Breastfeeding is a natural process and a skill mum and baby learn together usually within 6 weeks. A positive and supportive partner can create a good environment both for emotional support and managing difficulties to ensure a good experience, whilst mum and baby can benefit from health impacts.

Ways to support mum.

1. Listen, talk and encourage mum with her decisions about breastfeeding, how you both feel and when to end breastfeeding.

2. Help with the daily chores, ensuring mum is eating and drinking well and has a relaxed environment.

3. If she is struggling help her to access specialist help from midwives, breastfeeding counsellor or lactation specialist.

4. Remember to reassure and build her confidence.

Ways to bond with baby.

1. General care of baby including changing nappies, winding and bath time with skin to skin after. These all encourage bonding time with baby.

2. Taking time in the day to carry baby in a sling, talking, singing, reading (baby will recognize your voice) and take time as a family on small days out.

For further support please see the links below.

• A-dads-guide-to-breastfeeding.pdf (jpaget.nhs.uk)

• Partner's guide to breastfeeding :: Healthier Together (cymru.nhs.uk)

• https://youtu.be/UmvY7t6RRUo UNICEF UK Baby Friendly Initiative Video.

(Abbett, 2020)

When breastfeeding, it is recommended that you have no more than 200mg of caffeine a day as too much may cause your baby to be restless and keep them awake (NHS England, 2023).

This may be 1 mug, can or bar of – instant coffee, filter coffee, tea, coca cola, energy drink, plain dark or milk chocolate (NHS England, 2023).

During the beginning of pregnancy you may notice slight changes in your breasts such as tenderness and darkening to your nipples and areola, these changes support milk making.

Your milk is made and stored in the alveoli which are contained in lobules, during feeding milk is released and passed through the milk ducts to baby.

For a more in-depth and detailed understanding.

https://youtu.be/bYBil33k27I?si=xz0jUKB8a_SIsDKv

(Dunstall, et al., 2020), (Johnson & Taylor, 2023)

This is a natural process, however when baby latches on incorrectly this can lead to ineffective feeding which could cause weight loss in baby and is painful for mum causing sore and cracked nipples.

Whilst feeding baby effectively, mum should make themselves comfortable with snacks, drinks and any other useful items within reach - as you could possibly be there for a short while.

For successful attachment baby's head, neck and body should be lined up and baby needs to be able to flex their head. Then nose to nipple and as the baby opens their mouth their lip will brush the nipples encouraging baby to accept the nipple and start feeding.

During effective feeding the nipple should be towards the soft pallet with most of the areola inside the mouth . As baby starts suckling this stimulates the release of milk.

(Abbett, 2020)

See please the links below for different positions.

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

Breastfeeding positions - Start for Life - NHS (www.nhs.uk)

Positioning & Attachment - La Leche League GB

Guide & Tips on Breastfeeding Positions | Tommee Tippee UK

Best Breastfeeding Positions - Photo & Video Guide I Emma's Diary (emmasdiary.co.uk)

Breastmilk provides all of the energy and nutrients that an infant needs for the first months of life and continues to provide up to half or more of a child’s nutritional needs during the second half of the year and up to a third during the second year of life.

It has been shown that breastfed children perform better on intelligence tests, are less likely to become overweight or obese and are less prone to developing diabetes later on in life. It also has health benefits for the woman, such as a reduced risk of breast and ovarian cancers.

(World Health Organization, 2019)

Between day 3-5 your milk will change from colostrum to mature milk and your breasts will feel fuller and warmer, this is known as your milk coming in.

Mature milk is greater in volume and in liquid and changes during the feed to satisfy both hunger and thirst. The initial milk is known as foremilk which is watery and less in fat content. This gradually increases as the feed continues and the milk produced is now known as hindmilk containing two to three times more milk fat concentrate.

Prior to birth, around 36 weeks, you can start harvesting colostrum and storing in it the freezer for when baby arrives. Please ask your midwife for details and syringes at your antenatal appointments.

Breastmilk is used to treat a range of conditions like skin,

eye and nipple problems. Due to its natural antibodies and antibacterial properties it can have a therapeutic effect. Blocked eye ducts are common after birth and evidence has shown a couple of drops of human breast milk into each eye is effective (Witkowska-Zimny, et al., 2019).

Colostrum harvesting before birth.

Colostrum harvesting - Kingston Hospital

(Dunstall, et al., 2020), (Johnson & Taylor, 2023)

Employers have certain legal obligations to all breastfeeding mothers.

-They must provide you with a suitable and hygienic area where you can rest at work.

-Legally workplaces do not need to provide facilities to express and store breast milk, however, some workplaces have policies in place to facilitate this. You should not be expected to express breast milk in a bathroom, if you have concerns regarding your ability to breastfeed or express at work speak to your employer, occupational health department or human resources department as they may be able to support you. You can also seek support from your union.

An individual risk assessment should be carried out by your employer on your return to work.

It is important to make your employer aware in writing that you will be breastfeeding on your return to work, usually within 8 weeks prior to your planned return to work. This can help to facilitate the process above.

Further guidance can be found from the above link and by speaking to your midwife.

(Health and Safety Executive; Royal College of Midwives, 2024).

It is suggested 1 in 10 babies may be born with a tongue tie (Association of tongue tie practitioners, 2023). Nearly all babies have a piece of this skin under their tongue which does not usually cause any problems. However, tongue tie is when this piece of skin is abnormally short which can then cause problems with feeding due to the inability to move the tongue normally and therefore stop their ability to latch and suck effectively (UNICEF, 2023).

Sometimes babies who have a tongue tie have no problems at all with feeding. However, if the tongue tie is causing problems, it can be treated with tongue tie division, which involves cutting the short, tight piece of skin causing the tongue tie.

This must be done by a trained healthcare professional. However, not every case of tongue tie needs treatment and assessment by a trained health professional and someone trained in infant feeding is vital. (Breastfeeding Network, 2023).

Mothers living with HIV should breastfeed for at least 12 months and may continue breastfeeding for up to 24 months or longer, which is very similar to general breastfeeding advice, while being fully supported for taking antiretroviral medicines (WHO, 2023).

If you're taking HIV medication and you become pregnant, do not stop taking your medication without first speaking to your GP. Certain HIV medications can harm unborn babies and additional medicines may be needed to prevent your baby from getting HIV so your plan may need to be reviewed (NHS England, 2023).

Symptoms of mastitis usually come on quickly and tends to only affect 1 breast. Symptoms are - 

• A swollen, hot and painful to touch area on your breast 

• A wedge shaped lump on your breast 

• A burning pain that may be constant or only when you are breastfeeding 

• Discharge from the nipple that is white or contains streaks of blood 

• Flu like symptoms such as a high temperature, chills, aches and feeling tired 

  
  

Top tips to ease symptoms of mastitis -

• Continue to breastfeed your baby as normal

• Ensure baby is positioned and attached properly

• Use a cloth/flannel soaked in warm water and apply it to the breast to try and improve milk flow. A shower or bath can also help

• A cold compress can help to soothe any breast pain

• Rest and drink plenty of fluids

• Paracetamol and ibuprofen are both okay to take for pain or a high temperature (NHS England, 2023).

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NICE guidance (2017) recommends the supplement of vitamin D for infants and children under 4, pregnant and breastfeeding women, especially teenagers and young women.

Vitamin D during pregnancy corrects any deficiency and increases baby stores and during breastfeeding maintains and replenishes stores. Breastmilk is not lacking in comparison to formula, but is dependent on mothers levels of vitamin D and of that, that passes to baby.

Vitamin D is available from sunlight, food sources and supplements. Food sources include oily fish (salmon, tuna, mackerel), egg yolk, margarine, mushrooms and fortified breakfast cereals. Midwives if eligible can provide healthy start vitamins during antenatal appointments and health visitors can provide healthy start vitamin drops for newborns which include vitamin D.

(Abbett, 2020) (NICE, 2017)

During pregnancy, the hormones estrogen and progesterone are increased and they prevent the body producing breastmilk. Once baby is born and placenta is expelled these hormones start to decline and milk production commences.

Once your nipples and areola are stimulated by the suckling of baby this sends messages to your hypothalamus, which in return releases the hormones prolactin from the anterior pituitary gland and oxytocin from the posterior pituitary gland, working together in the production of milk and ejection milk from the breast.

Prolactin - Initiates and sustains lactation.

Oxytocin - Milk ejection where milk is pushed from the alveoli to the nipple by the myoepithelial cell contracting. Often referred to as the 'Love Hormone' which is important during labour and bonding.

Effective removal of milk decreases the feedback inhibitor of lactation (FIL) and decreases milk production. FIL is a protein which recognises the supply and demand of milk.

(Dunstall, et al., 2020), (Johnson & Taylor, 2023)

www.nct.org.uk

www.laleche.org.uk

www.abm.me.uk

www.tonguetie.net

www.tongue-tie.org.uk

www.babywearing.co.uk

www.babyfriendly.org.uk

www.thebabycafe.co.uk

www.lcgb.org

www.kellymom.com

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

-"How do I know if my baby is full?": UNICEF recommends women to provide responsive breastfeeding, this involves identifying cues that your baby shows you to know when they are hungry. Ways to check that your baby is feeding well is to monitor how alert they are, they may be more sleepy after a feed as they are full and satisfied. Keep an eye on your baby's nappies, for the first 2 days your baby may only have 2 or 3 wet nappies, this should increase to around 5 to 6 wet nappies by day 5. Your midwife and health visitor will monitor your baby's weight and this can indicate how well they are feeding. If you have any concerns with your baby and breastfeeding, contact your midwife for further support.

The following link provides a checklist that you can follow to monitor your breastfeeding and provide reassurance: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2016/10/mothers_breastfeeding_checklist.pdf

-Painful breasts and nipples: this can occur due to incorrect attachment, ensuring your baby has latched onto your breast rather than just your nipple can ease these discomforts, nipple balms and alternating breasts at each feed can help with this.

-"Only I can feed my baby": breastfeeding means that as a mother, you are the provider of your baby's nutrition and women sometimes wish that they could have support with this. Your partner, family or friends may not be able to feed your baby but they can be encouraged to help out in other ways: providing practical care to the baby outside of feeding (changing nappies, dressing baby and comforting the baby), keeping you fed and hydrated during breastfeeding, providing support through talking and listening and by providing help with your comfort so that you can learn new things together.

Further support from dads and partners can be found under the 'wellbeing' tab.

-Breastfeeding barriers and its toll on mental health: women may feel frustrated, lack confidence or feel that they cannot breastfeed their baby which increases their stress and may impact their mental health negatively. It is important to know that it is normal to seek breastfeeding support and that this can benefit both you and your baby. Effective breastfeeding can be rewarding and can reduce the risk of postnatal depression, it is important that women receive the support that they need to gain a positive experience in their breastfeeding journey.

Links for breastfeeding support can be found in the 'wellbeing' and 'further information' tabs.

Medela 0161 776 0400

Hire a Symphony Double Breast Pump | Hospital Grade - Medela Breast Pumps (medela-rental.co.uk)

Ardo Medical Ltd 01823 336 362

Rent a Breast Pump (ardomedical.co.uk)

-Nursing pillows can be purchased online or in a mother and baby store, these can make breastfeeding more comfortable for both you and your baby by providing support.

-Breastfeeding clothes/nursing bras are designed to allow for easier access while breastfeeding, allowing you to feed your baby without having to remove your shirt or bra when feeding your baby.

-Nipple balm can help to soothe dry and cracked nipples, these can be purchased at most pharmacies and supermarkets.

-Nursing pads are worn to absorb any milk that may leak from your breasts, keeping you dry and comfortable. These can be purchased at most pharmacies and supermarkets.

-A nursing cover is a great item for you if you want to breastfeed in public, it is not a requirement to use this in public but it may make you feel more comfortable.

-Plenty of water, snacks and entertainment, while you are breastfeeding it is important to keep yourself hydrated and eat well, you could benefit from keeping a water bottle and snacks close by when you are breastfeeding so that you can take care of yourself whilst you feed your baby. You may benefit from reading a book or watching television whilst feeding your baby.

Further information and recommendations can be found at: https://www.emmasdiary.co.uk/baby-products/breastfeeding-essentials-for-you-and-baby

A contraindication in breastfeeding is where a health condition will compromise the health of a newborn via breastmilk. If you are unable to breastfeed your baby with your own supply, you could consider donor milk.

Contraindications include:

• Maternal Illness - Cancer, chemotherapy, radiation.

• Maternal Drug Consumption

• Congenital Abnormalities - Cleft palate,

• TB Infection

(Dunstall, et al., 2020)

Breastfeeding in public may be a natural worry for many people as they may not know that legally, they can do this or they may feel uncomfortable doing so.

Laws and acts are in place to protect you from discrimination and unfair treatment when breastfeeding.

Nursing covers can be a great item that provides comfort and coverage whilst breastfeeding in public.

(The breastfeeding network, 2024).

Babies should have 8-12 feeds in 24 hours to thrive and be woken if they show no feeding cues within 3 hours. When offered the breast they should be interested, alert, attached well and sustain feeding.

Your midwife will complete feeding assessments during your postnatal visits to ensure baby is gaining weight, passing urine and having bowel movements including what colour. Babies can have a normal weight loss of up to 10% in the first few days after birth and this is usually regained by day 14.

If required to help achieve weight gain your midwife may implement a feeding plan, visit more often and might suggest top-up feeds once baby has finished on the breast. This can be expressed breast milk or formula - preference is yours and they will advise you how much to offer.

A good feed ensures baby has had both foremilk and hindmilk and been offered both breasts. If baby fails to gain weight they will be admitted for further investigation by a Paediatrician.

A good indication baby is feeding well is their dirty nappies. By day 6 you would expect 6 wet nappies and and by day 14 a minimum of two bowel movements in 24 hours.

Remember if there is a delay or pause in breastfeeding and you wish to continue please express both day and night.

Guidance on feeding cues.

NHS Tayside (scot.nhs.uk)

Guidance on how to prepare a formula feed.

https://youtu.be/7l9a5a2IY8Y - How do I prepare a bottle of formula milk for my baby? NCT

safe-prep-cup-feeding-leaflet.pdf (ennonline.net)

How to make up baby formula - NHS (www.nhs.uk)

(Local NHS Trust, 2021) (NICE, 2023) (UNICEF & WHO, 2018)

• Arabic

• Bengali

• Hindi

• Lithuanian

• Mandarin

• Polish

• Romanian

• Slovak

• Turkish

• Ukrainian

• Urdu

Foreign language resources - Baby Friendly Initiative (unicef.org.uk)

Contact Numbers for different languages.

• NCT’s support line: 0300 330 0700 is open every day, 8am to midnight, including bank holidays. 

• Association of Breastfeeding Mothers Breastfeeding helpline: 0300 330 5453 is open 9.30am to 10.30pm. 

• Breastfeeding Network supporter line: 0300 100 0210. 

• Breastfeeding Network Supporter line in Bengali/Sylheti: 0300 456 2421 is open 9.30am to 9.30pm, 7 days a week.

• La Leche League: 0345 120 2918. 

• National Breastfeeding Helpline: 0300 100 0212 is open 9.30am to 9.30pm, daily. 

• National Breastfeeding Helpline in Welsh and Polish: 0300 100 0212 and press 1 for Welsh and 2 for Polish.

This is because their immune system is undeveloped and could lead to illnesses like vomiting and diarrhoea caused from bacteria if the equipment is not clean.

For guidance on what method and how to ensure your equipment is clean, please follow the NCT link.

Here is the NHS Guidance - Sterilising baby bottles - NHS (www.nhs.uk)

Amy and Lucy
Parents of 1-year-old

To keep health risks from alcohol to a low level, it's safest not to drink more than 14 units a week on a regular basis. 

Fourteen units is equivalent to 6 pints of average-strength beer.

(NHS England, 2023).

For more information please see the link above.

Milk banks in the UK.

Find A Milk Bank - Milk Bank Near You, Nationwide Breast Milk (ukamb.org)

Your baby may have difficulty latching if there is a reduction in soft tissue surrounding your nipple.

If you use a binder, or wrap your chest, you may be at a higher risk of experiencing mastitis, mastitis is further explained under the "Health" tab.

Support is available for you, please speak to your midwife or general practitioner if you wish to chestfeed, as they can guide you to help your baby to latch.

It is also important to speak to your midwife or GP if you plan to take testosterone while chestfeeding.

Further support is available by contacting your midwife or by visiting:

https://laleche.org.uk/support-transgender-non-binary-parents/ - support for transgender & non-binary parents.

Responsive feeding provides satisfaction for your baby and for you. It provides your baby not only with nutrition but gives comfort and reassurance.

Your baby cannot overfeed when breastfeeding and at times your baby may only latch for comfort.

Recognising feeding cues can become easier as time goes on, these cues include:

-Stirring and wriggling

-Rooting or turning their head to the side

-Baby's hand in their mouth

-Crying

-Agitation

The following link provides additional information on feeding your baby. It also has an image indicating visual feeding cues: https://www.nct.org.uk/baby-toddler/feeding/early-days/reality-feeding-10-things-you-need-know

Most medications are safe to take whilst breastfeeding but it is important to speak with your midwife or GP about your prescribed medication and notify them that you plan to breastfeed so that your medication can be reviewed.

Medications to avoid include:

-Codeine phosphate

-Decongestant medications including nasal sprays

-Aspirin

-Herbal remedies

NHS (2022) also recommends speaking to your GP if you are taking antihistamines for allergies.

About Us – New Baby Network

Sutton Coldfield | Local activities & meet-ups | NCT

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Virtual Breastfeeding Lounge – Birmingham Forward Steps (bhamforwardsteps.co.uk) - Virtual and available in other Languages on Fridays.

Additional links

Bigger Breastfeeding – Behind the Statistics - Big Birthas

Guide to Plus Size Breastfeeding [+6 Things You Need] (plussizebirth.com)

Their goal is to educate and empower not only new and expected mums but the supporting health care professionals in the community.

Additional resources

Breastfeeding and Down Syndrome: Information for Families & Breastfeeding Supporters - The Breastfeeding Network

Breastfeeding My Baby with Down Syndrome - La Leche League GB

Additional resource

Breastfeeding (autism.org.uk)

Breastfeeding and Autism - La Leche League GB

Their aim is 'No one affected by cleft lip and palate in the United Kingdom will go through their journey alone'.

Other resources

Breastfeeding with Cleft Lip or Palate - ABM

Breastfeeding a baby with cleft lip and palate - La Leche League GB

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Breastfeeding | Bliss