Breastfeeding further information

In the first few days, you and your baby will be getting to know each other. It may take time for both of you to get the hang of breastfeeding. 

It is good to find out as much as you can about breastfeeding before the birth.  Knowing what to expect should help you feel as confident as possible when you've just given birth and want to breastfeed your baby. 

Every pregnant woman makes milk for her baby, which is ready and available at birth. This milk is called colostrum and is sometimes a yellow colour. It is very concentrated, so your baby will only need a small amount at each feed (approximately a teaspoonful).

Your baby may want to feed quite frequently, perhaps every hour. But they will begin to have longer feeds less often when your milk comes in, in a few days. The more you breastfeed the more milk you will produce. The time between feeds will vary, and you and your baby will settle into a pattern, which may change from time to time.

Having skin-to-skin contact with your baby straight after the birth will help to keep your body warm, calm your baby, and help with the first breastfeed. 

All babies are different. You will soon learn to recognise the signs of hunger in your baby. If you can spot these before he is crying for food it will be easier to feed him.  Your baby should feed within the first 2 hours after birth to get off to a good start.  Babies then sometimes have a sleep and will start to give you signs that they are ready for the next feed. These signs include:

• starting to move about as they wake up
• moving their head and mouth around
• finding something to suck, usually their fingers

A newborn baby's stomach is only the size of a walnut, therefore they will need to feed 'little and often'. This is why baby-led feeding, or 'on-demand feeding' is so important. Your baby can have a good feed and be hungry again quite quickly. Babies go through patterns of feeding more and less as they grow. Letting them feed when they need to will ensure that they're content and getting the milk they need, when they need it. 

Every baby is different. Some babies want frequent short feeds, and others prefer feeding for longer. Let your baby finish the first breast, then offer the second. If your baby feeds all the time and you are worried, contact your midwife, health visitor or breast feeding peer supporter.

All mums want to know that their baby is feeding well. When you first start breastfeeding, you may wonder if your baby is getting enough milk. There are clear signs that you can look out for:

Signs that your baby is feeding well

• Your baby has a large mouthful of breast
• Your baby's chin is touching your breast
• It doesn't hurt you to feed (although the first few sucks may feel strong)
• If you can see the dark skin around your nipple, you should see more dark skin above your baby's top lip than below their bottom lip
• Your baby's cheeks stay rounded during sucking
• Your baby takes rhythmic, long sucks and swallows. It's normal for them to pause sometimes
• Your baby finishes the feed and comes off the breast on their own

Signs that your baby is getting enough milk

• Your baby will appear content and satisfied after most feeds
• They should be gaining weight after the first 2 weeks
• Your breasts and nipples should not be sore
• In the first 48 hours, your baby is likely to have only 2 or 3 wet nappies
• From day 5 onwards, wet nappies should start to become more frequent, with at least 6 wet nappies every 24 hours
• They should appear healthy and alert when they are awake

Yes, you can. Make sure you get a skin to skin cuddle with your baby as soon as you're able to. Your midwife may help you have a skin-to-skin cuddle in theatre, or in the recovery room. If you keep your baby close to you and maintain lots of skin-to-skin contact, you'll be able to put them to the breast often, and this will stimulate your milk supply. 

After a caesarean you might find that the 'rugby hold' (baby's body is around to the side of your body supported by the arm on the same side) is preferable to having the baby lying on your stomach. Ask your midwife for pain relief before you're likely to feed your baby so that you can feed comfortably. 

Exclusive breastfeeding (with no other food or drink) is recommended for around the first 6 months of a baby's life. After this breastfeed alongside other foods for as long as you and your baby wish. This might be into their second year or beyond. 

Every day you breastfeed makes a difference to you and your baby. There is no need to decide at the beginning how long you will breastfeed for.

You may find it easier to express milk by hand than to use a pump, especially in the first few days.  It also means you won't have to buy or borrow a pump.

The following suggestions may help: 

1. Before you start, wash your hands thoroughly with soap and warm water, and gently massage your breast. 
2. Cup your breast just behind your areola (the darker part of your breast) 
3. Squeeze gently, using your thumb and the rest of your fingers in a C shape (see image above). This shouldn't hurt (don't squeeze the nipple directly as you’ll make it sore and unable to express). 
4. Release the pressure then repeat, building up a rhythm. Try not to slide your fingers over the skin. At first, only drops will appear, but keep going as this will help to build up your milk supply. With practice and a little time, milk may flow freely. 
5. When no more drops come out, move your fingers round and try a different section of your breast, and repeat. 
6. When the flow slows down, swap to the other breast.  Keep changing breasts until the milk drips very slowly or stops altogether. 
7. If the milk doesn't flow, try moving your fingers slightly towards the nipple or further away, or give the breast a gentle massage. 
8. Hold a sterilised feeding bottle or container below your breast to catch the milk as it flows.

You can store breast milk in a sterilised container:

• at room temperature for up to 6 hours
• in the fridge for up to 72 hours (4°C or lower)
• for 2 weeks in the ice compartment of a fridge
• for up to 6 months in a freezer (-18°C or lower)

Breast milk must always be stored in a sterilised container.  If you use a pump, always sterilise it before and after use. 

If you have frozen your milk, defrost it in the fridge before giving it to your baby.  Once it is defrosted store in the fridge and use within 24 hours. Milk that has been frozen is still good for your baby and better than formula milk. Do not re-freeze milk once it is thawed.

You can feed expressed milk straight from the fridge if your baby is happy to drink it cold.  Or you can warm the milk to body temperature by placing the bottle in lukewarm water. 

Do not use a microwave to heat up or defrost breast milk as it can cause hot spots, which can burn your baby's mouth.

As a dad you might feel that there isn't much you can do to help your partner with breastfeeding. But a dad or partner's role can be vital and make all the difference. 

Women are much more likely to breastfeed for longer when they have their partner's support. This leads to a greater sense of achievement for mum, and health benefits for both mum and baby. It can be a bonding experience for the whole family. 

Practical ways you can help

Go to an antenatal breastfeeding session. Learning the same information as your partner and discussing it together can be really helpful, especially in the early days when everything is very new and sometimes feels overwhelming. 

Give emotional and practical support. It can be a really hard time in the early days when babies and children take up all of your energy. But it doesn't last forever.  Try to make time for each other when you can. Do little things to make each other feel cared for and included. 

Make her life easier. It's the little things that make a big difference. For example, bring her dinner if the baby wants to feed at the same time; bring her a cup of tea and a magazine; or even arrange for family or friends to keep her company while you are at work. 

Provide some stress-relief. If you already have young children, take the stress away from mum by keeping them entertained while she feeds the baby.  Do your bit around the house, and give your partner some time to relax and regain her energy. 

Getting to know your baby

As the partner, you can get to know your baby in lots of different ways, such as bathing or carrying your baby in a sling close to you. Also, your baby may sometimes settle well with you rather than their mum. 

Get involved in your baby's care. Giving your baby their bath, changing nappies and being part of getting ready for bed are great ways of becoming close to your baby.

If your baby is unsettled at the breast and doesn't seem satisfied by feeds, it may be that they're not attached to the breast correctly. Check positioning and attachment to ensure that your baby is feeding well. lt can also be helpful to ask a breastfeeding supporter to work with you to improve positioning and attachment of your baby.

If your nipples hurt, take your baby off the breast and start again. To do this you can slide a finger gently into the corner of the baby's mouth until their tongue releases. Putting up with the pain could make things worse. If the pain continues or your nipples start to crack or bleed, ask a breastfeeding supporter to help you get your baby attached effectively. Pain is not normal, so ask for help and support. 

The following may help:

• Squeeze out a drop or 2 of your milk at the end of a feed and gently rub it into your skin. 
• Let your nipples dry before getting dressed again. 
• Change your breast pads at each feed (if possible use pads without a plastic backing). 
• Don't use soap, as it dries out your skin. 
• Wear a cotton bra so that air can circulate. 
• Treat any cracks or bleeding with a thin smear of white soft paraffin or purified lanolin.  Put the ointment on the crack (not the whole nipple) to help it heal and prevent a scab forming. 

There's no need to stop feeding. With help you should find that breastfeeding quickly becomes more comfortable again.

An over-supply of milk can build up in your breasts for a variety of reasons. If your baby is not well attached it may be hard for him to take your milk effectively, and some parts of your breast may not be drained during a feed. This area of your breast may feel sore or painful. It is worth checking to see if this is a possible cause so that you can prevent it from happening again. If you are not sure, ask for help. Other common causes include wearing a bra that's too tight, a knock or blow to the breast, and missing a feed. 

It is important to deal with a sore breast or a blocked duct as soon as possible so that it does not lead to mastitis (inflammation of the breast). 

If you have mastitis you're likely to have at least 2 of the following symptoms:

• breast or breasts that feels hot and tender
• a red patch of skin that's painful to touch
• general feeling of illness, as if you have flu
• feeling achy, tired and tearful
• you may have an increased temperature

This can happen very suddenly and can get worse very quickly. It's important to carry on breastfeeding as this helps to speed up your recovery. If you think you might have a blocked duct or mastitis, try the following: 

• Check and improve the attachment of your baby at the breast - ask your midwife, health visitor or volunteer breastfeeding supporter. 
• Feed your baby more often. 
• Let your baby feed on the tender breast first. 
• If your breasts still feel full after a feed or your baby can't feed, hand express some milk to relieve the fullness. 
• Warmth on your breast before a feed can help the milk to flow and make you feel more comfortable. Try warm flannels or a bath or shower. 
• While your baby is feeding, gently stroke the lumpy or tender area towards your nipple with your fingertips. This should help the milk to flow. 
• Get as much rest as possible. Go to bed if you can. 
• If you can, take a painkiller such as Paracetamol or Ibuprofen. 

Mastitis may also be a sign of infection. If there's no improvement within 12 to 24 hours, or you start to feel worse, contact your GP or healthcare professional. If necessary, they can prescribe antibiotics that can be taken while breastfeeding. 

Stopping breastfeeding will make your symptoms worse, so ask for help and support early. 

If you suddenly get sore, pink nipples after you've been feeding without problems for a while, you may have an infection known as thrush. Ask your health visitor or breastfeeding peer supporter to check that your baby is attached effectively.  Make an appointment with your GP. 

You and your baby will need treatment. You can easily give thrush to each other, so if your baby has it in his mouth you will need some cream for your nipples or an oral thrush tablet to stop it spreading to you. You many want to ask your pharmacist for information. Some anti-fungal creams can be bought over-the-counter from a pharmacy. 

Seek further information and help from your health visitor or GP if your baby continues to have symptoms.

Some babies are born with a tight piece of skin between the underside of their tongue and the floor of their mouth. This is known as tongue-tie and it can affect feeding by making it hard for your baby to attach effectively at your breast. 

Tongue-tie is easily treated. If you have any concerns, talk to your midwife, health visitor or GP

It can be hard to ask for help, but tackling breastfeeding problems quickly will give you more time to enjoy your baby's early days. In many cases, the solution is as simple as changing your baby's position or feeding them more often.

You can get help and support from your midwife or health visitor.