but shaped by your breastfeeding journey.
Endnotes

Weaning here describes the process of stopping breastfeeding, not the introduction of family foods which takes place around the middle of your baby's first year.

La Leche League International. The Womanly Art of Breastfeeding. 8th Edition, 2010: 337.

Bengson, D. How weaning happens. La Leche League International, 2000: 137.

Huggins, K and Ziedrich, L. The Nursing Mother's Guide to Weaning. 2007: 177.

Further reading
Still Nursing
Thinking about weaning
Breastfeeding beyond Infancy
Breastfeeding beyond one year
Nursing strike
A sudden end to breastfeeding
The goodness goes on

Written by Justine Fieth, LLL Cambridge, October 2020.

Thanks to Ginnie Sullivan and the Leaders of LLL Cambridge for their help writing this.

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After weaning - what next? - La Leche League GB

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Breastfeeding always comes to an end - at some point, every breastfed baby or child stops breastfeeding. This article looks at what happens after your toddler or older child weans,1 how it feels for you and what it might mean for you going forward. Sometimes, because of difficulties, breastfeeding your baby comes to an end [...]

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UNICEF How to know breastfeeding is going well? 

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UNICEF How to know breastfeeding is going well? 

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Oswestry Community Action Infant Feeding Peer Support Feedback Form

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Qube Infant Feeding Peer Support Feedback Form

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Qube Infant Feeding Peer Support Feedback Form

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We'd really like to hear your feedback on how you found the support and our service. A shout out to a peer supporter, a venue/ event that has been really handy to visit, a resource that was helpful, or perhaps you made a new connection with a service or another family. Do you have any suggestions or ideas to help us improve? Please follow the link to the forms and fill out a short survey to let us know. Thank you.

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Qube Infant Feeding Peer Support Feedback Form

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Qube Infant Feeding Peer Support Feedback Form

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Shrewsbury and Telford Neonatal Unit Parent Information

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Shrewsbury and Telford Neonatal Unit Parent Information

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Shropshire Together Community and Family Directory

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Shropshire Together Community and Family Directory

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Welcome to the Shropshire Together Community and Family Directory - Shropshire Together Community Directory

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Here to help you find organisations, groups and services to support you and help you live a healthier life

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Breastfeeding Twins & Triplets Padlet with links and resources for feeding multiples

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Breastfeeding Twins & Triplets Padlet with links and resources for feeding multiples

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Infant Feeding Peer Support Groups in Shropshire

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Infant Feeding Peer Support Groups in Shropshire

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Qube | Infant Feeding Peer Support Service

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With face-to-face ongoing support in the community being a key aspect of improving breastfeeding and maternal mental health, Oswestry Community Action will be hosting peer support groups in Oswestry, Shrewsbury and Ludlow and will look to further extend the service into other areas.

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Should I give water to my baby? First Steps Nutrition

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Should I give water to my baby? First Steps Nutrition

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When can my baby have water to drink? | NCT

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When can my baby have water to drink? | NCT

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When can my baby have water?

Young babies under six months won't usually need to have any water or extra drinks, other than their usual milk (NHS Choices, 2017).

I breastfeed my baby so do they need extra water in hot weather?

Babies who are breastfed won't need water until they're around six months old (NHS Choices, 2017).

"When you breastfeed your baby and they've started eating solid foods, you can offer them water out of a cup as well as breastfeeding frequently."

Even in hot weather, you won't usually need to offer your baby water if you feed them breastmilk. They will just breastfeed more frequently if they need to. Babies who are breastfed can feed more frequently because the energy content of breastmilk changes according to their feeds.

I feed my baby formula milk so do they need extra water in hot weather?

If you feed your baby formula milk, you might need to offer them water in hot weather as well as the milk. Make sure you boil and cool the water before you give it to them (NHS Choices, 2017).

How do I know my baby's getting enough to drink?

In hot weather, it's important to offer your baby frequent milk feeds, whether you are breastfeeding, formula feeding or both. In very hot weather, it's important babies drink plenty of fluids to prevent dehydration.

In general, your baby is getting enough to drink if they have at least six heavy, wet nappies every 24 hours. This should be the case from when your baby is five days old, as long as they're happy and alert, and they're feeding frequently. You can find out more in our how can I tell my baby is feeding well article.

When can my baby drink tap water?

Babies under six months should only drink tap water that has been boiled and cooled down. Water straight from the tap is not sterile so is not suitable for younger babies.

Once your baby is six months old, you can offer them water straight from the tap in a beaker or cup. They'd have this as well as their usual milk (NHS Choices, 2017; Oral Health Foundation, 2017).

Can my baby or toddler drink bottled water?

Bottled water is not recommended for babies or toddlers as it may contain too much salt or sulphate.

Water and milk are good options

Older babies and toddlers who have drinks like squash or juice during the day may fill up on calories from these drinks. This reduces their appetite for milk or solids, and can make it difficult for them to get enough nutrients. It might also lead to deficiencies over time, especially a lack of iron, which can cause anaemia (NHS Choices, 2017; Oral Health Foundation, 2017).

It's a good idea to simply offer your baby water to drink, as well as their regular milk feeds.

Taking care of your baby's teeth

Squash and fruit juice are high in sugar and can contribute to tooth decay. Fruit juice is often seen as a healthy alternative to squash, but it still contains sugars and acids that can harm tooth enamel (Oral Health Foundation, 2017). Children under three years of age should not have anything with artificial sweeteners in it (Oral Health Foundation, 2017).

If you want to offer squash or juice to your child, only give it to them sparingly, well diluted, and as part of meal times. Whole fruit juice is a better option than squash. Find out more in our taking care of your baby's teeth article.

This page was last reviewed in October 2017

Further information

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

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.

NHS Choices has information on how you can look after your baby's teeth.

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When can my baby have water to drink? | NCT

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We discuss when it's okay for your baby to drink water. We also look at how to keep your baby hydrated in hot weather.

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What is Healthy Start?

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

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

You can use your card to buy:

plain liquid cow's milk

fresh, frozen, and tinned fruit and vegetables

fresh, dried, and tinned pulses

infant formula milk based on cow's milk

You can also use your card to collect:

Healthy Start vitamins - these support you during pregnancy and breastfeeding

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

If you live in Scotland

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

Advice on healthy eating

For more advice on healthy eating, visit:

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

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Drinks and cups for babies and young children

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Drinks and cups for babies and young children

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Drinks for babies and young children

Not all drinks are suitable for babies and young children. Here's what to give to your child and when.

Breast milk

Breast milk is the only food or drink babies need in the first 6 months of their life.

It should continue to be given alongside an increasingly varied diet once you introduce solid foods from around 6 months.

The World Health Organization recommends that all babies are breastfed for up to 2 years or longer.

Breastfeeding up to 12 months is associated with a lower risk of tooth decay.

Formula milk

First infant formula is usually based on cows' milk and is the only suitable alternative to breast milk in the first 12 months of your baby's life.

All infant formula in the UK has to meet the same standards to help babies grow and develop. It does not matter if you choose a cheaper or more expensive brand of formula.

Follow-on formula is not suitable for babies under 6 months, and you do not need to introduce it after 6 months.

Formula milks are not needed once your baby is 12 months old. This includes first infant formula, follow-on formula, growing-up milks and toddler milks.

Cows' milk can be introduced as a main drink from 12 months.
Read more about the types of infant formula
Non-cows' milk formula

Goats' milk formula is available and produced to the same nutritional standards as cows' milk formula.

Goats' milk formula is not suitable for babies with cows' milk protein allergy. It's no less likely to cause allergies in babies than cows' milk formula as the proteins they contain are very similar.

You should only give your baby soya formula if a health professional advises you to.

'Goodnight' milk

"Goodnight" milk is not suitable for babies under 6 months old. This type of formula is not needed, and there's no evidence that babies settle better or sleep longer after having it.

Water

Once your baby has started to eat solid foods (from around 6 months) you can offer them sips of water from a cup or beaker with meals. Drinking water for babies over 6 months does not need to be boiled first.

Fully breastfed babies do not need any water until they've started eating solid foods. During hot weather they may want to breastfeed more than usual.

Formula fed babies under 6 months of age may need small sips of cooled boiled water during hot weather as well as their usual milk feeds.
Find out how to make up baby formula safely using water
Cows' milk

Cows' milk can be used in cooking or mixed with food from around 6 months but should not be given as a main drink to babies until they're 12 months old. This is because cows' milk does not contain the right balance of nutrients to meet your baby's needs.

Pasteurised whole milk and semi-skimmed milk can be introduced as a main drink once your child is 1 year old.

Skimmed and 1% milk should not be given as a main drink to children under 5 years old because they do not contain enough calories.

Lower-fat milks can be used in cooking from 1 year old.

Unpasteurised milk

Young children should not be given unpasteurised milk because of the higher risk of food poisoning.

Goats' and sheep's milk

Goats' and sheep's milk are not suitable as a main drink for babies under 1 year old as, like cows' milk, they do not contain enough iron and other nutrients babies this age need. As long as they're pasteurised, they can be given as a main drink once your baby is 1 year old.

Soya drinks and other milk alternatives

You can give your child unsweetened calcium-fortified milk alternatives, such as soya, oat or almond drinks, from the age of 1 as part of a healthy balanced diet.

Babies and young children under 5 years old should not be given rice drinks, because of the levels of arsenic in these products.

If your child has an allergy or intolerance to milk, talk to your health visitor or GP. They can advise you about suitable milk alternatives.

Rice drinks

Children under 5 years old should not have rice drinks as a substitute for breast milk, infant formula or cows' milk as they may contain too much arsenic.

Arsenic is found naturally in the environment and can find its way into our food and water.

Rice tends to take up more arsenic than other grains, but this does not mean that your baby cannot eat rice.

In the UK, there are maximum levels of inorganic arsenic allowed in rice and rice products, and even stricter levels are set for foods intended for young children.

Do not worry if your child has already had rice drinks. There's no immediate risk to them, but it's best to switch to a different kind of milk.

Fruit juice and smoothies

Fruit juices, such as orange juice, are a good source of vitamin C. However, they also contain natural sugars and acids, which can cause tooth decay.

Babies under 12 months do not need fruit juice or smoothies. If you choose to give these to your baby, dilute the juices and smoothies (one part juice to 10 parts water) and limit them to mealtimes.

Giving fruit juice and smoothies at mealtimes (rather than between meals) helps reduce the risk of tooth decay.

From 5 years old, you can give your child undiluted fruit juice or smoothies. Stick to no more than 1 glass (about 150 ml) a day, served with meals.

Squashes, flavoured milk, 'fruit' or 'juice' drinks and fizzy drinks

Squashes, flavoured milk, "fruit" or "juice" drinks and fizzy drinks are not suitable for young babies. They contain sugar and can cause tooth decay, even when diluted.

For older babies and young children, these drinks can fill your child up so they're not hungry for healthier food. Instead, offer sips of water from a cup with meals.

Fizzy drinks are acidic and can damage tooth enamel so they should not be given to babies and young children.

Diet or reduced-sugar drinks are not recommended for babies and young children.

Even low-calorie drinks and no-added-sugar drinks can encourage children to develop a sweet tooth.

Slush ice drinks

Children aged 4 years and under should not have slush ice drinks, sometimes known as slushies, as they may contain too much glycerol.

Slush ice drinks can have high levels of glycerol in them, used instead of sugar, to create the slush effect.

Young children who have too much glycerol may get a headache or feel sick. If they have a lot of glycerol, it can cause symptoms such as feeling dizzy, low blood sugar (glucose), confusion and they can even pass out.

'Baby' and herbal drinks

"Baby" and herbal drinks usually contain sugars and are not recommended.

Hot drinks

Tea and coffee are not suitable for babies or young children. If sugar is added, this can lead to tooth decay.

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Drinks and cups for babies and young children

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Drinks for young children, including breast milk, infant formula, cows milk, fruit juice, water and squash, plus choosing a cup or beaker.

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Maternity And Neonatal Voices Partnership Shropshire, Telford & Wrekin

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Maternity And Neonatal Voices Partnership Shropshire, Telford & Wrekin

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Maternity and Neonatal Voices Partnership

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Maternity and Neonatal Voices Partnership

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The Lullaby Trust raises awareness of sudden infant death syndrome (SIDS), provides expert advice on safer sleep for babies and offers emotional support for bereaved families

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Togetherness | Shropshire and Telford & Wrekin families: Emotional resilience for the everyday

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Togetherness | Shropshire and Telford & Wrekin families: Emotional resilience for the everyday

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Free learning resources on brain development, emotional wellbeing and parenting for healthier relationships and happier lives.

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Free learning resources on brain development, emotional wellbeing and parenting for healthier relationships and happier lives.

Created by NHS clinical psychologists, alongside practitioners and parents, these journeys will help you and your family better understand and manage your emotional health in daily life.

Use the exclusive access code:

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Learn about your child's development and build your confidence in parenting.

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Pathways introduce ideas to expand your caring 'toolkit' to respond to different behaviours and help raise thriving children.

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Shropshire and Telford & Wrekin | Togetherness - Togetherness

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Free learning resources on brain development, emotional wellbeing and parenting for healthier relationships and happier lives. Created by NHS clinical psychologists, alongside practitioners and parents, these journeys will help you and your family better understand and manage your emotional health in daily life.

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What is this team responsible for and how can you use its services?

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Beyond Bottles: alternative ways to supplement a breastfed baby

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Beyond Bottles: alternative ways to supplement a breastfed baby

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Beyond Bottles: alternative ways to supplement a breastfed baby

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

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How can partners support breastfeeding? | NCT

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How can partners support breastfeeding? | NCT

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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 new parent is more likely to choose to breastfeed if they're sure their partner is positive about it? And if they do decide to breastfeed, they're much more likely to have a good experience and manage any difficulties if their partner supports their decision (Tohotoa, 2009; Rempel, 2011). A partner's emotional support is so important for helping breastfeeding 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 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 they want 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 the parent 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 and parents 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:

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

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

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

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

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

There's no need to eat anything special while breastfeeding, but it's a good idea to encourage your partner to eat and drink regularly.

Help them get specialist support if they're struggling with breastfeeding. As mentioned above, you can both talk to one of our breastfeeding counsellors on 0300 330 0700.

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

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

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, talk it through. Maybe you're worried about your partner showing their breasts in public? Yet in reality, very little breast actually shows when a baby is feeding. You might have even seen someone breastfeeding before without realising it.

It might also help to talk to other families who are 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 breastfeeding (Maternity Action, 2019).

Many places now welcome breastfeeding and have special facilities for feeding in private.

Some people 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 NCT New Baby courses 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 partners support breastfeeding? | NCT

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This article looks at how partners can help support breastfeeding in the early days.

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Introducing a bottle - The Breastfeeding Network

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Introducing a bottle - The Breastfeeding Network

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Introducing a bottle - The Breastfeeding Network

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At the beginning babies have a strong sucking reflex which means they usually suck on a teat easily. After a few weeks this reflex fades and introducing a bottle can take a while for your baby to get used to sucking on a teat, even if they have had bottles before. Sometimes just getting used […]

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Breastfeeding has lots of health benefits for your new baby, including fewer infections and a lower risk of obesity, as well as protecting you from some cancers and other health problems, too.

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Planning a pregnancy and having a baby are life-changing and exciting events. We have lots of information and and support to help you.

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Many women struggle emotionally after having a baby. You are not alone and there is help available - have a look at where you can get support.

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Check out our delicious recipe and meal ideas for babies and toddlers - including weaning recipes, finger foods, snacks and first tastes.

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Ready or not weaning quiz - Start for Life

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Ready or not weaning quiz - Start for Life

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Ready or not weaning quiz - Start for Life

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Take our quick quiz to see whether your baby might be ready to start weaning, plus learn more about the signs and common myths of weaning.

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Starting Solid Foods: with Baby-led Weaning Tips - The Breastfeeding Network

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Starting Solid Foods: with Baby-led Weaning Tips - The Breastfeeding Network

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Starting Solid Foods: with Baby-led Weaning Tips - The Breastfeeding Network

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Starting your baby on complementary (‘solid’) foods is an exciting step but it can be daunting: How will I know when to start? How much food should I give?

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Safer Sleep & the Breastfed Baby - La Leche League GB

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Safer Sleep & the Breastfed Baby - La Leche League GB

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Safer Sleep & the Breastfed Baby - La Leche League GB

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“In most parts of the world… babies sleep close to their mothers, as they have through most of history.” – The Womanly Art of Breastfeeding A baby is born expecting to stay in close contact with his mother night and day, in order to keep safe, warm and well-fed. It is perfectly normal for babies—especially breastfed babies—to wake and feed […]

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Guest blog: Breastfeeding during Ramadan - The Breastfeeding Network

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Guest blog: Breastfeeding during Ramadan - The Breastfeeding Network

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BfN peer supporter and Camden Baby Feeding Team member Zamzam Elmi talks about her experience breastfeeding 4 children through Ramadan, and the decision she made each time. She also explores how we can best support Muslim mums to breastfeed during Ramadan, whether they decide to fast or not.

Ramadan Karim! May we all have a fulfilling and blessed month.

Firstly, I would like to say that Allah is aware of what you can bear or manage and will not expect beyond that.

Deciding on whether to fast or not is a tough and spiritually challenging decision to make especially knowing how blessed/special the month is, but we are fortunate that we have been given concessions by his mercy.

Remember that breastfeeding is a form of worship if done with right intention, and taking advantage of the concession is God given right to protect us and our babies.

Listen to your body and keep an eye on your baby if you do decide to fast, speak to a health professional if you have any concerns or worries. Also take your prenatal vitamin as levels of nutrients such magnesium, potassium and zinc may be affected.

Every drop of breast milk is reward gained and you can still gain more spiritually by reading the Quran and doing your dhikr whilst breastfeeding or bottle feeding. This is a lovely time to bond with your baby as well as lifting you spiritually and emotionally.

With all my children I did different things depending on the situation.

My first child was premature and I was expressing, so during his first few week of life I fasted some days and not others.

With my second child, I could not fast at all as she feed frequently. I made up the fast later once she was weaned.

As for my 3rd child, also exclusively breast fed, I managed to fast the full month with good preparation and knowing how to take care of myself whilst fasting.

With my 4th, I also fasted most days, and I gave fidya [feeding the poor for each day missed].

Supporting Breastfeeding During Ramadan
As peer supporters, we have great duty in supporting mums to feel empowered to achieve their goals by giving information so their decisions are informed. Supporting mothers during Ramadan is no different to helping mums reduce factors that may have a negative impact on their breast feeding or supply.

Things to consider are:

If a mum is fasting during the summer months (this usually an 18hr fast with 5/6hrs window to eat) she will need to drink little and often and during the times she is allowed to eat and drink.

Mums will need to eat high nutrient dense food such as date, fruits and nuts to help replace the magnesium, zinc and potassium levels that may reduce during fasting.

Avoid drinking too many caffeinated drinks and replace with water, fresh fruits juice, herbal teas and green smoothies.

If a mum is fasting during the winter months which can fall between 10/12hrs of fasting, this is much easier as the sunset is much earlier and they have a longer period to eat and drinking during dawn. So really its like having a very late lunch.

If a mum is exclusively breastfeeding and has a baby of 0-6months, its highly not recommended she fast at all, this is because of the increased nutritional demand. As I have done on many occasions, mums can make up the fast later or feed someone poor as a compensation but to also feel the spirit of Ramadan.

Some of the questions mums may have during Ramadan will be around supply and how best to protect it. Also, just as a reminder feeding support will not differ as the same information will apply when it comes to protecting supply and breastfeeding. Success in having enough to feed the baby depends on staying well hydrated, reducing stress and keeping breastfeeding as close/normal to when they are not fasting. If a mum is mix feeding, it's important to give the usual information on how bottle feeds can impact the breastfeeding, as well as the fact that she maybe more likely to increase the bottle feeds to help cope with demand. It's important she has the facts so she is aware of the possible risks.

We must remember to keep giving mum a safe space where they feel they have permission to come and talk through their decisions without judgment or fear of being misunderstood. This will help you protect the well-being of both mum and baby. Another question might be how do I know if I or baby are dehydrated? When should I seek help? It's important to make sure a mum feels safe to come for support if her decision to fast has had an adverse effect on their health.

Muslim mums know they may be able to fast if theirs or their baby's health is not adversely affected during that period of fasting. It's good to remember they are well experienced in fasting and they come from a place of having knowledge of what its like.

For peer supporters who are not Muslim or who may not know much about Ramadan, it is imperative to keep in mind that choice should always be at the forefront of any breastfeeding journey and the support we provide will very much be based on an individual case by case basis. It's also okay to say I'm not sure and signpost/refer mums to other sources for more information.
For more information on breastfeeding during Ramadan, click here: https://breastfeeding.support/breastfeeding-during-ramadan/
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Guest blog: Breastfeeding during Ramadan - The Breastfeeding Network

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BfN peer supporter and Camden Baby Feeding Team member Zamzam Elmi talks about her experience breastfeeding 4 children through Ramadan, and the decision she made each time. She also explores how we can best support Muslim mums to breastfeed during Ramadan, whether they decide to fast or not. Ramadan Karim!

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Skin-to-skin - The Breastfeeding Network

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Skin-to-skin - The Breastfeeding Network

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Skin-to-skin means holding your baby whilst they are naked or wearing just a nappy, so that their skin is in contact with the bare skin of your chest and tummy. Usually the mother does this, although other parents and caregivers can do it too. Skin-to-skin has lots of benefits for both you and your baby. It calms your baby and helps them maintain their body temperature and heart rate. It also helps you build your milk supply and helps breastfeeding get off to a good start by giving your baby easy access to the breast in those early days.

UNICEF recommends that:

all mothers have skin-to-skin contact with their baby after birth, at least until after the first feed and for as long as they wish

all mothers are encouraged to offer the first feed in skin contact when the baby shows signs of readiness to feed

mothers and babies who are unable to have skin contact immediately after birth are encouraged to commence skin contact as soon as they are able, whenever or wherever that may be

If you are having any issues with feeding, soon after birth or even in the first few weeks and beyond, spending time skin-to-skin with your baby can make a real difference. Sometimes feeding can become stressful. Going back to spending time being together cuddling in skin-to-skin contact without pressure to feed can help to relax both you and your baby and make feeding easier. Even if it doesn't help with feeding, skin-to-skin cuddles can help you and your baby to bond.

You can visit the UNICEF website for more information on skin-to-skin.

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Skin-to-skin - The Breastfeeding Network

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Skin-to-skin means holding your baby whilst they are naked or wearing just a nappy, so that their skin is in contact with the bare skin of your chest and tummy. Usually the mother does this, although other parents and caregivers can do it too. Skin-to-skin has lots of benefits for both you and your baby.

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Alcohol and Breastfeeding - The Breastfeeding Network

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Alcohol and Breastfeeding - The Breastfeeding Network

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This information can also be viewed as a PDF by clicking here.
Breastfeeding mothers can have occasional, small amounts of alcohol but should not drink regularly or heavily (e.g. binge drinking) without considering how to limit the baby's exposure. If you drink any alcohol DO NOT bed share with your baby or fall asleep in the sofa/chair. If you do binge drink, your baby should be cared for by an adult who has not had any alcohol. It is not necessary to express breastmilk to clear it of alcohol.

Never share a bed or sofa with your baby if you have drunk any alcohol. Doing this has an increased association with sudden infant death syndrome (SIDS).

Alcohol passes freely into breastmilk reaching approximately maternal levels BUT maternal blood levels have to reach 300mg/100ml before mild sedation is reached in the baby (this compares with a level of 80mg/100ml needed to fail the police breath test in England, Wales and N. Ireland; 50mg/100ml Scotland.

To reduce exposure of the baby to alcohol, avoid breastfeeding for 2-3 hours after drinking.

Peak levels in the milk appear after 30-90 minutes but this does not mean that social drinking of small amounts of alcohol mean that you cannot breastfeed.

Excess levels of alcohol in milk may lead to drowsiness, deep sleep, weakness and decreased growth in the infant. Reduction of let-down is reported when the mother drinks heavily. Alcohol may reduce the baby's sucking time at the breast but not the volume of milk consumed.

It is not necessary to express breastmilk to clear it of alcohol; as the mother's blood levels fall, the level of alcohol in the breastmilk will decrease.

Binge drinking (more than 6 units of alcohol in one period), may make you less aware of your baby's needs. If you have drunk enough alcohol to make you feel disorientated or cause vomiting you should not be caring for your baby without supervision from a sober adult. You should ideally express for comfort and to maintain your supply - although this may be the last thing on your mind!

Chronic consumption of alcohol is more likely to cause harm than occasional social drinking.

NB It is vital that mothers who have been drinking alcohol should never let themselves be in a situation where they might fall asleep with the baby; on a bed, chair or settee (this would also apply to other carers who have been drinking alcohol). The place of sleep is a bigger risk than the fact that the mother has been drinking unless her consumption has been very high.

Drinking alcohol reduces the ability of the mother to be aware of her baby's needs, whether she is breastfeeding or not. It is safest to ask someone else to care for the baby.

Other websites

NHS Breastfeeding and drinking alcohol. - Your pregnancy and baby guide www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-alcohol/

Guidelines from the NHS

Anything you eat or drink while you're breastfeeding can find its way into your breast milk, and that includes alcohol.

If you regularly drink as much as 14 units per week, it's best to spread your drinking evenly over 3 or more days.

If you wish to cut down the amount you drink, a good way to help achieve this is to have several drink-free days each week.

Fourteen units is equivalent to: 6 pints of average-strength beer, 10 small glasses of low-strength wine

Use Alcohol Change's alcohol calculator to check your units: https://alcoholchange.org.uk/alcohol-facts/interactive-tools/unit-calculator
©Dr Wendy Jones MBE, MRPharmS and the Breastfeeding Network March 2021

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Alcohol and Breastfeeding - The Breastfeeding Network

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This information can also be viewed as a PDF by clicking here. Breastfeeding mothers can have occasional, small amounts of alcohol but should not drink regularly or heavily (e.g. binge drinking) without considering how to limit the baby's exposure. If you drink any alcohol DO NOT bed share with your baby or fall asleep in [...]

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CoppaFeel! | Check Your Chest | Breast Cancer Awareness Charity

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CoppaFeel! | Check Your Chest | Breast Cancer Awareness Charity

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CoppaFeel! | Check Your Chest | Breast Cancer Awareness Charity

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Breast cancer can affect any body. Getting to know yours could save your life. Learn more about breast cancer awareness with CoppaFeel!.

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Pregnancy, baby and parenting

Welcome to Better Health - Start for Life.

We may have a new name and look, but don't worry, you will still find all the trusted NHS advice and guidance you need to help you have a healthy and happy baby during pregnancy, birth and parenthood.

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Get trusted NHS advice during pregnancy, birth and parenthood. Start for Life is your essential guide for having a healthy, happy baby.

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Pregnant and Breastfeeding - La Leche League GB

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Pregnant and Breastfeeding - La Leche League GB

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Pregnant and Breastfeeding - La Leche League GB

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If you’re expecting a baby and are continuing to breastfeed your older child, many questions may be going through your mind. Mothers can breastfeed while pregnant; some go on to nurse both their new baby and their older child after the birth. This is known as ‘tandem nursing’. Breastfeeding during pregnancy is a special, unique relationship […]

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Breastfeeding and coronavirus
Getting breastfeeding started

Life with a new baby

Common Concerns

Milk Supply and Combi-Feeding

Milk Expression and Storage

Family Foods

Working and separation

Breastfeeding an older baby

Can I breastfeed if...?

Other Topics

Breastfeeding Today (LLLI)
Information & stories
article index
Please note: The breastfeeding information on this website has been put together by La Leche League Leaders, who are accredited by La Leche League to provide breastfeeding information. Please note that Leaders have a wide knowledge and experience of breastfeeding but are not medically trained. If you have a medical query, or are concerned about your health or the health of your child please consult your doctor.

Information, references and links on this website are taken from La Leche League resources, unless stated otherwise. Please note that La Leche League GB does not endorse information from outside sources, extra information is provided for you to consider.

Information supplied is not intended as advice. You are in the best position to make a decision as to how the information offered will affect you and your baby.

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There are a range of ways LLLGB can offer you support with breastfeeding, by telephone, in writing, or using our online information and printed materials. If the blue "chat now" button is showing, then you can also use our online chat service to have an instant conversation with one of our breastfeeding counsellors.

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What do I need? - The Breastfeeding Network

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What do I need? - The Breastfeeding Network

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You don't need any special equipment for breastfeeding. Although you may choose to wear specially designed nursing clothes or use a nursing cover, breast pump, or special breastfeeding pillow, none of these things are usually necessary for breastfeeding. You may find it more comfortable to wear a nursing bra. You might find a very soft-cupped, unstructured nursing bra particularly useful for the early weeks. Your breasts are likely to change after you give birth, so it's best to buy, at most, one or two before you baby is born, in case they don't fit later on. It is worth making sure they fit correctly, as a poorly fitting bra or one not intended for breastfeeding can be uncomfortable and cause your breasts to become inflamed. You might also find absorbent breast pads useful. You can get either the disposable or washable type.

If you need to express your breastmilk after your baby is born, to help you establish breastfeeding, your midwife or breastfeeding supporter can show you how to hand express. If you prefer to use a pump, there may be one in the hospital you can use if you haven't gone home yet, or you can hire a hospital grade one. There are lots of different pumps you can buy, but it may make more sense to wait and see if you need one before buying.

There are a number of books about breastfeeding that you might like to read before your baby is born, or dip into in the early days for information. Some of these are listed below. You may be able to buy these cheaply second hand or borrow them from your local library. Some baby groups may have copies that they lend out.

The Positive Breastfeeding Book: Prof. Amy Brown

You've Got It In You - a positive guide to breastfeeding: Emma Pickett IBCLC

The Womanly Art of Breastfeeding - La Leche League International

Why Breastfeeding Matters - Charlotte Young

Speak to a registered Breastfeeding Supporter

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What do I need? - The Breastfeeding Network

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You don't need any special equipment for breastfeeding. Although you may choose to wear specially designed nursing clothes or use a nursing cover, breast pump, or special breastfeeding pillow, none of these things are usually necessary for breastfeeding. You may find it more comfortable to wear a nursing bra.

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Expressing & Storing Milk - La Leche League GB

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Expressing & Storing Milk - La Leche League GB

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Why Express Milk?

Expressing Milk

Storing Milk

Why express milk?

There are several reasons why you might need or want to express milk for your baby. These include:

when a baby can't breastfeed

to make more milk

a return to paid work

separation

choice

When a baby can't breastfeed

Babies and parents have many instincts for breastfeeding, but it is still a learned skill that can take time and practice. When babies won't breastfeed, it is usually because they can't. This could be for many reasons, for example:

they are preterm

they are unwell

they have a tongue tie

they are sleepy as a result of birth medications

they had a difficult birth

it is taking time to learn how to breastfeed

Expressing milk when your baby cannot nurse - or nurse effectively - protects your milk supply and provides milk to feed them. Breastmilk is especially important for babies who are unwell and/or preterm as it helps protect against illness and infections, and is ideal for a baby's sensitive and immature digestive system.

Expressing milk is often a short-term solution. However, some mothers may find themselves exclusively expressing breast milk (' exclusively pumping ') long-term when their baby is ill or has medical difficulties.

A return to paid work

There are many ways to combine working and breastfeeding. It is not always necessary to express milk when returning to work. It may depend on:

the age of your baby

the length of time you are apart

your willingness - and ability - to express; pumping is not effective for everyone, although there are ways to improve this.

your baby's willingness to take your milk when you aren't there

Many mothers express initially for reassurance and comfort, and to avoid blocked ducts and mastitis. However, you may find that your body quickly adjusts to a new breastfeeding pattern and you no longer need or want to express.

You and your baby may need to be apart. This may be for illness or health reasons, an appointment or event, or a night away.

Your baby has an intense need for your presence as well as your milk, and separation can be hard for both of you. It may be possible to take your baby with you - young babies are very portable and often enjoy being out and about.

Some mothers choose to express milk some or all of the time. You might want - or feel pressured - to let a partner or other family member feed your baby. Some parents choose to exclusively pump because they don't enjoy breastfeeding, but want their baby to have the benefits of their milk.

Expressing Milk

What kind of pump do I need?

Pumps are available to hire and to buy. The pump you use depends on your reason(s) for expressing and your personal preference. We all respond differently to pumps and have different needs.

Single electric pumps and manual pumps are best suited to occasional expressing, for example, short term separation or a return to work. They can also be used to express 'to comfort' any time your breast feels very full and your baby doesn't want to feed.

Double electric pumps express milk from both breasts at once, which often saves time. It is also said that they tend to stimulate more milk production. They are available as personal use pumps and 'hospital grade' pumps.

Hospital grade pumps are very powerful and are intended to be used by more than one person multiple times a day. They are usually hired. Hospital grade pumps are recommended when you are exclusively expressing, expressing very frequently, or trying to increase your supply. Parents might start with a hospital grade and then switch to a personal use pump once their supply is established and if they need to keep expressing.

Silicone pumps tend to be best suited to occasional use. Some mothers have found them helpful to relieve blocked ducts. (Note: When attached to the breast, a silicone pump is not just a device for collecting dripping milk - it creates a vacuum stimulating a 'letdown'. If this is not your planned use, it can create supply issues.)

Hands-free pumps come as single or double electric pumps. They can be handy for mums who want to pump on the go, or pump and multitask. Hands-free pumps have small motors and are possibly best suited to occasional pumping. You can buy or make a hands-free bra for a pump to fit in to.
Types of Pump (image above)
A. Manual breast pump
B. Single electric pump
C. Double electric pump

It is also possible to express without any equipment. Hand expressing is a great skill to learn for all ages and stages! It can take a little practice, but it can quickly become second nature:

It is free and can be done any time, anywhere!

It is the perfect choice for the early days when you are producing colostrum (you can collect - or 'harvest' - colostrum before your baby is born).

You can practise antenatally and become familiar with your breasts before your baby arrives.

Getting 'hands-on' during a pumping session can increase milk output. See Expressing Tips.

What else do I need to know about pumps?

Pumps are often sold in a standard size, however pump parts come in different sizes. The funnel-shaped piece that touches your breast is usually called a flange . The tubed-shaped bit that the nipple goes into is sometimes called the nipple tunnel

If pumping is comfortable with good milk flow, you probably have a good fit. However, if pumping is painful or causing swelling and/or rubbing, you may need a bigger or smaller flange. Sometimes a different flange size is needed for each breast. A poor fit can also reduce milk flow. 1

The nipple should have enough room to slide in and out during pumping, without rubbing. The areola (darker area around the nipples) may move slightly with it, but it shouldn't be drawn into the nipple tunnel. After pumping, the nipple will almost certainly be bigger, but shouldn't seem darker or swollen. 2
Pump Flange Sizes (image above)
A. Milk expression
B. Flange is too big
C. Flange fits
D. Flange is too small
Suction strength and cycle speed
Electric pumps often come with a range of settings. There will be settings for suction strength and settings for cycle speed.

A pump is trying to mimic a breastfeeding baby. When a baby nurses, they do a fast, light suck to trigger a letdown. Once the milk lets down, the sucking slows and they swallow more.

You might begin by using a low suction, high speed setting and once your milk starts flowing, switching to a higher suction, lower speed setting.

Exactly how high or low depends on how it feels and if it is removing milk well. Expressing should be comfortable, and a pump provides most milk when it is set at the upper end of fully comfortable. 3

Painful pumping may impact milk flow, damage your nipples, and is unlikely to make you feel like doing it!

How often and when should I express?

If your baby can't breastfeed yet, aim to express 8-10 times in a 24-hour period, including at least once at night. These do not need to be at regular time intervals, but avoid stretches longer than 5 or 6 hours. Once your supply is well established, you may find that you can get by with fewer sessions.4

If you are trying to make more milk, express after or between feeds. How often depends on how much more milk your baby needs and how feeding at the breast is going.

If you are returning to paid work, how often you express will depend on a number of things. Some parents look at how often they feed on average in a 24-hour period and work out how many feeds they will typically have when they are with their child, so express the same number of times when separated to maintain this daily average.

If you are stockpiling milk for short-term separation or in the run up to a return to work, express once or twice a day after or between feeds. If your baby typically feeds from one breast, you could express from the other side while they feed. The amounts may seem small, but they quickly build up!

Some mothers try 'power pumping' as a short-term strategy to increase their milk supply, or when they are struggling to fit pumping into their daytime routine. This approach involves expressing very frequently for short periods, stopping and starting as many times as possible - it is said to mimic cluster feeding.

How long should I express for?

Just like breastfeeding, expressing milk is not a 'one-size-fits-all'. Observe your milk flow, notice how your breasts feel and find what works for you.

If you are using a single pump, this usually takes about 20-30 minutes for both breasts. You might try switching sides when the milk flow slows, usually every 5-7 minutes.5

Double pumps save time. A double-pumping session that replaces what would have been nursing will probably last no more than 15 minutes. However, it is more important to pay attention to your breasts than the clock.6

How much milk will I express?

How much we can express at any one time depends on lots of different things. If you've never used a pump before, it might be helpful to think of the first pumping sessions as practice. 7

Expect small amounts in the early days. This will be drops for some and as much as a teaspoon for others. Many parents think of it as 'putting in their order' for more milk later.8

If you are breastfeeding full-time, expect to express around 15-60ml (0.5-2 fl oz) in total from both breasts per pumping session.9

If you are exclusively pumping, consider the overall volume in 24 hours. Full milk production is about 750-900 ml (25-30 fl oz) per baby. Milk production reaches its peak at about five weeks and stays relatively stable until around six months.10

Once milk production peaks, a typical feed is about 60-120ml (2-4 fl oz).11

We all respond differently to pumps. How much you can express is not always a reliable or accurate sign of how much milk is there. It's important to remember that a baby who is nursing effectively will get more milk than a pump.

Expressing tips

Before expressing:

Wash your hands and get comfortable

Put something warm on your breasts, such as a warm flannel

Gently massage your breasts

Use any objects or techniques that help you to feel calm and relaxed. This might be a photo of your baby, an item of their clothing, a favourite warm drink or snack, music or visualisations.

While expressing:

Try 'hands-on pumping'. This is said to produce better results than relying on a pump alone12

Use breast compression to increase milk flow

Take a break midway and gently massage the breasts to help increase the amount of milk.13

Hand express from both breasts after you have finished pumping.

Try nursing your baby on one side and expressing on the other, or expressing from both sides at the same time, to encourage more letdowns

After expressing:

Hand-express for a minute or two to help increase output and supply.

Cleaning pump parts

There is not complete agreement about cleaning pumping equipment. Some public/advisory bodies (including NHS England) recommend sterilising equipment after every feed.

Others recommend washing pump parts thoroughly after every feed and sterilising once a day.

Some advisory bodies and breastfeeding organisations state that pump parts do not need to be sterilised, and that washing in hot soapy water is enough if your baby is healthy and full term.

Day-to-day milk handling

There is very little research on the day-to-day problems of milk handling, so guidelines often err on the side of caution.

Fresh human milk kills almost all bacteria, viruses and fungi that it comes in contact with.14

Mothers who are exclusively expressing, or expressing frequently, sometimes put the whole pumping kit (flanges attached) in a clean container in the fridge until the next expressing session and clean everything at the end of the day.

Breastmilk can be safely stored at room temperature for up to 4 hours (see below). Some parents apply the same timeframe to their pump and pump parts, and express multiple times within a 4 hour period before cleaning everything.

One quick method of sterilising is to use a sterilising fluid that you change every 24 hours. Submerge pump parts in the solution after washing them each time.15

Washing and drying

Ensure hands and pump area are clean.

You may like to use a separate basin and separate utensils for cleaning pump parts and equipment rather than the sink.

Clean with hot soapy water and rinse separately with clean water.

Some pump equipment is also dishwasher-safe.

Air dry or dry with paper towels.

Clean pump dials and switches with a disinfectant spray or wipe.

Store dry pump equipment in a clean container.

If you are expressing milk for a sick or premature baby, good hygiene is vital and sterilising is essential.

Storing Milk

How long can I store milk for?

There isn't complete agreement about milk storage.

Wherever you are storing milk, the fresher it is, the better.

Good hygiene is important - clean hands, clean pump parts, clean storage.

For healthy, full term babies 16:
Room temperature

Ideally, use within 4 hours.

Depending on room temperature and how clean storage conditions are, up to 6-8 hours may be safe.

Frozen milk that has thawed and kept at room temperature should be used within 4 hours.

Fridge

Ideally, use within 4 days.

When conditions are very clean, 5-8 days may be acceptable.

Store milk in the back of the fridge rather than in the door.

Frozen milk that has thawed in the fridge should be used within 24 hours.

Freezer

Ideally, use within 6 months.

Can be stored for up to 12 months.

Store at the back of the freezer, away from the door where temperatures may fluctuate.

Insulated bag
Milk left over after a feed should be used within 1-2 hours as it mixes with a baby's saliva, although it may be safe to put it in a fridge for up to 4 hours. 17

For premature or sick babies, consult with hospital staff and follow hospital guidelines.

Combining expressed milk

When combining milk expressed at different times, mix cold with cold:

Chill newly expressed milk before adding it to an existing container.

You can add refrigerated milk to frozen as long as there is less refrigerated milk than frozen.

Use within the time limit of the oldest expressed milk.

What can I store milk in?

You can store milk in any clean container, such as a hard (BPA-free) plastic or glass container with a tight-fitting lid, or a disposable milk storage bag.

Milk expands in the freezer, so leave space in the bag or bottle if you plan to freeze it.

Put the date on the container.

How much milk should I store?

Store milk in small quantities to avoid waste. Small amounts also defrost more quickly.

For babies older than one month, a feed is approximately 60-120ml. You could also store some smaller amounts in case you need to offer more.

How do I prepare stored milk?

You don't have to warm milk - some babies like it cold!

If you do warm milk, run the container under a warm tap or place it in a pan of warm water.

Never use a microwave or heat milk directly.

Swirl milk to combine rather than shaking it.

If defrosting milk, thaw it overnight in a fridge or hold it under warm running water.

Thawed milk should not be kept at room temperature. It should either be fed immediately or put in the fridge.

Smelly milk

Sometimes milk smells or tastes soapy after a short time in the fridge or freezer. This is because of an enzyme (lipase) that breaks down fats in milk. The milk is completely safe and most babies will drink it. However, if they refuse to, heat freshly-expressed milk to scalding (bubbling around the edges, but not boiling) and then quickly cool and freeze it. Scalding reduces some of the immune factors, but may be the only option for some families. You can also experiment with the length of storage time needed for the milk to acquire the smell.

Feeding your baby your milk

See Further Reading and resources below for information on ways to feed your baby your expressed milk.

Further Reading

Bottles and other tools
Comfortable Breastfeeding
How to increase your milk supply
Engorged Breasts - Avoiding & Treating
Hand Expression of Breastmilk
My Baby Needs More Milk
My Baby Won't Breastfeed
Sleepy Baby - Why and What to Do When Mum Can't Be There
Working and Breastfeeding

Online Information

Hand expressing:

Maximizing milk production when expressing:

Books

La Leche League International, The Womanly Art of Breastfeeding, Pinter and Martin, London: 2010.
Marasco, L & West, DMaking More Milk, McGraw Hill, New York: 2019.
Mohrbacher, N.,Breastfeeding Answers, Nancy Mohrbacher Solutions, Illinois: 2020.
Ruddle, L.,Relactation: A Guide to Rebuilding Your Milk Supply, Praeclarus Press, Texas: 2020.

References

La Leche League International, The Womanly Art of Breastfeeding, Pinter and Martin, London: 2010; 298.

As above, p304.

As above, p489.

La Leche League International, The Womanly Art of Breastfeeding, Pinter and Martin, London: 2010; 300.

As above, p500.

Bonyata, K. I'm not pumping enough milk. What can I do? Accessed: 28 March 2023.

La Leche League International, The Womanly Art of Breastfeeding, Pinter and Martin, London: 2010; 307.

As above, p301.

As above, p300.

As above, p309.

As above, p515.

Copyright LLLGB 2023

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Expressing & Storing Milk - La Leche League GB

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Why Express Milk? When a baby can't breastfeed Making more milk A return to paid work Separation Choice Expressing Milk What kind of pump do I need? What else do I need to know about pumps? How often and when should I express? How long should I express for?

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Breastfeeding the Brave – Supporting breastfed medically complex infants and children

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Breastfeeding the Brave – Supporting breastfed medically complex infants and children

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Breastfeeding the Brave – Supporting breastfed medically complex infants and children

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Welcome to the home of Breastfeeding the Brave, a resource for both mothers/parents and professionals supporting breastfed medically complex infants and children.

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This site stores certain information as “cookies” on your device in order to improve your website experience. We also share information about your use of the site with analytics partners who may combine it with other information that you’ve provided to them or that they’ve collected from your use of their services.

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Shropshire’s community hubs are vibrant spaces at the heart of local communities, designed to enrich the lives of local people.

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Train to be a registered BfN volunteer - The Breastfeeding Network

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Train to be a registered BfN volunteer - The Breastfeeding Network

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At the heart of our organisation are our volunteers who give their time to support other families in their communities and over the helplines. We currently have over 650 volunteers across the UK of all ages and from all backgrounds. You can give a few hours every week, or each month or offer to help with a specific task or event for a short period of time, it is completely up to you.

Some people volunteer to give something back as a thank you for the support they received, others do it to meet new people or gain experience that might help them find a job. Whatever your reasons we would love to hear from you. Our volunteers make us who we are and enable us to support thousands of families each year, why not join us!

If you would like to volunteer your time to support other mums with breastfeeding you will first need to complete our Training. This helps us make sure that the support and information our volunteers offer is safe, up to date and consistent across the UK.

We would love to be able to offer training to everyone who asked, but unfortunately, this is not possible due to funding. This means we may not have training available in your area or you may need to wait for several months before you can get a place on a course.

We provide two levels of training designed for mums who have breastfed to become registered BfN volunteers. This can be provided as part of a Peer Support projector as a stand-alone activity, to increase breastfeeding awareness and support in a specific area.

All our peer support training is accredited by OCN London and is delivered by trained BfN tutors. You will work through the training as part of a group. This enables you to share experiences and develop relationships with other women training to volunteer in your local area or across the UK.

BfN training is open to all women who have personal experience of breastfeeding their own babies. It is open to mothers of all ages and background; to enable them to widen their knowledge, skills and experience to support breastfeeding within their communities or remotely.

BfN is committed to promoting equality and diversity and to eliminating discrimination in our training and coordination of volunteers. We will always look to make reasonable adjustments and to provide additional support so as to ensure that our training is accessible to everyone.

What do you get when you train with us?

All workbooks, manuals, course materials and other resources to help you support mums and families

The opportunity to complete training as part of a group of mums who have breastfed

Support from a trained BfN Tutor

Assessment and internal moderation of completed coursework

Peer support from other trainees on the course and the opportunity to develop a supportive network

Registration and accreditation with Open College Network (London)

BfN ID badge and OCNL certificate upon completion

Full complimentary membership of BfN for two years (see here for full details) - including DBS and PVG checks, low-cost or free entry to our annual conference and subscription to our quarterly BfN News

Insurance to volunteer on behalf of BfN

Regular supervision (usually monthly) and ongoing support

Ongoing training and opportunities for further development (Helpers can train to become Supporters and Supporters can go on to train as Supervisors and Tutors)

The opportunity to work as a registered volunteer which can be useful work experience when applying for paid employment, also with a reference from a national charity

BfN Helper Course (Peer Supporter)

This is our first level of training for volunteers. By completing the course you can hope to achieve:

The knowledge to support other mums with breastfeeding

A nationally recognised, Open College Network (London) accredited qualification (two units at Level 2, equivalent level to GCSEs in England and National 5s in Scotland)

The opportunity to continue training to become a BfN Registered Breastfeeding Supporter

Training to become a BfN Helper volunteer is free and may include a crèche facility.

BfN Registered Helpers (peer supporters) can volunteer in a variety of different ways: in BfN breastfeeding drop-in groups, in hospitals, schools and in antenatal classes.

The course itself usually consists of twelve 2 hour sessions which are traditionally delivered face to face at a local community venue. We are currently developing a more blended approach. This combines the same excellent support from an experienced BfN tutor and access to an accredited course using an online format. The online course includes around seven group tutorials delivered via video call.

There is also a version of the BfN Helper Course aimed specifically at training peer supporters to be able to volunteer in the neonatal unit.

BfN Supporter Course

BfN Registered Helpers may go on to do a second stage of training if they wish. On completion of this second level of training you would become a BfN Registered Supporter. You would develop the skills to work more independently and to offer phone support on the National Breastfeeding Helpline (NBH).

The BfN Supporters course consists of at least two units at OCNL level 3, with the opportunity to complete a further unit (equivalent level to GCE A levels in England and Highers in Scotland and worth up to 12 credits). There are 13 group sessions delivered face to face or as online video calls over around 6 months. Trainees are expected to complete 13 assignments which are then assessed and moderated. This course may be delivered entirely face to face or using a mix of online training and group video call tutorials.

Availability of Training

Courses accepting applications just now are listed below. If there is no course listed for your area at present, please to go to our Peer Support Projects page where you can view individual project pages and contact details.

Please refer to our Volunteer Recruitment Policy for more information about how the process works.

If your area is not listed it is unlikely that we are currently offering training near you. We are developing new courses, including online training, and information will be made available here on the website and on social media so please keep checking back.
If you would like to tell us more about why you would like to train please complete this form to register your interest.
We will keep these details on file and we will try to let you know of any new courses that may be of interest. Any information you provide will be handled in accordance with our Privacy Policy.

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Train to be a registered BfN volunteer - The Breastfeeding Network

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At the heart of our organisation are our volunteers who give their time to support other families in their communities and over the helplines. We currently have over 650 volunteers across the UK of all ages and from all backgrounds. You can give a few hours every week, or each month or offer to help [...]

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Looking for volunteers: trained BfN peer supporters and OCA 'Group Hosts'

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Looking for volunteers: trained BfN peer supporters and OCA 'Group Hosts'

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We are delighted to have joined with Oswestry Community Action (Qube) to offer training for volunteers who will run breastfeeding peer support groups across the Shropshire area. Places on the course will be allocated to people who live in Shropshire (excluding Telford & Wrekin) and who are able to volunteer in the following areas: Ludlow, Shrewsbury and Oswestry.

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Helper2026/01 Shropshire Qube(2) - The Breastfeeding Network

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Course Title: Helper2026/01 Shropshire Qube(2) Number of places available: 12 Course start date: Thursday 8th January 2026 Course end date: Thursday 26th March 2026 Day and time of sessions: Thursday afternoons, 12.30pm to 2.30pm on Zoom 08-Jan15-Jan22-Jan29-Jan05-Feb12-Feb19-Feb – Half term, no session26-Feb05-Mar12-Mar19-Mar26-Mar Assignments to be completed by: 1st March 2026 Course venue: All sessions will be held […]

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Breastfeeding with a disability - The Breastfeeding Network

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Breastfeeding with a disability - The Breastfeeding Network

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If you have a disability you may be concerned that this will affect how you choose to feed your baby. In most cases, with the right help and support, breastfeeding with a disability is not only possible but can offer distinct advantages for both the mother and baby.

A person is considered to have a disability if they report a long-standing illness, disability or impairment which causes substantial difficulty with day-to-day activities. This is the core definition of disability in the Equality Act 2010.

Everyone's condition is unique but mothers with disabilities have told us that these are the most common problems:

Positioning and attachment issues - due to fatigue, physical difficulties, overwhelming sensory issues and use of medical equipment (e.g. wheelchairs, stoma bags) the most common positions may be impractical and unhelpful. There are many more positions out there, you can even invent your own to find the best for you and your baby.

Knowing how medication affects breastmilk - doctors and other healthcare professionals may not always have the knowledge to inform you. Always speak to your healthcare professional first but if you have other questions the The Drugs in Breastmilk information service offers up to date information on various drugs and their safety in breastfeeding mothers.

Other problems that come up are more specific to the long term condition or disability: hormone problems interfering with milk supply, digestive problems causing mother to have difficulty maintaining enough calorie intake to nourish themselves and their child, connective tissue disorders affecting joints or skin to name a few. Most of these can be helped with some creative thinking and up to date relevant knowledge. Knowing how to access help is essential to your support.

Where to look for help

Midwife/consultant - you may need to ask specific questions about the difficulties you are facing

BfN Drugs in breastmilk Facebook page

Support groups for your condition (face to face or on social media) - ask if anyone in them has breastfeed and can share tips with you

Local BfN support groups or local BfN Facebook pages

National Breastfeeding Helpline

Quotes from breastfeeding mothers with a disability:

I knew I would really struggle with fastening bottles so kept on breastfeeding. I also wanted to avoid having to go up and down stairs at night.'

That it's so handy and convenient don't have to get out of bed don't have to move boobs are always there and less to carry in bag. I think breastfeeding is one of the most accessible tools mums have!!'

Don't give up breastfeeding or think it's not possible because of your disability - tell professionals they need to help you find a way to crack it! Besides, for many of us, bottle feeding is even more difficult with holding/position of baby and washing bottles'

Many autistic women worry about sensory sensitivities and breastfeeding. But these vary from person to person. After the initial week or so when my nipples were very tender sensitivity was not a problem. On the positive side, being autistic, breastfeeding was good because the baby could be fed immediately, reducing the amount of crying. There was also no anxiety about preparing formula correctly.'

For some health conditions breastfeeding can be a protective factor in the child's future health. Breastfeeding for me staved off the postnatal crohns flare, unfortunately it did appear once my baby weaned but of course I preferred it then than in the postnatal phase!'

If you are a mother with disabilities and you want to share your experience of breastfeeding please get in touch or join our Facebook page to chat to other mums.

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Breastfeeding with a disability - The Breastfeeding Network

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If you have a disability you may be concerned that this will affect how you choose to feed your baby. In most cases, with the right help and support, breastfeeding with a disability is not only possible but can offer distinct advantages for both the mother and baby.

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Barriers to breastfeeding for younger mothers - La Leche League GB

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Barriers to breastfeeding for younger mothers - La Leche League GB

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Barriers to breastfeeding for younger mothers - La Leche League GB

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Lynsey Hansford describes her own experience as a younger mum and looks at some of the barriers to breasfeeding they face. You may have heard or observed that younger mums are less likely to breastfeed than older mums. The 2010 UK Infant Feeding Survey found that women aged 30 or above were the group most […]

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I don't enjoy breastfeeding- La Leche League GB

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I don't enjoy breastfeeding- La Leche League GB

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Pain: if breastfeeding hurts - The Breastfeeding Network

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Pain: if breastfeeding hurts - The Breastfeeding Network

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Pain in your nipples or breasts whilst breastfeeding is most often linked to how you are holding your baby and bringing them to your breast (often referred to as positioning and attachment). Before considering any alternative reasons for experiencing pain whilst breastfeeding please use our guide to positioning and attachment to rule this out as a cause of pain. Even if there is another medical basis for the pain, getting positioning and attachment as comfortable as possible will still help.

When you first start breastfeeding, it is common to experience a strong and sometimes uncomfortable sensation for the first few seconds of your baby latching on. However, this should pass quickly, and feeding should become comfortable. If this is not the case, trying some small changes to your positioning and attachment could help make feeding more comfortable for you.

Signs that attachment is not as effective as it could be include:

If the pain is worst at the start of a feed, and continues for more than a few seconds.

If your nipple changes shape after breastfeeding - either lipstick shaped or flattened

If your baby slurps onto nipple rather than attaching with open gape

If your nipple changes colour after the breastfeed - classically a white tip to the nipple, although this may not be visible on all skin tones

If your nipple is damaged, with cracks or bleeding

If the pain is not improved after trying some of the ideas in our guide on positioning and attachment, please seek support from a breastfeeding supporter. They can observe and assess a full feed. You can also find a local support group here or contact the National Breastfeeding Helpline.

If your nipple is damaged, use moist wound healing within the wound (avoid applying cream to whole nipple) to stop a scab forming, which will deepen the wound. You can continue to breastfeed on a damaged nipple as it will still be able to heal, but it is very important to get support with positioning and attachment to prevent further damage occurring.

If a breastfeeding practitioner has helped you adjust your positioning and attachment and you still have pain or nipple damage, your baby may need to be assessed for a tongue tie or other issues that might be making breastfeeding harder.

Other causes of pain in breastfeeding:

Allergy

If your nipples are itchy (which may be triggered by warmth) or changed in colour (which may show as redness on lighter skin tones) but you do not see any change in the shape of your nipples and are not experiencing pain, the problem may be an allergy to something in contact with your nipples, such as nipple cream or breast pads. Try eliminating these to identify the cause. If disposable breast pads are causing irritation, you could try washable ones instead.

The symptoms may be relieved by a non-sedating antihistamine and hydrocortisone 1% cream applied sparingly. See our factsheet on antihistamines for more information on taking these whilst breastfeeding.

Vasospasm

If your nipple turns white at tip after breastfeeds and pain or itchiness, and redness on some skin tones, occurs immediately at end of feed when blood returns, vasospasm could be the cause.

This is due to restricted circulation from compression of the nipple by the baby squashing it between their tongue and the roof of their mouth during a feed. It can be relieved by help with attachment from a specialist breastfeeding practitioner. Vasospasm can occur in one or both breasts. It does not respond to medication which is unnecessary, but can be improved by adjusting positioning and attachment.

Raynaud's Phenomenon

If the pain is worst at the end of or after a feed and your nipples change colour rapidly after breastfeeds from white to purple then red (this might not be visible on all skin tones), you may be experiencing Raynaud's Phenomenon.

If you have a history of circulation problems or migraine and pain is triggered or made worse by cold, Raynaud's Phenomenon is more likely. Pain can be immediately after a feed but may also be delayed or can be triggered by cold even when not feeding.

You may be able to improve your symptoms by avoiding breastfeeding in cold places, covering your nipple as soon as a feed is finished and applying warmth after feeds. If this is not effective, consider asking GP to prescribe nifedipine 10mg three times a day or nifedipine LA 30mg daily. Treatment for two weeks may be sufficient or may be needed long term. You can find more detail in our Raynaud's phenomenon factsheet.

A white spot, bleb or blocked nipple pore.

If pain is worst at the end of or after a feed and you can point to a discrete spot (which may be white, yellow or pale pink) on your nipple as the origin of the pain, this is likely to be due to a white spot, also called a bleb, blocked nipple pore or milk blister. Symptoms may return periodically.

A white spot is thought to be caused by a thin bit of skin growing over a milk duct opening, and milk backing up behind it.

You can continue to feed with a white spot, and feeding may cause it to clear spontaneously. If it does not clear, the skin overgrowth can sometimes be removed by soaking the nipple in warm water and rubbing gently with a clean, moist washcloth. You can also try softening the skin with an oil such as olive oil. If this doesn't work, the skin may require removal by a healthcare professional using a sterile needle. Antibiotic cream may be required if a significant wound results. If you squeeze just behind the blister some toothpaste-like thickened milk may come out through the now opened blister.

Expressing milk

If your nipple is sore or damaged and you are using a breast pump rather than feeding directly, you may need to reduce the strength of the suction on your pump or you may be using a flange that is the wrong size. Speak to your health visitor, midwife or peer supporter to get support with expressing your milk if needed.

Strong let-down

If the pain is strongest at start of feed or just before a feed and there is a sharp intense pain in your breast(s), often described as squeezing pain, this can be due to the let down or milk ejection reflex. Pain can be worse on fuller breast.

If it is associated with leaking milk, you can reduce this by applying firm hand pressure to your breast at the time of leaking.

If your baby also makes a clicking noise during feeds or pulls away choking once the feed has started, the fast flow of milk may mean your baby is struggling to attach well. Further support from a skilled breastfeeding practitioner to improve attachment may be useful.

You may find it helpful to express a small amount of milk just before a feed if your breasts are full, to get past the powerful let-down before starting the feed, or to use a laid-back breastfeeding position, so that the milk flow is less overwhelming for your baby.

Engorgement

If your breasts are painfully hard and full, and feeding or expressing milk relieves this sensation, your breasts may be engorged. This may be worst first thing in the morning, especially if you have not fed frequently through the night. You can avoid engorgement by feeding frequently and responsively, including at night time. Consider offering your baby a feed whenever your breasts start to feel full or uncomfortable. If you are unable to feed at that time, or if your baby refuses a feed, you can express just enough milk to relieve the discomfort. Avoid expressing more milk than necessary, as this could trigger an increase in your milk supply and make the engorgement worse. Allowing your breasts to remain engorged could lead to your breasts becoming inflamed (mastitis), or a reduction in your milk supply, so it is best to avoid this whenever possible.

If you find it hard to latch your baby on when your breasts become very full, you may like to try reverse pressure softening. Reverse pressure softening is a way to soften your areola. It can help make latching and removing milk easier when your areola is very swollen and engorged by temporarily relieving firmness and swelling.

It can be particularly helpful if you have some oedema or swelling due to IV fluids or drugs given during labour and birth, especially if you had a caesarean section. Breast engorgement in the early days can be caused by your milk coming in or by a combination of fluid held in the breast tissue around the milk ducts as well as by milk within the breast.

Reverse pressure softening briefly moves mild or firmer swelling away from under your areola, slightly backward into your breast for a short period of 5-10 minutes. This allows your areola to change shape and makes latching easier as your baby is able to get more of your areola and breast tissue into their mouth.

Reverse pressure softening also causes a 'let-down' reflex, making it easier for your baby to get milk or for you to remove milk by hand expressing or expressing with a breast pump.

Reverse pressure softening should not be used if you have mastitis, plugged ducts or a breast abscess.
How to do reverse pressure softening:
The key is to make your areola very soft right around the base of the nipple. This can make it easier for your baby to get a better latch.

Press gently on the edge of your areola, inward towards your chest wall, counting slowly to 50

Once the areola has softened, you can start to feed your baby or express (by hand or using a breast pump on low to medium pressure)

If you have very swollen breasts, doing reverse pressure softening lying on your back (taking advantage of gravity) will give more relief

Soften your areola right before each feeding (or expressing) until the swelling goes away. This takes two to four days or more

Blocked ducts and Mastitis

If there is a sore, lumpy area on your breast that may also feel hot and can appear red on lighter skin tones, you may have a blocked duct or mastitis. Mastitis is an inflammation of the breast. It may be accompanied by flu-like symptoms. Continue to feed responsively and seek support from a specialist breastfeeding practitioner as soon as possible. Blocked ducts or mastitis may be triggered by feeding infrequently, allowing your breasts to become overfull or other situations that increase pressure on your breast, for example, wearing a bra that is too tight or wearing your baby in a sling for longer than usual. Adjusting the way you hold your baby and bring them to your breast when feeding ( positioning and attachment) may also help.

You can take ibuprofen 400mg as anti-inflammatory if appropriate (i.e. if you have no contra-indications such as asthma or stomach ulcer), and also paracetamol for pain or fever. Antibiotics are not usually required if self-help measures are started quickly, but you should see a doctor if your symptoms persist. You can read our factsheets on pain relief medicines and breastfeeding and our mastitis page for more detailed information.

Abscess

An abscess is a rare complication of mastitis. You might want to consider whether you have an abscess if mastitis has not resolved following frequent, effective feeding and a course of antibiotics and if the skin on your breast looks like orange peel. A milk sample should be taken to ascertain the micro-organism involved in the infection to help decide which antibiotic might be most appropriate. An ultra sound investigation may be required to diagnose an abscess. Drainage of pus by needle aspiration or surgical drainage together with appropriate antibiotic might be offered. Abscess formation is a rare complication of infectious mastitis and may involve MRSA. You may benefit from emotional support from a breastfeeding supporter alongside specialist support from medical staff.

Thrush

Signs of thrush in you

Thrush (Candida albicans) infection can affect your breast while you are breastfeeding. Symptoms of thrush are a sudden start of breast and/or nipple pain in BOTH breasts after some weeks of pain free breastfeeding - pain is severe and can last for an hour after EVERY breastfeed. It should be confirmed by a swab of your nipples.

Thrush should not be diagnosed if:

You have pain in only one breast/nipple (thrush spreads quickly from one breast to the other)

You have never had pain free breastfeeding

If your nipples are shaped oddly after breastfeeds

If your nipple is white at the tip after breastfeeds

If the pain is different at different times of the day

If your baby has a tongue tie which you are waiting to have snipped.

Thrush in the first few weeks of feeding is rare unless the mother had vaginal thrush at delivery or had deep breast thrush at the end of a previous lactation. Less than perfect positioning and attachment with consequent damage are more likely to cause the pain at this stage.

Signs of thrush in your baby

Creamy white patches in your baby's mouth, on the tongue and may be far back or in the cheeks. Patches do not rub off.

Baby's tongue/lips may have a white gloss

It should be confirmed by a swab of the baby's mouth.

If you think you have thrush:

Before treating either you or your baby you should ask the person supporting you with breastfeeding to watch a full breastfeed from the moment the baby goes to the breast to the moment he/she comes away from the breast at the end of the feed. They need to look at your nipples at the end of the feed to look for change in colour and shape

If your baby has a white tongue but you are not experiencing pain, be aware of the risk of thrush but do not treat either of you immediately. Some babies have white tongues in the first few weeks after birth or this may be associated with tongue tie where the milk is not thrown to the back of the mouth.

Diagnosis should be confirmed by nipple swabs cultured for fungal and bacterial infection.

Breastfeeding should be pain free from the point of attachment (the moment the baby goes to the breast) onwards. Pain from thrush begins after a feed. There should be no change in the shape or colour of the nipple after a feed. Even good attachment can often be improved and help to relieve symptoms of pain. Be aware of the other causes of nipple and breast pain described on this page, and exclude them first.

Self-help measures

Thrush can be passed between you and your baby - and also between you, your partner and other children

Anecdotally, some mothers find acidophilus capsules can help to restore bacteria which can keep thrush under control (available from health food stores or chemists)

It is necessary to be very careful with hygiene in order to get rid of thrush completely - be sure to wash your hands well after each nappy change

Use a separate towel for each person in the family

Anecdotally, some mothers find reducing the level of sugar and yeast in their diet helps

If a thrush infection is confirmed, to make sure that you get rid of it, both you and your baby need treatment, prescribed by a doctor. Usually, once treatment begins the pain and other symptoms will begin to improve within 2 or 3 days. It may take longer for full recovery.

If there is no improvement at all after 7 days, consult your breastfeeding helper again as the cause of the pain may not be thrush.

Treatment

Ongoing attention to positioning and attachment is important because even the best latch can slip a little sometimes.

Miconazole cream applied to your nipples after every feed - sparingly and without washing off before the next feed

Miconazole oral gel applied gently to your baby's mouth 4 times a day a small amount at a time

If symptoms persist you may need fluconazole 150-400mg as a loading dose followed by 100-200mg daily for at least ten days. This is rarely necessary if your baby is less than 6 weeks old and could cause vomiting and stomach pains.

For more information, see our detailed factsheet on thrush and our factsheet on miconazole oral gel and the breastfed baby with oral thrush.

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Pain: if breastfeeding hurts - The Breastfeeding Network

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Pain in your nipples or breasts whilst breastfeeding is most often linked to how you are holding your baby and bringing them to your breast (often referred to as positioning and attachment). Before considering any alternative reasons for experiencing pain whilst breastfeeding please use our guide to positioning and attachment to rule this out as [...]

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Tongue-tie (ankyloglossia) is where the strip of skin connecting the baby's tongue to the bottom of their mouth is shorter than usual.

Some babies who have tongue-tie do not seem to be bothered by it. In others, it can restrict the tongue's movement, making it harder to breastfeed.

Tongue-tie is sometimes diagnosed during a baby's newborn physical examination, but it's not always easy to spot. It may not be obvious until your baby has problems feeding.

See a health visitor, midwife or GP if you're concerned about your baby's feeding and think they may have tongue-tie.

Signs of tongue-tie

To breastfeed successfully, a baby needs to latch on to both the breast tissue and nipple, and their tongue needs to cover the lower gum so the nipple is protected from damage.

Some babies with tongue-tie are not able to open their mouths wide enough to latch on to the breast properly.

If you're breastfeeding your baby and they have tongue-tie they may:

have difficulty attaching to the breast or staying attached for a full feed

feed for a long time, have a short break, then feed again

be unsettled and seem to be hungry all the time

not gain weight as quickly as they should

make a "clicking" sound as they feed - this can also be a sign you need support with the positioning and attachment of your baby at the breast

Tongue-tie can also sometimes cause problems for a breastfeeding mother. Problems can include:

Most breastfeeding problems, however, are not caused by tongue-tie and can be overcome with the right support.

If you're finding breastfeeding difficult, ask a midwife, health visitor or a breastfeeding specialist for help.

Read more about breastfeeding problems and how to overcome them.

Other signs of tongue-tie

Other signs that may indicate your baby has tongue-tie include:

difficulty lifting their tongue up or moving it from side to side

difficulty sticking their tongue out

their tongue looks heart-shaped when they stick it out

Treating tongue-tie

Treatment is not always needed, if your baby has tongue-tie but can feed without any problems. If their feeding is affected, treatment involves a simple procedure called tongue-tie division.

Tongue-tie division

Tongue-tie division involves cutting the short, tight piece of skin connecting the underside of the tongue to the bottom of the mouth.

It's a quick, simple and almost painless procedure that usually improves feeding straight away.

The procedure

Tongue-tie division is done by doctors, nurses or midwives.

In very young babies (those who are only a few months old), it is usually done without anaesthetic (painkilling medicine), or with a local anaesthetic that numbs the tongue.

The procedure does not seem to hurt babies. This is because there are very few nerve endings in the area around the bottom of the mouth. Some babies sleep through the procedure, while others may cry a bit.

A general anaesthetic is usually needed for older babies with teeth, which means they'll be unconscious throughout the procedure.

The baby's head is held securely while sharp, sterile scissors with blunt ends are used to cut the skin.

It only takes a few seconds, and you can start feeding your baby immediately afterwards.

There should not be much bleeding. Your baby may get a white patch (ulcer) under their tongue, but this should heal in 1 to 2 days. It will not bother your baby.

Research suggests most babies who have treatment for tongue-tie find breastfeeding easier afterwards.

The Association of Tongue-tie Practitioners (ATP) can help you find a tongue-tie practitioner.

Older children and adults

Untreated tongue-tie may not cause any problems as a child gets older, and any tightness may resolve naturally as the mouth develops.

However, tongue-tie can sometimes cause problems such as speech difficulties and difficulty eating certain foods.

Speak to a GP if you think you or your child are having problems caused by tongue-tie.

Tongue-tie division can be carried out in older children and adults, although it's usually done under general anaesthetic.

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Tongue-tie (ankyloglossia) is where the strip of skin connecting the baby's tongue to the bottom of their mouth is shorter than usual. Some babies who have tongue-tie do not seem to be bothered by it. In others, it can restrict the tongue's movement, making it harder to breastfeed.

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10 Things You Don't Expect About Nursing Aversion - The Breastfeeding Network

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10 Things You Don't Expect About Nursing Aversion - The Breastfeeding Network

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Zainab Yate explains the often complicated phenomenon of nursing aversion. To hear more, come along to BfN's annual conference on Saturday 2nd October, where Zainab will be giving a talk entitled, "Help! Breastfeeding Makes Me Feel Sad, Mad and Bad." Tickets for this virtual event are available here.
Many mothers and those who support them do not know that they can experience negative emotions associated with breastfeeding. In modern society breastfeeding is often used - problematically - to exemplify myths about motherhood and maternal love, and is bound up with ideas of what makes a 'good mother'. In this context nursing aversion and agitation - intense, distressing feelings that are experienced by the mother during breastfeeding - can be both unexpected and hugely upsetting, particularly when women may have already overcome significant challenges in order to breastfeed. In a new book on the subject, When Breastfeeding Sucks, Zainab Yate examines what we know about this poorly understood aspect of infant feeding. Here she sets out the 10 most common misconceptions...

1. Breastfeeding mothers who experience aversion do not always want to stop breastfeeding!

Breastfeeding or Nursing Aversion (aversion) is when breastfeeding appears to trigger particular negative emotions like anger and agitation, skin-crawling sensations and an overwhelming urge to de-latch. You can also feel like a prisoner when breastfeeding or have thoughts of pushing your nursling off you and running away. Although it creates an emotional burden for mothers, and a strain on their breastfeeding relationship, mothers do not often want to 'just stop breastfeeding'. What most of them desperately want is for aversion to go away.

2. Aversion can strike at any point in any breastfeeding mothers journey.

Whilst many in the infant feeding and mothering world knew that aversion can strike when a mother is breastfeeding while pregnant or when she is feeding an older nursling, it can actually happen at any point in a breastfeeding journey - with some mothers experiencing it at the newborn stage. Even though there is a strong argument that aversion is a natural biological trigger to start the weaning process in older nurslings, if you experience aversion and your nursling is under 12 months old, milk is their main source of nutrition so it is best to seek advice from an infant feeding specialist.

3. One reason for aversion could be oxytocin!

In some mothers, it is possible that they have a negative association to breastfeeding, whether it is due to being a survivor of previous sexual abuse, childhood trauma or simply because the start of their breastfeeding journey was very painful or challenging for many weeks, even months. I argue that these can cause a stress response due to the oxytocin, instead of loving, calming feeling it is well known for when breastfeeding. This is because oxytocin actually plays a role in stress regulation, and can cause fear and stress in negative experiences as it activates a part of the brain that intensifies the memory.

4. Some mothers self-harm in order to continue to breastfeed through aversion if they find breastfeeding painful.

This is known as the gate control method, a scientific theory that asserts the activation of nerves which do not transmit pain signals can stop or interfere with signals from pain fibres. So digging your nails into your thighs or biting down on your hand can inhibit the perception and therefore the sensation of pain in your nipple when breastfeeding. Many mothers in this predicament seem to instinctively do this. This would be a particularly severe level of aversion, as aversion can be experienced on a spectrum. If you feel like this, please seek advice from a health care professional or infant feeding specialist.

5. Aversion is different from Dysphoric Milk Ejection Reflex (D-MER)

D-MER is a medical condition that can be diagnosed in a breastfeeding mother when her letdown causes her to feel negative emotions like despair, despondency and hopelessness. It lasts a few minutes and is dissimilar to aversion as the latter can last throughout a whole feed, whether it is 2 minutes or 2 hours - like the breastfeeding-to-sleep-marathon that can happen at night. Mothers can, however, experience both, and I believe if you struggle with D-MER you are more likely to experience aversion due to the added difficulty you experience when breastfeeding.

6. Misdiagnosis can occur with aversion.

Some mothers have sought help and advice from their doctors about their aversion when breastfeeding, but because some of the symptoms of negative emotions are similar to post-natal depression, and because they have just had a baby, health care professionals had wrongly assumed they must be post-natally depressed. If you are otherwise managing fine in day to day life and your emotions, and your difficulty with breastfeeding is just when your nursling is latched, or if anti-depressants the doctor prescribed you do not help your aversion, return back to your doctor and asked for proper screening, assessment and support.

7. Weaning and stopping breastfeeding can be just as hard as carrying on!

Breastfeeding cessation can be very difficult for mothers with aversion because of compounded guilt and shame that they experience in the aftermath of their negative emotions. Even if breastfeeding mothers who experience aversion do decide to wean, many can be surprised at how difficult it is to wean, both practically (if they have a particularly boob-attached nursling), and emotionally, as mothers have to process the feelings of guilt and shame around the negative emotions, and separate that with the guilt of stopping. Understanding that aversion is actually a reasonable response to an intolerable situation, what can alleviate or lessen aversion, and what the weaning process entails can help you get through it.

8. Mothers with aversion fear they are harming their nurslings

So many mothers I support are concerned about having aversion when breastfeeding - that it will harm their nurslings because of the nature of the emotions - but there is no evidence to show this happens. Whether it is feeling stressed or angry when breastfeeding, or even weaning earlier than you or your nursling want due to severe aversion, there is no evidence to indicate there is any long term harm caused to your nursling due to this. We all know the benefits of breastfeeding both mentally and physically as there is a lot of research about this, but we must understand these facts in the context of the research. These studies and statements are about when breastfeeding is going well. With severe aversion and breastfeeding challenges, it is questionable whether all the benefits of breastfeeding and bonding remain, and we know the research shows that when breastfeeding is hard or painful mothers are actually more at risk of post-natal depression.

9. Aversion can lessen or even go away for some mothers

For mothers who figure out their triggers, make lifestyle changes, improve their sleep hygiene, eating habits or use supplements like magnesium, aversion can abate and for some, it disappears as quickly as it reared its ugly head. There is always something you can try, and accessing our free online structured support course on www.breastfeedingaversion.com, or our peer-to-peer support group 'Aversion Sucks' on Facebook to get tips and tricks from other mothers struggling can instantly help you deal with aversion.

10. You don't get aversion with every nursling.

Sometimes mothers worry that because they experienced aversion with their first nursling they will automatically get it again, but this isn't always the case. As I outline my biopsychosocial theory of the phenomenon of aversion in my book 'When Breastfeeding Sucks', I cover why some physiological, psychological and societal causes can mean you experience aversion. I believe forewarned is forearmed, and the second or third time around as a breastfeeding mother you know more and are more empowered to protect yourself against things that can compromise your physical and mental health and therefore to protect you against aversion.
This blog was originally published on www.breastfeedingaversion.com, and is reproduced here with the permission of the author. Zainab Yate BSc, MSc (Medical Ethics & Law, Imperial College London, UK) is a biomedical ethicist, clinical hypnotherapist, independent researcher and campaigner. Zainab is vice-chair and named qualitative lead of a London Research Ethics Committee, with the Health Research Authority (HRA) and has a background in public health and commissioning with the National Health Service (NHS). She published the first peer-reviewed study looking specifically at breastfeeding/nursing aversion and agitation in 2017 and has published the only book on the topic with specialist publishers Pinter & Martin, London. Zainab has been a breastfeeding peer supporter with the NHS for a number of years and is the owner of the only resource site for mothers and healthcare practitioners on aversion (www.breastfeedingaversion.com), she has helped tens of thousands of women and families when breastfeeding triggers negative emotions - both Dysphoric Milk Ejection Reflex and aversion, through her advocacy, free structured support course and peer-to-peer support groups.
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#BfNConf21 Guest Blog: 10 Things You Don't Expect About Nursing Aversion - The Breastfeeding Network

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Zainab Yate explains the often complicated phenomenon of nursing aversion. To hear more, come along to BfN's annual conference on Saturday 2nd October, where Zainab will be giving a talk entitled, "Help! Breastfeeding Makes Me Feel Sad, Mad and Bad." Tickets for this virtual event are available here.

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The Flange FITS Guide by Babies in Common 2023 Jeanette Mesite Frem IBCLC

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The Flange FITS Guide by Babies in Common 2023 Jeanette Mesite Frem IBCLC

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Every day mothers panic and end breastfeeding or start using formula and there is not an underlying problem with their milk supply.

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The Lived Experience - Breastfeeding a baby with Down syndrome

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The Lived Experience - Breastfeeding a baby with Down syndrome

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The Lived Experience - Breastfeeding a baby with Down syndrome

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Birmingham Women's and Children's NHS Foundation Trust- human milk bank

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Birmingham Women's and Children's NHS Foundation Trust- human milk bank

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Human Milk Bank

Our Human Milk Bank is the only one in the West Midlands, providing donor breast milk to our own neonatal babies, as well as to hospitals around the region and beyond. We offer donor milk to support mothers while they are establishing their own milk supply, or if they are unable to provide their own milk due to geographical separation or maternal illness.

We actively encourage and support our mothers to provide their own breast milk to their sick and premature babies, as research demonstrates a reduction in infection and other problems due to its unique composition and special anti-infective properties. This increases their chances of survival as well as helping their long term development.

Who can donate breast milk?

Mothers who have established breast feeding with their own baby and find they have surplus milk to their baby's requirements. Enrolment as a donor must be before your baby is six months old and you can continue to donate until your baby is 12 months old. On initial contact the milk bank team will ask some general questions about your health and lifestyle, and the health of your baby. There are certain reasons which will exclude you from becoming a donor, such as smoking or taking certain prescribed medicine.

Blood tests are required to ensure infections or viruses will not be passed on via your milk. Although you will have blood tests during pregnancy, milk banks are required to take them again for their own records.

If you would like more information about donating or have any questions, please contact us on 0121 335 8245 or bwc.milk.bank@nhs.net.

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Our Human Milk Bank is the only one in the West Midlands, providing donor breast milk to our own neonatal babies, as well as to hospitals around the region and beyond.

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Nursing Supplementers - La Leche League GB

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Nursing Supplementers - La Leche League GB

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If your baby needs a supplement of expressed breastmilk or formula, a nursing supplementer can help you enjoy the closeness of breastfeeding while your milk production increases.

You can use a supplementer to:

Stimulate breastmilk production while feeding infant formula or expressed mil, without using bottles.

Breastfeed an adopted baby.

Breastfeed as a non-birth parent.

Maintain breastfeeding if your milk production isn't able to meet your baby's needs eg insufficient glandular tissue.

Maintain breastfeeing if your milk production is compromised eg breast surgery or reduction.

Encourage a baby who is reluctant to breastfeed.

Breastfeed a baby who is unable to feed effectively because of sucking or health problems. However this will only work if you baby can feed well enough to obtain milk.

How it works

A nursing supplementer lets a baby get any supplement he needs at the breast without using bottles. The supplementer container holds the milk, which travels through a tube into your baby's mouth while he breastfeeds. As he swallows, he continues sucking, stimulating your milk production.

If you are breastfeeding expressing your milk, and giving top-ups to your baby, you may find it simpler to use a supplementer, which allows all the feeding to happen at the breast.

A good latch-on

It's especially important that your baby latches on deeply at the breast when you are using a supplementer. Get help with positioning and attachment so your baby can get milk from the breast as well as from the supplementer.

Different supplements

Expressed breastmilk Your expressed breastmilk is the first choice for a supplement. If your baby has feeding difficulties, expressing will help you maintain and increase your milk production. To find our more about increasing your supply, see our article How to Increase Your Milk Supply. And for more information on Expressing Your Milk our article can help.

Donor milk Human milk banks provide pasteurized, screened donor milk.

Infant formula Concentrated and ready-to-feed forms of infant formula are less likely to clog nursing supplementer tubing than powdered forms. Although expensive, ready-to-feed formula may also be more convenient when you are out and about or at home without help. Powdered infant formula is not sterile, so always follow the NHS guidelines for preparing it.

Available products

Disposable bag system This uses disposable sterile plastic bags with a top opening and a single tube. Milk only flows when a baby sucks and it is discreet to use as the bags are not bulky or noisy. You can also feed lying down without fear of leaks. When your baby sucks, the flow increases as the flow of milk from your breast decreases. This reinforces proper suckling, making the most of your milk production. (As in photograph above.)

Bottle system This system uses a bottle with a tube for each breast, making switching sides easy or for twins. Each tube can be clamped. Three tube widths are available. Sets can be cleaned and reused. (As seen in the photograph below.)

Homemade system You can make your own supplementer using an ordinary baby bottle, bottle teat and an infant nasogastric feeding tube (size #5 french, 52-75 length). Tubing can be obtained from online suppliers. (As seen in the first and last photos in this article.)

Cut a small hole in the bottle teat so the tube fits tightly. Thread the tube through the teat from the inside and attach the teat normally so the end of the tube sits in the supplement. The tube end is rounded and won't hurt your baby's mouth. Pierce a second hole in the teat, or use a teat with a vent to allow air in so your baby won't need to suck harder as the bottle empties. The bottle needs to stay upright. You may find tucking it into your bra keeps it in place.

How to use a nursing supplementer

Introduce the tube into your baby's mouth along with the breast at the very beginning of a breastfeed by placing it between your baby's upper lip and cupped tongue. If your baby doesn't like the feel of the tube on the roof of his mouth try placing it so it lies along his tongue. Or, slip the tube into the corner of your baby's mouth once he is well-attached at the breast.

You may need to extend the tube past the end of your nipple - experiment to see what works for your baby. The tube can be secured to your breast with medical tape. Taping along the tube is generally more secure than taping across it.

To hold the tube in position some mothers use fabric sticking plasters cut from a long strip. They thread the tube under the non-sticky sections.
The tube can be easily removed while the plasters stay in place, reducing skin irritation from tape removal and providing a guide for positioning each time.

Milk flow - too fast or too slow?

Constant milk flow can cause ineffective feeding as your baby will not need to actively suck to get milk. When using a supplementer you will see the milk travel along the tube to your baby's mouth. Adjust the tube position and container height so your baby gets milk quickly when he starts sucking. Check he isn't overwhelmed with milk, especially if he has heart or breathing difficulties or is premature.

Slow down the flow of milk by lowering the milk container, raising the tubing or using thinner tubing. Or pinch the tube to slow or stop milk flow. If using the bottle system, stop milk flowing by clamping the tube in the slots in the bottle likd. To speed up milk flow, raise the bottle, use wider tubing or use two tubes at the same breast. You may need to adjust the tube in your baby's mouth to create more suction.

Cleaning

To avoid having to throw away tubing when milk had dried inside, force cold water through the tube at least three times straight after use, using the bottle of a 5-10ml syringe. Using warm water may cause fat to cling to the sides of the tube.

For commercial supplementers follow the manufacturers' cleaning instructions. For homemade systems, follow the NHS guidance when cleaning the bottles and teats. Wash the tubing with hot soapy water, rinse with clean water and force air through the tube (or spin the tube fast) to dry. Take extra care if using infant formula. Store the clean supplementer parts in a sealed container in the fridge.

Nasogastic tubes should not be boiled, steamed or chemically sterilised as they are not designed for multiple uses. If your baby is at a higher risk of infection, a commercial system may be a safer option than a homemade system. Replace the nasogastric tube when it starts to stiffen, after about a week.

Eliminating supplements

The use of infant formula is sometimes essential to meet a baby's nutritional needs. You may need to use formula as a stopgap measure, while you work to increase your milk production. Supplementing with formula without protecting your milk supply may reduce the duration of your breastfeeding experience.

Over time, you may be able to reduce the amount of supplement your baby needs as your milk production increases. Expressing in between feeds will signal to your breasts to make more milk and give you some milk for the next feed. For more on Increasing Your Milk Supply, see our article.

Begin the feed with your baby taking milk just from the breast. When he is no longer swallowing regularly start the supplementer. If your baby is reluctant to nurse at all, start the milk flowing at the beginning of a feed to get him started. As your breasts start to make more milk you will notice your baby takes less supplement, especially at certain times of day.

For more information on managing and reducing supplements see My Baby Needs More Milk and Relactation and Induced Lactation.

Seek support

Whether using a supplementer as a temporary or a long-term solution, support from your local LLL Leader and group can be a great help. For individual face-to-face help or a home visit, you could also consult a board certified lactation consultant (IBCLC) or specialist breastfeeding clinic.

Written by Karen Butler, Sue Upstone & mothers of LLLGB. Photos courtesy of Lynn Adams, Rae Vacher Lowe and Alison Widdup.

Further reading
Comfortable Breastfeeding
My Baby Needs More Milk
My Baby Won't Breastfeed
Expressing Your Milk
Hand Expressing Your Breastmilk
How to Increase Your Milk Supply
Using donor milk and formula to support breastfeeding
Nipple Confusion
Relactation and Induced Lactation

Mothers' stories
In praise of at breast supplementers
Breastfeeding with a nursing supplementer

LLLI articles
At breast supplementer nursing

Books
The Womanly Art of Breastfeeding. LLLI. London: Pinter & Martin, 2010.
Exclusively Pumping Breastmilk. Casemore, S. Gray Lion Publishing, 2014
Making More Milk Second Edition. Marasco, L and West, D., NY: McGraw-Hill, 2019.

Other websites
Homemade Supplemental Nursing System
NHS leaflet: Guide to bottle feeding
Increasing milk production

Nursing Supplementers
Please note: LLLGB does not endorse any particular breastfeeding product, aid or device or brand. La Leche League GB supports the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly Resolutions (referred to together as "the Code"). For more information about LLLGB's support of the Code, see here.

Nursing Trainer System: www.lact-aid.com
Supplemental Nursing System: www.medela.co.uk

This information is available in printed form from the LLLGB shop.

Copyright LLLGB 2022.

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Nursing Supplementers - La Leche League GB

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If your baby needs a supplement of expressed breastmilk or formula, a nursing supplementer can help you enjoy the closeness of breastfeeding while your milk production increases. You can use a supplementer to: Stimulate breastmilk production while feeding infant formula or expressed mil, without using bottles. Breastfeed an adopted baby.

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Bottles and other tools - La Leche League GB

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Bottles and other tools - La Leche League GB

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Feeding breastmilk other than at the breast

When the nursing mother and baby are separated or the baby cannot feed at the breast, they may need another way of taking breastmilk.
These tips assume that your baby is being fed expressed breastmilk. If this is not available, please check with your baby's healthcare provider.
When is the best time to introduce a bottle?

La Leche League's manual The Womanly Art of Breastfeeding suggests that unless it's essential, ideally the introduction of a bottle is left until the baby is at least three to four weeks old, and breastfeeding well. Milk supply can adjust to the baby's needs more easily if they are able to breastfeed directly, and the more practice the baby gets at the breast, the more quickly they will become skilled at breastfeeding.

Some people worry that if they don't introduce a bottle early on, the baby won't take one later. While a younger baby is slightly more likely to accept a bottle than an older one, it's not a strong effect. Most babies of all ages will accept a bottle - some with a little coaxing!

If you are thinking ahead to going back to work or study, but you won't be doing this until your baby is older than six months, it may be reassuring to know that your baby probably won't need a bottle by then. They will already be eating other foods and drinking water, and could be offered milk in their usual cup. Healthcare providers recommend that by a year, all babies (even those who have been completely bottle-fed) have stopped using bottles, because of their impact on teeth.
When a baby isn't able to breastfeed at all, or isn't able to take enough milk at the breast, it's important to start expressing milk early and often, to protect your milk supply and keep your baby safely fed. You can find information about this here:
https://laleche.org.uk/hand-expression-of-breastmilk/

Ideas for introducing a bottle to a breastfed baby

If you would like to introduce a bottle, here are some ideas that have worked for other families:

Choose a time when your baby is happy and relaxed, and not too hungry. It's difficult to learn a new skill when you're hungry! It can be helpful at first to think of it as a play activity, rather than a meal.

Have someone else offer the bottle to your baby. A breastfed baby may be least likely to accept a bottle from his mother - they knows where they expect the milk to come from! This doesn't mean that they won't accept an alternative when she isn't available. Even very young babies understand that different people care for them in different ways. Often, the best person to give a bottle to a reluctant baby is an experienced, confident bottle-feeder. Ideally, this will be someone who knows the baby well. Limit the number of people feeding your baby to no more than two or three; feeding is an intimate process, and it's important that your baby feels safe and comfortable, and that the feeder can get to know your baby's preferences.

Hold the baby comfortably, but not lying in the crook of your arm. Babies who are bottle-fed lying on their backs can end up taking too much milk, too quickly. Very young babies (under about six weeks) can be fed lying on their side, on a pillow on your lap, with their feet towards you. Some younger babies, and most older babies feed best sitting up fairly straight, supported behind their neck and shoulders by your arm or hand.

Gently present the bottle teat across the baby's lips , to stimulate their gaping (mouth-opening) reflex and invite them to take the teat into their mouth. You could gently tickle their lips with it, as many mothers do with the breast. If they accept it, give them a good mouthful, so they aren't just sucking on the end of the teat. Most babies do best with a teat that encourages them to open their mouth wide.

Keep the bottle in a horizontal (flat) position, so the baby needs to suck actively to get the milk, as they do at the breast. This is often called "paced bottle feeding." You will need to tip the bottle as it becomes emptier, so that there is milk at the end of the teat, but the whole teat doesn't need to be full of milk all the way through the feed. Most babies do best with a slow-flow "newborn" teat; you might need to try a few different brands and teats to find one with a speed your baby likes (flow rate is not standardised across different brands). It typically takes about 15-20 minutes to finish a bottle - there's no rush. Tilting the bottle to pour milk into the baby's mouth can lead to them taking more milk than they need, faster than they can easily manage. This can cause discomfort, as well as frustration when he returns to the breast and the flow of milk is slower.

Watch for signs that the baby needs a break. When breastfeeding, the baby waits for a few seconds up to a minute before the milk "ejects" in a rush, then gradually slows down, allowing natural pauses. Bottle-feeding can be tiring for the baby, because they have to keep sucking at the same speed throughout the feed. The following signs suggest they might need a rest: a wrinkled forehead (frown); wide, alarmed eyes as they gulp quickly; "starfish hands" (fingers splayed out); turning their head away from the bottle; suddenly going to sleep (not just gently drifting off as they become full and satisfied). If you notice any of these stress signals, or if milk spills from theirmouth, tip the bottle down to stop the flow, or take the bottle away, until she asks for more milk. If she doesn't ask for more, she has had enough for now.

As at the breast, babies may want a feed that comes in two parts. Young babies may want a short nap (often about 10-20 minutes) before taking the second part of their feed. Most adults prefer always to give a bottle using the same hand, but you could even try turning them round to have some more on the "other side"!

Alternatives to bottles

Most breastfed babies in the world never use a bottle, going straight from the breast to drinking from a cup. And a few babies who are offered a bottle simply refuse to take one, whatever their parents and carers try! Bottles are not the only alternative feeding method - there are lots of other options.

Even premature babies can drink from an open cup, with care and practice. Special cups are available, but any clean cup can work; some parents prefer a small one, such as a shot glass.

To cup feed:

Sit your awake baby upright on your lap, supported behind her neck and shoulders by your arm or hand.

Place the rim of the cup on their lower lip and tilt the cup until the milk approaches their lip. Their tongue will explore and find the liquid. Thet will then lap or sip the milk - on the first few attempts, this may take a few minutes. You might want to use a bib or cloth to catch spills, until you've got some experience of feeding this way! Don't pour the milk into your baby's mouth. Keep the level constantly by their lower lip and allow them to rest and pause while drinking, but do not remove the cup.

When they have finished, they will let you know by turning their head away, or by other obvious cues.

To learn how to cup feed, try practising with another adult first - you will quickly work out how far you need to tip the liquid to avoid frustration or spills!

Other feeding methods:

For a tiny baby, other options for offering milk include a dropper, oral syringe or teaspoon.

A baby who can breastfeed but needs extra milk as well could be fed using a nursing supplementer - a gadget that delivers milk via a tube that is taped or held next to your nipple. The baby takes both breast and tube at the same time, and gets milk from the supplementer as he nurses at the breast. Your LLL Leader can help you decide whether this might be a suitable option for you. You can find information about this here: https://laleche.org.uk/nursing-supplementers/

Babies who can sit up may prefer to feed themselves (well supervised) from a regular cup or a "sippy cup" with a lid. If you are also breastfeeding, you may want to avoid models that rely on the baby biting or pressing firmly on a valve to get liquid out.

Your baby may enjoy drinking milk from something he often sees you using, such as your favourite coffee mug - just make sure you wash the coffee out first!

When your baby is fed by one of these methods, be sure to breastfeed often when you are together, to satisfy your baby's sucking need.

How much milk?

Most breastfed babies take about 60-120ml (2-4oz) of breastmilk per feed, from 1-6 months of life. The composition of breastmilk changes as the baby grows, but not the quantity.

This is different from artificial milk, which the manufacturers suggest needs to be given in increasing volume, in line with the baby's weight as he grows. Some experts think that this leads to overfeeding, and may be one of the reasons why babies fed on formula milk are at higher risk of overweight and obesity in later life.

If you are feeding carefully, in a "paced" way (as described above), you can trust your baby to show you how much they want at each feed. It may be a quick drink or a full meal - just like adults, babies don't need all their feeds to be the same size.

Make sure that the alternative caregiver doesn't give your baby a lot of milk shortly before you return, though; you will probably want to feed as soon as you arrive, to reconnect with your baby and relieve your breasts!

Changing feeding patterns when mother and baby are apart

It's common for breastfed babies to refuse a bottle initially when their mother returns to work or study, while they adjust to major changes such as a new daycare environment and caregivers. Adults often feel less hungry when they first start a new job, too! The baby's appetite will come back as they settle into their new rhythm and gets to know theircarers.

Some babies may choose to "reverse cycle," which means refusing a bottle or taking less milk than normal when away from mum, then nursing a lot when they are together. Breastfeeding isn't just about milk, of course; allow your baby to "fill up" on cuddles, as well as milk, as much as possible when you are together. Give yourselves a week or two to adjust to your new pattern. As long as your baby's nappy output and growth are normal, he's getting enough milk.

Babies older than about six months, who are also eating other foods, may choose to manage without milk altogether while you are away, managing fine with food and water until you get back. Babies often surprise their mothers by eating much more when you aren't there than they do at home, especially if other children are also eating!

When other people want to bottle-feed your baby

Often family members sometimes express a desire to bottle-feed a breastfed baby as a way of "bonding" with them. They may be impressed by the powerful connection you are making with your breastfeeding baby, and want the same kind of closeness.

It can be helpful to know that what strengthens attachment is touch (especially skin-to-skin holding) and gaze (looking into each other's eyes) - not the transfer of milk. Fathers, co-parents and other key adults who spend lots of time holding babies skin-to-skin and sharing gaze and smiles with them experience a surge of nurturing hormones, like breastfeeding mothers do. If you want to promote a closer connection between your baby and the other important people in her life, encourage them to wear her in a sling, take a bath with her or just hang out together between breastfeeds, and let nature do its magic!

Even very young breastfeeding babies can have strong, loving relationships with several people at once, including other close adults and siblings. Their mother is usually the centre of the baby's universe, and especially if they are tired, upset or unwell, there will be times when "only mum will do".

Fathers and other close adults can feel frustrated and powerless, and wonder whether life might be easier for them if the baby weren't breastfed. Experienced parents know that these early months and years pass quickly, and the time will come when the baby or young child reaches out to someone else, in preference to their mother! Older babies and toddlers typically go through cycles of intense connection with one favoured parent or carer, then another.

In the meantime, there are many ways a loved one can help you and your baby at the same time.

They can love, listen to and support the breastfeeding parent.

They can change a nappy.

They can bathe the baby.

They can hold and calm the baby when he is not hungry, especially in those evening hours when young babies often need long periods of intensive soothing.

They can "babywear" and spend time skin-to-skin.

They can play with, sing and read to the baby.

They can bring mum a glass of water, snack, phone, TV remote, or anything else she needs when she sits down to nurse.

They can take care of housework, errands and meals.

They can defend mum when others may not support breastfeeding or other parenting choices.

They can be right there next to mum when she breastfeeds in public, helping her feel confident.

They can contact a La Leche League Leader for help!

Bottles are not a necessary part of a close relationship with the baby.

Differences between feeding at the breast and being bottle-fed

Exclusive pumping ("EP"), when a baby is fed completely on his mother's expressed breastmilk, is becoming more popular, for many reasons. Most mothers who express all their milk for their baby have experienced such overwhelming breastfeeding challenges that breastfeeding directly does not feel like an option for them. They invest precious time in milk expression so that their babies can still have the benefits of mother's milk. This is a true "labour of love".

A few mothers may have the option of breastfeeding directly, but wonder whether expressing their milk and feeding by bottle isn't just as good. It may be helpful to know that there are some differences between direct breastfeeding and "breastmilk feeding" by other means.

Your milk has the highest level of antibodies when your baby takes it directly from your breast, and next highest when it is freshly expressed. Your body responds to your baby's saliva - if your baby is exposed to something that he needs antibodies for, this need is communicated to your body as your baby breastfeeds.

The longer milk is stored, the more the active components are deactivated. Your refrigerated or frozen milk still provides excellent nutrition and protection for your baby, just not as good as directly from the breast or freshly expressed.

The activity of breastfeeding helps exercise the baby's facial muscles. This promotes the development of strong jaws and balanced facial structure. Several studies have shown breastfeeding to enhance speech development and speech clarity. Increasing duration of breastfeeding is associated with decreasing risk of later need for braces or other orthodontic treatment. One study showed that young children with a history of suboptimal breastfeeding have a higher prevalence and risk ratio for malocclusions. other studies suggest breastfeeding could reduce childhood stuttering

Breastfeeding directly is also less time consuming - as any EP mother can tell you! There are no pump parts to wash, a skilled breastfeeding baby can remove milk faster than any pump, and the mother doesn't need to spend extra time pumping and then feeding the expressed milk to her baby. When the baby is hungry or needs to be comforted, you simply put your baby to the breast, without needing to prepare the bottle and warm the milk.

The benefits of skin-to-skin contact

Skin-to-skin contact provides a baby with huge benefits. It increases the mother's milk supply by helping her hormones to flow, and helps to "organise" the baby's behaviour so that he learns to feed more easily. Babies who are held skin-to-skin cry less, saving their energy for growing, and have more stable breathing, heart rate, blood sugar, and temperature.

When you are breastfeeding, you have to be in skin-to-skin contact with your baby, even if you don't feel like it! And a baby at the breast is at the perfect distance for gazing at your face, basking in the warmth of your smile. When a baby is fed partly or entirely by bottle (or any means other than the breast), they can still benefit from lots of skin contact, holding and gaze - carers just need to be more intentional about it.

Your baby might enjoy:

Taking a bottle snuggled against your bare breast

Falling asleep with their cheek pillowed on your breast at the end of a feed (some babies may be willing to use the breast to suck themselves peacefully off to sleep after a bottle-feed, even if they get most of their calories by bottle)

Taking a bath with you

Being "worn" in a sling or front carrier near the breast

La Leche League is all about mothering - not just breastfeeding. While we believe that " mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby ", we know that when this isn't an option, or can only be done some of the time, with care and thought, babies can be fed and mothered lovingly and responsively in other ways too. We have supported thousands of mothers to provide breastmilk for their babies by means other than the breast, and to have a wonderfully close, satisfying relationships with their babies. You can too!

La Leche League groups welcome anyone who is pregnant, breastfeeding or providing their own milk for a baby, or trying to do so. Please don't feel awkward about feeding your baby from a bottle or other means during a LLL meeting, or asking questions about it! Breastfeeding mothers understand better than anyone else the challenges of breastfeeding, and the work involved in expressing milk. We would love to meet you and your baby, and support you on your feeding journey.

Originally published by La Leche League International in January 2019 and available at https://www.llli.org/breastfeeding-info/bottles/

You can see a poster about cup feeding here

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Bottles and other tools - La Leche League GB

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Feeding breastmilk other than at the breast When the nursing mother and baby are separated or the baby cannot feed at the breast, they may need another way of taking breastmilk. These tips assume that your baby is being fed expressed breastmilk. If this is not available, please check with your baby's healthcare provider.

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Feeding on demand - Bottle feeding - Start for Life

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Feeding on demand - Bottle feeding - Start for Life

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Responsive feeding

You do not need a feeding schedule. Health professionals recommend "responsive" or "on demand" feeding - this means following your baby's cues and feeding them when they are hungry.

Although most babies gradually settle into a feeding routine, they vary in how often they want to feed. Feed your baby when they show signs that they are hungry.

Babies tend to feed little and often, so they may not finish their bottle. Never force your baby to finish the bottle - always be led by your baby.

Unused infant formula that has been kept at room temperature must be thrown away within 2 hours. Read our guide to making up a feed to find out more.

Signs of hunger

After a while, you will get to know your baby's hunger signs.

Your baby may:

try to find something to suck - usually their hands or fingers

move their eyes around

"root around" or look for the teat of the bottle

start wriggling and getting restless

open and close their mouth

If you can spot these early signs before they start crying for food, your baby will be easier to feed.

If your baby is upset, try soothing them before feeding - a cuddle and some skin-to-skin contact may help.

Babies cry for lots of different reasons. If they have been fed recently then hunger is unlikely to be the cause of their crying.

The NHS website has lots of useful information on how to soothe a crying baby. You can also have a look at our guide on bottle feeding challenges which covers reflux and colic.

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Feeding on demand - Bottle feeding - Start for Life

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Feeding on demand, or responsive feeding is when you feed your baby when they show you they're hungry, rather than a strict schedule.

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© 2023 The Milk Bank at Chester - Registered Charity No. 1050015

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UK Human Milk Bank - Breast Milk Donation, BreastMilk Storage, UKAMB

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UK Human Milk Bank - Breast Milk Donation, BreastMilk Storage, UKAMB

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UKAMB

Welcome to UKAMB

Donated breastmilk from the country's network of milk banks helps to save the lives of premature and sick babies.

UKAMB is a registered charity that supports human milk banking in the UK and was set up in 1997. Our motto is 'Every Drop Counts' and we believe that the provision of safe and screened donor breastmilk makes an important contribution to the care of the premature and sick infants who receive it. Our goal is to ensure access to donor milk to every child who would benefit from its use.

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UK Human Milk Bank - Breast Milk Donation, BreastMilk Storage, UKAMB

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UKAMB, a registered organization supports human milk banking to save the lives of premature and sick babies. Connect with our network today!

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The Office for Product Safety and Standards has issued an Urgent Safety Alert for baby self-feeding pillows and is urging the public to stop using them immediately and dispose of them safely.
Self-feeding pillows/prop feeders present a risk of serious harm or death from choking or aspiration pneumonia.

Talking through your feeding choices with your health visitor and your partner can help you feel more confident that the choices you are making work best for you and your babies. You can also contact Twinline or Twins Trust's breastfeeding peer supporters to help you work through your options.

If your babies are born early, are unwell or are not putting on weight, ask your health professional for guidance on how and when to feed your babies.

Some parents find that developing a routine of some sort works well for them and their babies, while others find they prefer to 'go with the flow' - it's your choice.

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The options for feeding twins, triplets and multiples are the same as feeding singleton babies: breastfeeding, mixed feeding, feeding expressed milk solely or formula (bottle) feeding. We have information on the practicalities of feeding multiple babies.

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