Breastfeeding

All of our health visiting team have received UNICEF Baby Friendly training in order to support parents with feeding and caring for their babies.

Baby feeding support groups are run in collaboration with The Hillingdon Hospital maternity services and Hillingdon Children’s Centres. For more information, please download this flyer.

Breastfeeding support is also available in the Children’s Centres where staff have been trained to help you. Parents are advised to telephone their local Children’s Centre or Health Visitor to ask for help during normal working hours. There is also a specialist referral pathway for more complex feeding issues via the Infant Feeding Coordinator.

The Hillingdon Hospital maternity unit has developed a Breastfeeding Guide which provides simple and clear guidance to get you off to the best start.

Your baby will be happier if you keep them near you and feed them whenever they are hungry. This will remind your body to produce plenty of milk. It is not possible to overfeed a breastfed baby.  Feeds are not just for nutrition, but also for love, comfort and reassurance.

What happens in your baby’s first years has a big effect on how healthy they will be in the future. Mum’s milk gives your baby all the nutrients they need for around the first 6 months of life and it remains important, along with solid food, beyond 6 months.

Breastfeeding delivers many benefits including supporting close and loving relationships, improving maternal mental health and can reduce the risk of postnatal depression. Through these close relationships, breastfeeding helps baby’s brain development and formation of a positive attachment. Breastfeeding also has numerous physical health benefits shown through research to reach far into life for both baby and mother; just a few examples are an increase in IQ, reduction in gastrointestinal infections, childhood cancers, asthma, obesity, the risk of Sudden Infant Death Syndrome (SIDS) as well as a reduction in breast and ovarian cancer for mother. In addition breastfeeding is environmentally friendly and saves your family time and money. To find out more see Unicef's benefits of breastfeeding.

Infant formula is made from cows’ milk and other ingredients. It doesn’t contain the ingredients that help protect your baby from infection and disease - only your body can make those.

It doesn’t matter what type of birth you have, Skin to skin contact and holding your baby against your skin straight after birth, for as long as possible will calm baby, steady their breathing and heart rate and help to keep them the right temperature. It will also begin the important bonding and milk production just by this simple act! This is a great time to start your first breastfeed because your baby will be alert and will show signs they want to feed in the first hour after birth. Your midwife can help you with this.

Unicef's Baby Friendly video - Meeting baby for the first time:

Carry on with skin-to-skin (baby can wear a nappy) when you get home to help you and your baby to feel calm and help you tuning-in to your baby's cues.

Breastfeeding is a skill that you and your baby learn together, and it can take time to get used to.

There are lots of different positions you can use to breastfeed. You can try different ones to find out what works best for you. You just need to check the following points:

  • Are you comfortable? It's worth getting comfortable before a feed. Use pillows or cushions if necessary. Your shoulders and arms should be relaxed.
  • Are your baby's head and body in a straight line? It's hard for your baby to swallow if their head and neck are twisted.
  • Are you holding your baby close to you, facing your breast? Supporting their neck, shoulders and back should allow them to tilt their head back and swallow easily.
  • Always bring your baby to the breast and let them latch themselves. Avoid leaning your breast forward into your baby's mouth, as this can lead to poor attachment.
  • Your baby needs to get a big mouthful of breast. Placing your baby with their nose level with your nipple will encourage them to open their mouth wide and attach to the breast well.
  • Try not to hold the back of your baby's head, so that they can tip their head back. This way your nipple goes past the hard roof of their mouth and ends up at the back of their mouth against the soft palate.

Take a look at Unicef's Baby Friendly video - Positioning and attachment:

Good positioning and attachment really are the key to successful breastfeeding!

See Start4Life's 4 common breastfeeding positions and natural breastfeeding video to see positions that can help get your baby off to the best start.

Responsive breastfeeding means feeding is not timed and is not just for nutrition, but also for love, comfort and reassurance between both baby and mother. If you need to, feed your baby for whatever reason; for example, if you would like to reconnect with your baby or them with you, if your breasts are full or you need to pop out and you would not be able to feed whilst you are out.

Your baby needs you to respond to their feeding cues. Waiting until they cry for food will make it more difficult to breastfeed them.

Feeding cues may include

  • Hands to mouth
  • Turning head
  • Licking lips
  • Mouthing
  • Squeaking noises
  • Light fussing
  • Rooting (moving mouth and head as if looking for a feed)

For successful breastfeeding, you need to feed your baby whenever they ask, and for as long as they want at each feed. In the first few weeks you will get to know your baby and settle into a feeding pattern.

  • Your baby starts feeds with a few rapid sucks followed by long, rhythmic sucks and swallows with occasional pauses. 
  • You can hear and see your baby swallowing. 
  • Your baby's cheeks stay rounded, not hollow, during sucking. 
  • They seem calm and relaxed during feeds. 
  • Your baby comes off the breast on their own at the end of feeds. 
  • Your baby appears content and satisfied after most feeds. 
  • Your breasts feel softer after feeds. 
  • Your nipple looks more or less the same after feeds – not flattened, pinched or white. 

You can use this checklist by Unicef. If you are unsure or have worries please get in touch with your midwife or health visitor.

There are various reasons why you may want to express milk. If you do not need to express your milk straight away, it's best to wait until you and your baby feel happy and confident with breastfeeding before you start expressing milk regularly.

Expressing after breastfeeds whether by hand or by pump can help to increase your milk supply. Express until the flow stops and aim to do this at least 8-10 times in 24 hrs and at least once in the night. 

Please note that the amount of milk expressed is not a measure of your milk supply, your baby will normally more effective at removing milk than a pump

How to Hand Express

  1. Stimulate oxytocin by massaging your breasts (make sure your hands are warm). Start off with long strokes from your armpit, working towards your nipple and rolling the nipple between your fingers. 
  2. Create a “C” shape with thumb and first or middle finger, place them opposite each other approximately 2-3cm from the base of the nipple. Your finger and thumb should be opposite each other – if you imagine that your breast is a clock, your thumb would be at 12 o'clock and your finger at 6 o'clock
  3. Compress and release in a steady rhythm without sliding fingers along the skin. 
  4. Adjust fingers forward or back a little if nothing comes. 
  5. Milk may take a few minutes to flow. 
  6. When you notice your milk flow slowing down, move your hands around your breast so you are expressing from a different area (position your finger and thumb at 11 o'clock and 5 o'clock) and repeat the process.
  7. Once you've expressed as much as you can from one breast, repeat the process on your other breast

A hospital grade double electric breast pump may be also be necessary and will be more effective than a hand pump or a mini electric pump. This will also reduce time spent pumping and double pumping (both breasts together) has been shown to increase milk yield. Pumps can be hired at Ardo Breastpumps and Medela Breastpumps

Find more information on maximising your milk supply at Unicef and Global Health Media

If top ups are being given consider paced bottle feeding as slowing the flow may reduce confusion at the breast.

Breast milk can be stored in a sterilised container, or special storage bags – remember to label and date it.

Store it in small quantities to avoid wasting any. Your breast milk can then be kept:

  • at the back of the fridge, not the door, for up to 8 days (at 4C or lower)
  • in the ice compartment of the fridge for up to 2 weeks
  • in the freezer for up to 6 months (at -18C or lower)

The best way to defrost frozen breast milk is by leaving it in the fridge to thaw out completely. But if you need it straightaway, you can defrost it by placing the bag or container in a jug of warm water, or by holding it under running warm water.

Whichever way you defrost the milk, it must be used immediately (never re-freeze it).

Most babies go through several growth spurts (also called frequency days or wonder weeks) during the first 12 months. Many find that the most noticeable sign of a growth spurt is their baby feeding more. It’s important to be aware of these so you understand and don’t doubt yourself (or your milk supply) when you experience them.

What is a growth spurt?

During a growth spurt, breastfed babies feed much more often than they may have been (sometimes as often as every hour or what feels like constant feeding) and often act fussier or grumpier than usual. You may feel like baby is suddenly “attached” to you, is really grumpy, not sleeping as well and hard to settle or you suddenly feel like you don’t have enough milk.

Baby is actually working to increase the amount of milk (because of their own growth) and the content of the milk also changes! Just as babies grow and change, so does our breastmilk to adapt to them- another huge benefit of breastfeeding as formula can not do this!

Physical growth is not the only reason that babies may have a temporary need for increased breastfeeding. Babies often exhibit the same type of behaviour (increased breastfeeding with or without increased fussiness) when they are working on developmental advances such as rolling over, crawling, walking or talking. Mom’s milk is for growing the brain as well as the body!

When do babies have growth spurts?

Common times for growth spurts are 2-5 days old and around 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months and 9 months (more or less). Babies don’t read calendars, however, so your baby may do things differently.

How long do growth spurts last?

Growth spurts usually last 3-5 days, but sometimes last a week or so.

What is the best way to handle a growth spurt?

Follow your child’s lead. Baby will automatically get more milk by breastfeeding more frequently, and your milk supply will increase due to the increased breastfeeding.

It is not necessary (or advised) to supplement your baby with formula or expressed milk during a growth spurt. Supplementing (and/or scheduling feeds) interferes with the natural supply and demand of milk production and will prevent your body from getting the message to make more milk and change the content during the growth spurt.

Some breastfeeding mums feel more hungry or thirsty when baby is going through a growth spurt. Listen to your body — you may need to eat or drink more during the time that baby is nursing more often.

You will find that some places have the blue picture of a mother feeding her baby in the window and this means that this establishment welcomes breastfeeding mothers but this is not an exclusive scheme. By law, the only places you can be refused access to breastfeed are places where there is a risk to the health and safety to you or your baby. 

During your baby's first few days, you may prefer to breastfeed only where you feel most comfortable. But, as you get more used to doing it, you're likely to feel more confident about breastfeeding in front of other people when you're out and about.

Here are some ideas to help you get started.

  • Know your rights. You should not ever be made to feel uncomfortable about breastfeeding in public. It is illegal for anyone to ask a breastfeeding woman to leave a public place, such as a cafe, shop or public transport.
  • Plan ahead. Before you go out, it can help to think about where you will feel comfortable breastfeeding when your baby gets hungry. Ask breastfeeding friends for recommendations.
  • A midwife, health visitor or peer supporters at a local breastfeeding drop-in will also know of good places in your area where you can feed your baby.
  • Clothes and bra. What you wear when you're breastfeeding is a matter of personal taste and what you feel comfortable in. For example, some mums like to wear loose tops that can be lifted up.
  • Others, who prefer to keep their tummy covered, wear two stretchy tops, so that the top layer can be lifted up and the bottom layer can be pulled down. A soft, non-underwired bra can be easily pulled up or down when you want to feed your baby.
  • Baby slings, scarves and cloths. Some baby slings are designed so you can breastfeed while your baby is in the sling. Some mums feel more comfortable putting a scarf or muslin cloth over their chest while they're breastfeeding.
  • Take someone with you. It can help to go with a friend who has an older baby and can take you to places that she already knows. You could go with someone else, such as your mum, partner, sister or friend, so that there's always someone to talk to.
  • Avoid the loos. Do not feel that you should sit in a public toilet to breastfeed. You would not eat in there, so do not feel that your baby should be fed there.

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

Breastfeeding exclusively (giving your baby no other food or drink) is recommended for around the first 6 months. After this time, breastfeeding is recommended alongside solid food.

Therefore, it's likely that you'll be breastfeeding when you return to work, training or education.

There are several options. You can:

  • arrange for childcare close to work or college so that you can breastfeed during breaks, or before and after work – the evening feed can be a wonderful way for you to relax with your baby
  • express breast milk (taking milk from the breast by hand or using a pump) so that someone else can feed your baby while you're at work
  • ask your employer or college for flexible working hours arranged around your breastfeeding needs
  • combine breastfeeding and bottle feeding to fit around your hours

Think about it early. Before you go back to work or college, tell your employer or tutor you’re breastfeeding.

You may have an HR department that can help. It can make preparations, such as finding you a private room where you can breastfeed or express your milk.

Organising breastfeeding and work

Before returning to work you can:

  • label and date expressed breast milk before putting it in the fridge or freezer so your childminder knows which one to use first
  • have a trial run with childcare before returning to work
  • store breast milk in a sterilised container or in special breast milk storage bags in the fridge for up to 8 days at 4C or lower (you can buy fridge thermometers online) – if you're not sure of the temperature of your fridge, or it’s higher than 4C, use it within 3 days

What the law says about breastfeeding mothers at work

It's up to mothers to decide how long they want to breastfeed. Returning to work doesn't mean a mother has to stop. Before returning to work, she should give her employer written notification that she's breastfeeding. Her employer must then conduct a specific risk assessment.

Workplace regulations require employers to provide suitable facilities where pregnant and breastfeeding mothers can rest.

The Health and Safety Executive (HSE) recommends that it's good practice for employers to provide a private, healthy and safe environment for breastfeeding mothers to express and store milk. The toilets are not a suitable place to express breast milk.

The HSE has more advice about protecting new and expectant mothers at work.

For more help on making breastfeeding at work as easy as possible check out the start for life pages

If you're pregnant or breastfeeding, you do not need to avoid foods that can trigger allergic reactions (including peanuts), unless you're allergic to them.

Speak to your GP or health visitor if your baby is showing signs of allergy, but some symptoms are more worrying than others.

Seek immediate medical help if your baby has signs of an anaphylactic reaction: sudden onset of breathing difficulties, swelling, or collapse, with or without a rash, after physical contact or eating a particular food.

You do not need to stop breastfeeding if your baby is allergic to something in your milk.  Removing the allergen from your diet will remove it from your breast milk so you can continue breastfeeding if you wish to.

Babies that are exclusively breastfed DO NOT need water from a bottle.

They may need more regular feeds from the breast - these may be shorter and more frequent. Make sure you offer a little more often. Keeping an eye on wet nappies will help you know that your baby is staying hydrated.

Babies need to be in the shade, only lightly dressed and kept cool.

Babies only need breastmilk for the first 6 months of life. For more information about why, signs that they are ready and so on please see our first solid foods page and talk to your Health Visitor.

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