Feeding and nurturing your baby

Key messages to all parents

• It is not possible to ‘spoil’ any baby or toddler with emotional attention-You can never give enough love and cuddles, remembering you are growing your baby’s brain and self-confidence for later life.
• Responding early to your baby’s needs and not leaving a baby to cry for long periods, is good for your baby’s development and brain growth
• We will talk to you about the ongoing protection and values of breast milk, and will give you the practical skills and knowledge to support you in exclusive breastfeeding
• Exclusively breastfed babies cannot be overfed.

Responsive breastfeeding is about:

• Nutrition and acting on early cues your baby will give you
• The comfort for the mother
• The comfort for the baby
• Enables the mum to sit down, relax and bond with her baby.

If you have any questions or are feeling anxious about feeding your baby, please speak to your midwife at your antenatal check-ups, at parent education classes, or on the maternity ward.

Throughout your pregnancy and postnatal journey we will be discussing with you and your partner how you can respond to and start developing a loving relationship with your baby.  We will explore your feelings on how to responsively feed your baby such as breastfeeding, expressing and giving formula milk; this may be influenced by you and your partner's feelings and the attitude of your family and friends.

The most important thing to know is that however you decide to feed your baby, you will be supported by our midwifery and neonatal team. Please do take a few minutes to read the information below which explains the evidence to support why exclusive breastmilk and breastfeeding is recommended for you and your baby.

Breastfeeding is the normal, natural way to feed and care for your baby and babies are born expecting to breastfeed. Breastfeeding is more than nutrition it also helps with bonding, mothering and nurturing. Practical support and information is available from the staff within the unit on all aspects of infant feeding.

How does Milk production work? Click here to find out.

 

Positioning

We encourage every mother to try laid-back breastfeeding which is about using positions that tap in to your baby's natural reflexes. It's sometimes called "biological nurturing". Your baby is born with the ability to move towards his food source - your breasts. You can play to this instinct by lying back and placing your baby, tummy down, on your chest.

Please see links of positioning videos that may help you:

Click here to access videos about how to make adjustments to make breastfeeding comfortable especially if you have sore nipples.

Click here to watch videos about how to help a baby get more milk and make breastfeeding more comfortable.

Positioning info from La Lache can be found here.

Video for beastfeeding in the first hours.

“Human Milk, Tailor-Made For Tiny Humans”

Please watch the following video:

 

Breastfeeding

Breastfeeding is the normal, natural way to feed and care for your baby and babies are born expecting to breastfeed. Breastfeeding is more than nutrition it also helps with bonding, mothering and nurturing. Practical support and information is available from the staff within the unit on all aspects of infant feeding.

 

Values of breast milk and exclusive breastfeeding

For your baby

As well as promoting optimal growth and development, breastfeeding helps protect babies from infections and diseases, particularly:

• Gastroenteritis, diarrhoea and tummy upsets
• Chest infections and wheezing
• Ear infections
• Asthma and eczema (especially if you have a family history)
• Lower risk of childhood diabetes
• Necrotising enterocolitis – this life threatening condition, which occurs mainly in premature babies, is much less frequent if the baby is given only breast milk
• Childhood leukaemia
• Cot death (SIDS)

For you:

• Lowers risk of ovarian cancer
• Lowers risk of breast cancer
• Lowers risk of hip fractures which means stronger bones later in life
• Reduces postnatal depression
• Uses up the fat you have stored during pregnancy and helps you return to your pre-maternal size
• Helps your uterus to contract more quickly and return to its normal size
• It is cheaper than formula feeding and it is less work as you don’t have to make up feeds, sterilize bottles and teats, etc.

Please watch the following video, how breastfeeding works:

Position and attachment for breastfeeding

Positioning is what you as a mother do to enable your baby to attach themselves at the breast. Attachment is what your baby does.

• Keep your baby close with as much skin to skin contact as possible

• Whatever position you choose to feed your baby in there five main key principles:

CHINS is the acronym we use:
Close
Head free
In line
Nose to nipple
Sustainable for both 

• Respond to your baby’s feeding cues
• Feel reassured that your baby will be getting enough milk if they are feeding at least eight times in 24 hours, have a changing suckling pattern during a feed and they have at least six wet and two dirty nappies that will change in colour (from one week old; before this your baby may feed less and their urine and stool output will increase daily)

Always seek help if you have any concerns, especially if you have pain when your baby feeds.  For further guidance:

Unicef sore nipples

Globalhealthmedia - What to do about nipple pain

Is my baby getting enough milk? Nappies are a great early indicator! Remember…What goes in, comes out and babies poo is colour coded for us

Globalhealthmedia - increasing your milk supply

 

Breastfeeding twins and multiples

For more information on feeding twins or multiples please see the Multiple Births Foundation leaflet on Feeding twins, triplets and more, TwinsTrust, or Breastfeeding Twins and Triplets UK.

Your babies may be born small or premature and our leaflet to add  informs you about how to ensure your baby is feeding well.

More resources:

La Leche - breastfeeding a premature baby

Bliss

 

Healthy eating and breastfeeding

You do not need to eat or avoid any special foods while breastfeeding, but it is a good idea for you to eat a healthy diet, just like anyone else. It is recommended that all pregnant and breastfeeding women take a daily supplement of 10mcg of Vitamin D.

If you are getting Healthy Start vouchers (to check eligibility and to apply see What are Healthy Start Food Vouchers?) you can get free Healthy Start vitamins.

https://globalhealthmedia.org/videos/increasing-your-milk-supply/?portfolioID=5623

 

Bottle feeding your baby: Expressed Breastmilk(EBM) or Formula

Although we encourage all mothers to breastfeed because of the many ongoing protective and short- and long-term health benefits for mothers and babies, we know that some mothers may be unable to, or you have made an informed choose not to breastfeed. Midwives will offer the opportunity to explore your thoughts about feeding,  support your informed choice and encourage you and your partner to do as many feedss in skin to skin.

If you are choosing to give formula ,then please bring in your own supply of ready-made Stage 1 New-born Infant formula as we do not have the facilities to make up formula on the wards. We do not supply infant formula in hospital unless it is needed for a medical reason. We do supply disposable sterile bottles and teats while you are on the wards.

 

Safe bottle feeding

We will support you to bottle feed your baby as safely as possible in a responsive, paced way—this includes having a discussion on :

• Avoiding overfeeding by bottle- Many of the health risks of formula are related to increased risk of obesity in childhood and later life. It can be tempting to encourage a baby to feed when they are no longer hungry, hoping to get them to sleep for longer, or simply to use up the amount of formula milk you have made up. It is safer to feed your baby little and often in response to their signs of hunger. 
• Bottle feeding in a way which promotes a close mother-baby relationship-Develops close loving relationships, strong influences on your baby’s brain development and a secure baby. Maximises opportunities for developing language and communication skills.
• Try to limit the number of different people who bottlefeed your baby—preferably just the mother and one other person—so that the pleasurable feelings associated with feeding are linked to that person.
• Making up formula and sterilising equipment correctly- If you make up powdered milk feeds, please read the  Bottle feeding leaflet for detailed information on making up feeds and sterilising equipment. Current guidance is to make up only one bottle of formula at a time, and to add the milk powder to water which is 70°C—this is approximately the temperature if you boil a large kettle (at least 1 litre) and leave it to cool for no more than 30 minutes—in order to reduce the risk of infection.
• Using the correct formula- Babies only need Stage 1 Newborn Infant Milk until they are one year old, and then they can start drinking full fat cows’ milk. There is no need for them to have ‘follow-on milk’. See https://www.firststepsnutrition.org/parents-carers and for more detailed information on different infant milks see First Steps Nutrition’s Guide to Infant Milks.  

If you have or are considering  bottle feeding and breastfeeding-Please ensure you speak to a health professional who will discuss the below points:

Giving infant formula to a breastfed baby will reduce your milk supply if not protected by either stimulation to your breasts by hand expressing/Pumping

Bottle feeding will make it harder for your baby to learn to feed at your breast. If you mix bottle feeding and breastfeeding, you are likely to stop breastfeeding sooner than if you just breastfeed.

If you wish to mainly bottle feed, you can continue giving regular breastfeeds as often as you want—for example, just once a day.

Breastfeeding is the healthiest way to feed your baby. If you have not previously breastfed, or you have stopped breastfeeding, it is possible to try starting again at any time.

See the UK Baby Friendly Initiative guide https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2019/04/Infant-formula-and-responsive-bottle-feeding.pdf and more detail about how to bottle feed in the Formula Guide for Parents leaflet which answers questions like ‘How often should I feed my baby?’, ‘How do I know if my baby is hungry?’, ‘How do I know if my baby is getting enough milk?’, and ‘How do I help my baby to feed from a bottle?’. The UNICEF Bottle Feeding Assessment Tool helps families and midwives/health visitors to recognise if bottle feeding is going well.

 

Mixing bottlefeeding and breastfeeding

Giving infant formula to a breastfed baby will reduce your breast milk supply. Bottle feeding will make it harder for your baby to learn to feed at your breast. If you mix bottle feeding and breastfeeding, you are likely to stop breastfeeding sooner than if you just breastfeed.

If you wish to mainly bottle feed, you can continue giving regular breastfeeds as often as you want—for example, just once a day.

Breastfeeding is the healthiest way to feed your baby. If you have not previously breastfed, or you have stopped breastfeeding, it is possible to try starting again at any time.

• Making up formula and sterilising equipment correctly
• Using the correct formula

Many of the health risks of formula are related to increased risk of obesity in childhood and later life. It can be tempting to encourage a baby to feed when they are no longer hungry, hoping to get them to sleep for longer, or simply to use up the amount of formula milk you have made up. It is safer to feed your baby little and often in response to their signs of hunger. 

Safe bottlefeeding also means feeding in a way that encourages a close relationship between mother and baby and maximises opportunities for developing language and communication skills. Try to limit the number of different people who bottlefeed your baby—preferably just the mother and one other person—so that the pleasurable feelings associated with feeding are linked to that person.

See the UK Baby Friendly Initiative guide https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2019/04/Infant-formula-and-responsive-bottle-feeding.pdf and more detail about how to bottle feed in the Formula Guide for Parents leaflet which answers questions like ‘How often should I feed my baby?’, ‘How do I know if my baby is hungry?’, ‘How do I know if my baby is getting enough milk?’, and ‘How do I help my baby to feed from a bottle?’. The UNICEF Bottle Feeding Assessment Tool helps families and midwives/health visitors to recognise if bottle feeding is going well.

 

How to hand express your milk

You may need to express your milk by hand if:

• you are separated from your baby
• your baby is sleepy or unable to attach at the breast effectively
• your breasts feel too full
• to help clear a blocked milk duct

Watch UNICEF’s Hand Expression video or Global Health Media’s How to Express Breastmilk video to learn how to do this. If your breasts are very full, hard or painful, Breastfeeding Medicine of Northeast Ohio has produced a video The Basics of Breast Massage and Hand Expression.

For detailed information about storing expressed breastmilk see the Breastfeeding Network website.

You can drip expressed milk into your baby’s mouth or offer larger amounts from a clean teaspoon or cup—allow your baby to lap the milk from the spoon or cup (like a cat) and do not pour the milk into their mouth. If you give expressed milk by bottle, see bottlefeeding your baby.
 

Responsive bottle feeding; expressed breastmilk or formula milk

If you choose to formula feed, we will support your choice.

Please be aware that all infant formulas have to reach a minimum standard, first stage milk are the only milks suitable for babies up until 1 year old (follow on milks are not required).  Independent evidence shows that there is very little significant difference between the formula brands.

For more information and guidance on responsive bottle feeding, please see Infant formula and responsive bottle feeding - A guide for parents[docx] 15KB.This needs to be replaced with:https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2019/04/Infant-formula-and-responsive-bottle-feeding.pdf  

 

Key messages to all parents

• It is not possible to ‘spoil’ any baby or toddler with emotional attention
• Responding early to your baby’s needs and not leaving a baby to cry for long periods, is good for your baby’s development and brain growth
• We will talk to you about the value of breast milk, and will give you the practical skills and knowledge to support you in breastfeeding
• Exclusively breastfed babies cannotbe overfed.

Responsive breastfeeding is about:

• Nutrition and acting on feeding cues
• The comfort for the mother
• The comfort for the baby
• Allowing the mum to sit down, relax and bond with her baby.

If you have any questions or are feeling anxious about feeding your baby, please speak your midwife at your antenatal check-ups, at parent education classes, or on the maternity ward.