Feeding your baby

 

What position should I adopt when feeding?

Whatever works and is comfortable for both you and baby. The following acronym combined all the essential components to your baby having a good position:

C         hold baby Close to you

H         keep baby’s Head free – support their neck back and shoulders allowing the head to flex in the same way yours would when drinking a glass of water.

I           hold baby’s head and body In line with each other – facing you, not twisted.

N         position baby Nose to Nipple, when baby opens their mouth wide bring them towards you with their chin touching your breast first.

S          ensure your position is Sustainable, the normal length of a breast feed is anywhere between 5- 40 minutes so you will need to be comfortable.

For more information on good positions for feeding your baby, see Babycentre's advice Good Breastfeeding Positions which includes some diagrams you might find useful.

How do I know my baby is feeding well?

  • The baby's chin is indenting the breast.
  • The baby's mouth is open wide and has a large mouthful of breast
  • There is more areola (the darker pigmented skin around the edge of your nipple) above the baby’s upper lip than below the baby’s lower lip.
  • Their cheeks are full and rounded when sucking.
  • They are feeding in a rhythmic suck/swallow pattern with pauses.
  • It doesn’t hurt (although the first few sucks may be strong)


If I do get sore breasts what shall I do?


It is possible that at some time the latch may not have been correct and this has damaged some of the nipple tissue. As the baby draws the nipple to the soft palate at the back of its mouth, this process can be sore, but only for a few seconds. If this persists, get some help with positioning and latching.

When your milk first ‘comes in’, usually between day 3 and 5, your breasts may feel uncomfortably full or engorged. You can help ease this discomfort by alternating hot and cold compresses and gently massaging your breasts in the bath or shower. This is also beneficial to do if you feel you have a blocked milk duct. If your baby finds it difficult to latch at this stage due to the fullness of your breasts, it is a good idea to gently hand express to soften the areola (your midwife should teach you how to do this before you leave the birth setting).

It is possible to get a breast infection (Mastitis) if there have been problems with feeding or if you suddenly choose to stop feeding. Symptoms include a fever; red patches radiating over you breast tissue; agonisingly painful, hard breasts. If you are concerned that you have any of these symptoms, your midwife or GP can quickly establish if there is an infection and arrange treatment.
 

When can I start to express?


You can start to express as soon as you feel confident which will normally be when breast feeding has become second nature. Remember not to over stimulate your production by expressing too much as this can lead to altering the supply and demand gauge your baby has made for its stage of development.

It is important to keep expressed milk in a sterile storage container to prevent bacteria from infecting the milk. The milk can be kept in the back of the fridge for 5 days (at 4c or lower) and frozen for 6 months in the freezer or 2 weeks in the ice compartment of a fridge. Do not heat the milk up in a microwave as this can cause hot spots which may scald your babys mouth. You can warm your baby’s milk up by standing it in hot water and should be given to your baby at body temperature.

If your baby is transferred to special care when it is born you should express immediately to ensure your baby gets the colostrum. Hand expressing is important as the colostrum is in such small quantities and can get lost in the pump.

For more advice on expressing, please see our video
"A Guide to Expressing"


I really want to breastfeed but feel immense pressure and worry that I won’t be able to, so many of my friends have had problems.


Firstly, only 1% of mothers in the whole world do not have milk, which leaves 99% of us that can breast feed.

The choice is whether you feel you are able to commit to it because it doesn't always come easily to everyone. Many mothers don't realise how much commitment is required and are shocked at how often their baby feeds in the first few days and weeks. The feeds cannot be shared in the early days for obvious reasons! It is important to not put too much pressure on yourself, or allow others to do so, and take it one day at a time.

A baby from 34 weeks gestation has the ability to suck and instinctively knows how to feed when it is born. It takes time for both you and your baby to negotiate how the baby latches on and feeds. Everybody is different and has different anatomy. As long as you have the principle of the baby's nose opposite your nipple and that the baby's tummy is against your tummy, then the baby can latch itself if you let it.

It is essential that as soon as the baby is born it is placed skin to skin and can start to look for the breast. If you have had some medical intervention or medical drugs in your labour or birth, it may be different for you and the baby may need assistance. If this is the case then watch for the cues that the baby gives and how the baby has latched so you can identify when the baby is comfortably feeding.

Remember that breastfeeding can be tricky but there is lots of support available from your midwife, lactation consultants and local groups that you can access.

 
What are the benefits of breast feeding?

It is not just about nutrition! It is about the physical and emotional interaction between a mother and her baby. The design of breast milk and the size of their stomach (a small marble at birth and a walnut at day 10) mean that the baby must only have small amounts of milk frequently and that they should be with their mother for emotional growth as well as physical.

There are a number of benefits of breast feeding for your baby:

  • The milk is warm, accessible, free, easy to digest and perfectly suited to them, now and as their demands grows;
  • There is a lower incidence of allergies such as eczema and asthma compared to artificial milk;
  • Fewer breastfed babies develop childhood obesity and therefore diabetes and other associated illnesses later in life;
  • Fewer breastfed babies get respiratory tract, middle ear and gastrointestinal infections. 
  • Breast milk contains a wide range of antibodies which fight infection; they are passed on in breast milk. As the baby's immune system takes time to mature, it provides the baby with valuable protection.

For mums, the benefits include:

  • Breastfeeding lowers the chance of you getting Breast and Ovarian cancer.
  • It burns approximately 5-600 calories a day, making it easier to lose any extra weight gained in pregnancy.
  • It’s free!


What is in breast milk?

Breast milk is a complex living element. It contains:

  • Lactoferrin which absorbs iron.
  • Enzymes which aid digestion.
  • Hormones which aid growth outside the womb.
  • Immunoglobulins which are transferable antibodies from mother to the baby's gut to line and seal the gut.
  • Viral fragments which trigger the baby's own immune system.


What is colostrum?

Colostrum is the very first milk you produce. It is a concentrated form of all the elements of mature milk but with less water content. It is bright yellow in colour. It contains all the protection from the very first feed and allows the baby to coordinate sucking, swallowing and breathing before the larger volumes come around day 3 to 4.

Colostrum has a laxative effect which clears the meconium from the baby's gut. The meconium has a high Bilirubin content and if it remains in the gut it can be reabsorbed which can lead to prolonged jaundice.
 

How will I know when my baby wants to feed?


Contrary to popular belief, a crying baby is the very last sign that your baby is hungry. He or she uses a number of cues to try to tell you that they need a feed:

  • Your baby will be restless or wakeful;
  • He or she will make small movements of the mouth;
  • They will smack their lips or suck their fist;
  • Your baby will root and turn their head towards the breast.


Feeding a calm baby is a different experience to trying to feed a baby that is screaming because it's too hungry. It is stressful for both you and the baby.
 

Should I breast feed or bottle feed?


There is no doubt that breast feeding offers more than just nutrition. It is specifically designed for the baby to develop emotionally and grow at the pace it is supposed to.

Formula feed cannot replicate exactly breast milk. However, it is not the intention of health care professionals to make any woman feel that they are not a good parent if they do not to wish breastfeed. They just want you to have all the information so you can make an informed choice. There is plenty of information surrounding the breast milk advantages for you and your baby but very little on formula milk.

Here are some of the reasons why health care professionals encourage breast feeding in favour of formula feeding:

 
Breast feeding Formula Feeding
Milk is readily available and at the correct temperature, allowing demand feeding as recommended. Making up bottles is time consuming. Preparation should not be done in advance of the feed (due to bacterial growth), so boiling the kettle, waiting for it to cool down (approx 30 minutes wait) and then mixing the powder until you are able to feed your baby can take time and make it difficult to pre-empt your baby's demand.
The nipple is a sealed unit. There is significantly less chance of the baby suffering from wind. Sucking in air is part of the feed which means winding is an integral part of the process. If your baby is unable to bring the wind up, the baby can become uncomfortable.
Immunity is transferred from mother to baby via the milk which gives the baby mini immunisations so their immune system can fight infection. There is no immunity in formula milk. Your baby is at a higher risk of developing gastrointestinal upsets from not having the protection of breast milk There are enzymes present in breast milk which line the stomach preventing these infections.
It is not advised that a baby should be given cows milk until the age of one year as the fat content is too high for it to digest.Cows milk protein is similar in structure to pancreatic cells. Some babies have developed antibodies to this protein which then attack the pancreas. Some research has attributed this to juvenile onset of diabetes. Formula milk is based on cows milk.
Breast milk changes to suit your baby's age. The packaging does not reflect this but formula milk can differ from product to product. The formula milk manufacturers need to source the ingredients to maximise their profits so the content can vary.
Breast milk is not exposed to pollutants. Pollutants and chemicals may be present in formula from the tin it is in, from the water it is mixed with or the plastic from the feeding bottle.
The mother can only feed the baby or express milk for others to feed. Anyone can feed your baby.  
It can be uncomfortable to feed in public.
and is more difficult to find somewhere
where you feel happy and relaxed. Breastfeeding your baby should be in a clean environment, i.e. not locked away in a toilet cubicle.
It is not embarrassing to feed in public but you do need enough milk for the duration of your trip.


How do I know my baby is getting enough milk?

You can be confident that your baby is getting enough milk if he or she is content and falls asleep after a feed (this applies to a formula fed baby too).

If you are breastfeeding you may also start to feel your breast emptying. The high frequency of breastfeeding is not an indication of dissatisfaction. It is normal for a breastfed baby to digest the milk quickly and demand more!

The contents of your baby's nappy can also help you work out if your baby is getting enough milk. Firstly your baby will be producing wet nappies which will show that they are hydrated. In the first 48 hours, it is expected that your baby will pass just 2-3 wet nappies in total, this will gradually increase in the following days with at least 6 wet nappies in a 24 hour period by day 5 onwards.

The first stools the baby will pass will be black and very sticky called Meconium. [A hint to help remove the meconium is to use alternate wet and dry cotton wool]. It is normal for these stools to continue for the first 2 days

The stools will turn less black and by day 3 the poo will be green in colour and the consistency will be much looser. On day 4 onwards the poo will be bright yellow and very explosive with small seeds in it. They look a bit like sesame seeds and are fat deposits. The bright yellow poo is proof that breast milk has passed through your baby's digestive system and out into the nappy. You can expect your baby to pass at least 2 stools in a 24 hour period.

If you are formula feeding your baby then the poo will have more bulk to it. Babies can get constipated with formula so ask your midwife if you think this is happening.

Your baby should gain weight after the first 2 weeks. It is normal for your baby to lose up to 8-10% of its birthweight in the first 5 days, it should then gradually regain its birthweight by 2 weeks of age.


How often do I need to feed my baby?


All babies differ in how long and how often they will need to feed, but a breast fed newborn baby will feed at least 8-12 times in 24 hours.

A formula fed baby will usually feed every 3 to 4 hours. The fat content in formula feed is higher than that in breast milk which is why they sleep for longer periods; they can't digest the milk as quickly. Breast milk is specifically designed for them and easily digested, making them hungry for a feed sooner.


How do I fit everything into a day with feeding etc?


It is a difficult transition from being pregnant to having a baby that is completely dependent on you. You can help yourself by making sure you sleep when your baby sleeps as sleep deprivation makes everything worse. Although it is exciting to share your baby with friends and family, try and limit visitors in the first few days at home so you can adjust to your new way of life. If you are well rested it helps to prioritise what can wait and what can't. Family and friends want to help so when they ask if there is anything they can do, it is useful to be honest and say yes!

Your partner may be on paternity leave so can help you run the house in the early days, until you can adjust and get used to caring for your baby. Don't ever think you are alone in your chaos. Everyone has some kind of disruption when the baby comes home, some just disguise it better.
 

Does breast feeding exclude my partner from being involved with looking after our baby?


As only you can breast feed there is an element of exclusion in this particular area of care. However, the benefits of breast feeding far outweigh this. Once breast feeding is established your partner can feed the baby expressed breast milk if they wish.

Just because your partner can't feed the baby it doesn't mean they will not have any contact with the baby. There are a few ways to ensure that dad handles the baby as much as mum. These include:

  • Taking charge of bathing.
  • Changing their clothes.
  • Spending time calming and massaging the baby.
  • Changing the baby’s nappy.
  • Skin-to-skin contact.
  • Carrying the baby in a sling when out and about.