How to breastfeed

​​What to expect during t​he first few days 

It's common for babies to feed infrequently in the first 24 to 48 hours. Your baby may be unsettled in the first few days following birth and won't follow any routine. This is normal but don't be afraid​ to ask for advice from your midwife or doctor if you think something is wrong or are worried.

Your baby may only have 3 to 4 feeds in the first 24 hours. Feeding increases as your baby gets older and by day 3 you should be feeding 8 to 12 times in a 24-hour period.  

If your baby was exposed to certain drugs during birth (pethidine or epidural) they may be sleepy and uninterested in feeding. Effects should only last up to 72 hours. Skin to skin contact helps stimulate babies to feed as well as helping to stimulate your milk supply. Changing your baby's nappy halfway through a breastfeed can also stimulate them to wake.

In the first couple of days, babies will pass Meconium, which is a thick black tar-like substance. Colostrum helps meconium pass quicker due to its laxative effect. See page 18 of the mothers and Others Guide for information on what to expect.

Your hormone levels decline towards the end of the day. This can reduce your milk supply a little, babies respond to this by feeding more often (cluster feeding). Your hormone levels rise again in the night, and you may notice your breasts are fuller first thing in the morning.

Latching on NHS website

Breastfeeding positions NHS website

Colostrum is the perfect first food for your baby's tiny tummy. It is very easy to digest and breaks down in the stomach very quickly. It is highly concentrated, low in fat but high in protein. Colostrum also contains lots of white blood cells which produce antibodies to guard against infection.

Giving your baby colostrum helps to regulate their blood sugar levels. Expressing and storing colostrum is particularly beneficial for babies who are at greater risk of low blood sugars at birth.

Breastfeeding ​in the Neonatal Unit

Your breastmilk is one of the best things you can give to your premature or sick baby. You milk is uniquely tailored to your baby and helps provide protection against infection.

Your colostrum is particularly rich in infection fighting antibodies. Colostrum and breastmilk can give pain relief as well as providing comfort and essential nutrition for your baby.

Skin to skin positive loving touch, kangaroo care, and scent transfer are all ways you can help your baby feel safe and comforted during this time. Expressing frequently and being close to your baby can create strong bonds and increase maternal milk production.

Donor breast milk may be an option for your premature baby while you are trying to increase your milk supply. You can discuss this with the neonatal doctors and nurses to see if your baby would meet the criteria for donor breast milk

Responsive feeding 

A new born baby's stomach is very small, so they need to feed little and often. Your baby can have a good feed and be hungry again soon after.  This is why responsive feeding is important.

The idea is that you respond to your baby's cues such as;

• stirring
• turning their head
• seeking and rooting
  

Breastfeeding is not only about your baby getting enough milk. Your baby feeds for comfort and reassurance too. There is further information on responsive feeding on page 17 of the mother and others guide. 

Skin to skin 

Breastfeeding and lots of skin-to-skin contact, is good for:

• early bonding
• brain development
• oxytocin release
• keeping babies warm
  

It has a calming effect on you both, you can never over cuddle your baby. Your baby may want a breastfeed for comfort, to calm them if they are upset or because they are lonely and need to be with you. You can also offer a breastfeed if your breasts are full. You can't over feed a breastfed baby.

Like us babies sometimes want larger meals and will want both breasts at each feed. ​

Expressing your breastmilk

Hand expressing is a useful skill to learn. Page 21 of the mothers and others guide gives visual step by step information on how to express. Access a hand expressing video from BFI here hand expression video Baby Friendly Initiative (unicef.org.uk)

Storing breastmilk

Expressing and storing your milk on NHS website

Breast pump hire

Breast pump hire is available from Lila Plumley, call +44 (0) 7700706868 for more information. Lila is an independent agent for Ardo Medical Limited. Hire for the first 14 days costs £29.70 for a single pump and £39.60 for a double pump. Each week thereafter is charged at £9.90. ​​

Introducing solids

The World Health Organisation recommend exclusive breastfeeding for the first six months of life. Whether you choose to breastfeed or feed with infant formula should wait until your baby is 6 months old before you introduce any complimentary foods. This reduces the likelihood of allergies and ensures baby's gut is mature enough to digest solid food.

Milk is an important part of baby's diet for the first year. Cow's milk can be used in cooking or mixed with food from 6 months old but should not be given as a drink to babies until they are 12 months old. Pasteurised whole, semi-skimmed, 2.5% fat Jersey cow's milk can be given as a main drink from age 1 year as can goats and sheep milks. Pasteurised skimmed and 1% cow's milk should not be given as a main drink until 5 years of age but can be used in cooking.

Non-dairy alternatives to animal milk such as soya, almond and oat milks can be given if preferred as part of a healthy, balanced diet from the age of one. They should be fortified with calcium and unsweetened.

Follow on milk is unnecessary and expensive.

Individual vegetables and fruits are ideal first foods for your baby to explore. Try to include vegetables that are not so sweet, such as broccoli, cauliflower, and spinach. This will help your baby get used to a range of flavours and prevent them being fussy eaters as they grow older.

Foods to avoid:

• gluten (wheat), dairy and eggs, meat and fish should be avoided before 6 months
• honey should not be given to your baby until they are one year old
• whole nuts should not be given to children under the age of five, but smooth nut spreads are fine
• sugar should be avoided unless from natural sugars (such as from fruits and vegetables)
• salt should not be added to any foods whilst cooking or serving
• children aged 1 to 5 years should not be given rice drinks as they may contain too much arsenic
  

First Steps Nutrition have many recipe suggestions for you to try with your baby. They also offer evidence-based advice on formula milks and dairy free alternatives.

Visit First Steps Nutrition

The NHS start4life weaning hub has many recipe ideas. It also has videos of dietitians and other health care professionals talking through different aspects of your weaning journey.

What is weaning on start4life​