Breastfeeding your baby
Just after the baby’s born, the first breastmilk you make is called colostrum, and it’s jam-packed with essential nutrients and protective antibodies, so put your baby to your breast as soon as possible after birth.
You only make small amounts of colostrum because at a day old, your baby’s stomach is tiny – the size of a blueberry! It can only hold around 5-7ml liquid. The colostrum helps your baby pass their first poo (known as meconium). Getting rid of the waste in their body like this lowers the risk of them becoming jaundiced.
Three or four days after birth, your baby’s stomach has grown and can now hold around 22-27mls. The size of a cherry tomato. It’s at this time that your milk production starts to increase: people talk about the milk ‘coming in’. As your baby suckles, a hormone is released which tells your body to produce milk. This is called the ‘let down reflex’.You may feel a tingling sensation. The more your baby suckles, the more of this hormone is released, and the more milk you make. Another hormone is released which stimulates the milk making cells high up in the breast to get you ready for the next feed. That’s why your milk supply is always able to meet the demands of your baby.
A baby needs to suck at the breast effectively to make sure there is a good milk supply and as your baby grows, your breasts will automatically produce more milk. Remember: more milk out, more milk made.
Did you know that your milk changes throughout a feed? At the start of a feed, the milk is thin and watery, it quenches your baby’s thirst and wakes them up. Then, gradually the milk starts to contain higher amounts of fat. That’s why it’s important to give your baby time to finish feeding so that they get enough calories to have a satisfying feed. Don’t follow strict timings for breastfeeding, but let your baby decide how often and for how long they want to feed. It can take between five minutes to half an hour, and varies from baby to baby. Often the feeds are longer at first. Once your baby has stayed on your breast long enough to get the fatty milk, you can offer your second breast. Start the next feed off from this second breast.
Babies will self regulate and naturally come off the breast when they’ve had enough. You can offer the breast for comfort too, if your baby is distressed or lonely or just needing a bit of love and attention. It’s also OK to wake your baby to feed, if your breasts are uncomfortably full or you have an appointment to go to.
Babies can feed between eight and 12 times a day in the early weeks, but gradually as mum and baby learn to master this new skill, feeds become more efficient and less frequent. By three months your baby may be asking for six to eight feeds a day. Remember, this is just an average as all babies have different needs. They will ask for more at times when they’re having a growth spurt, often at ten days, three weeks and three to four months old.
It’s recommended that you breastfeed exclusively for the first six months, and then continue providing breastmilk alongside other foods up to a year old, and even beyond to really benefit your baby.
Remember, any amount of breastmilk is a positive!
It’s all about the latch
Nearly all the problems women have when trying to get breastfeeding established are because the baby isn’t held in the right position. That makes it hard for the baby’s mouth to be properly attached or ‘latched on’ at the nipple.
Follow these step-by-step instructions to help your baby latch on well for feeding. You can also try using the acronym ‘CHINS’ as a checklist to help you get your baby in the right position:
C (Close) – cuddle your baby close during breastfeeding
H (Head free) – support your baby across their shoulders and back, leaving their head free to tilt back so they can attach to the breast at the right angle, with their chin leading
I (In line) – check your baby’s body is in alignment
N (Nose to nipple) – this allows your baby to attach at the breast ‘off centre’ so they get a good mouthful! Your nipple will reach to the roof of the baby’s mouth and in this position, breastfeeding won’t be sore for you.
S (Sustainability) – you’ve got to make sure the position is comfy for both of you as you’re likely to be there for a while!
How do I know my baby’s getting enough milk?
Many women give up on breastfeeding because they don’t think they’re producing enough milk, but in fact nearly all women are physically able to produce enough for their babies. Your baby’s feeding well if:
- They feed between eight and 12 times a day. It’s normal for babies to ‘cluster’ feed at some point in the day, often during the evening. This helps to maintain milk production
- They’re gaining weight after the first two weeks
- They have lots of wet nappies: in the first 48 hours after birth, your baby’s likely to only have two or three wet nappies, but from day five onwards, this should increase to at least six in a 24 hour period
- They’re pooing regularly! From four days after birth, and for the first few weeks, your baby should produce at least two yellow coloured poos each day that are at least the size of a £2 coin. It’s normal for breastfed babies to produce loose poos compared to formula fed babies. Find out more about what’s in a newborn’s nappy
- Your baby is content and satisfied after most feeds, coming off the breast on their own
Remember, talk to your health visitor if you have any concerns.
There are lots of reasons why you might want to express your breast milk. For example:
- If your baby is premature, or unable to feed from you for another reason
- To overcome a breastfeeding difficulty – maybe you need relief from full (engorged)breasts, avoiding blocked ducts or mastitis.
- You plan to leave your baby with your partner or other carer who will need to feed them
- Your supply is slowing down and you need to increase production
- Or perhaps you are returning to work or study, but still want your baby to have your breast milk
You can either express using your hands, or with a manual or electric breast pump. Whichever option you go for, make sure you wash your hands and sterilise any containers or pump parts first, especially if your baby’s less than six months old. When you’re expressing, encourage your milk flow by:
- Gently massaging your breasts
- Having a warm bath or shower, or applying warm flannels to your breasts
- Having your baby (or something that reminds you of them) close by
- Making sure you’re relaxed and are somewhere quiet, private and warm
To hand express, make a ‘C’ shape with your thumb and finger. Position them on your breast around two to three cm back from the base of the nipple. Gently squeeze your thumb and fingers together and repeat in a rhythmic movement. Avoid sliding your fingers down your breast though. You might find it takes a short while before the milk starts to drip out. When the milk flow slows, move your fingers around the breast and repeat the process. That way you’ll make sure you’ve expressed all of the milk. When you first start to express you may only get a few drops of milk. The more you practice the easier it gets.
There are two main types of breast pump available, hand or electric/battery. Electric pumps can be hired, but for long term use it may be cheaper to buy a mini electric pump. These are expensive items so make sure it is really necessary. Many women find that hand expression works well for them.
If you are using a hand pump place it in position on the first breast and express until the milk flow slows to a drip. You can then swap over to the other breast – you may need to massage it a little to get the milk going. You can continue to swap between breasts, until you’ve expressed the amount of milk you need, or until your breasts feel softer. Some electric pumps have two collection sets which means you can express from both breasts at once. This not only saves time, but can stimulate your breasts to produce more milk.
Your midwife or health visitor can advise you on buying or loaning a breast pump. Don’t forget to view our article, Expressing- your questions answered, for further information too.
Returning to work
Returning to work doesn’t mean you automatically have to stop breastfeeding. If you’re able to continue breastfeeding, you’ll be boosting your baby’s immunity at a time when they may well be coming into contact with different germs through contact with other babies and children, for example at a nursery or childminder. Breastfeeding’s also a lovely way for you to reconnect with your baby when you get back from work (not to mention a great excuse to sit down for a while after a busy day!)
Your health visitor will talk you through the options for continuing to breastfeed after you return to work.
- Unicef- Infant Feeding during COVID-19
- Best Beginnings website – a series of short films about different aspects of breastfeeding, including the first feed after giving birth, breastfeeding in the early days, breastfeeding out and about, overcoming challenges and breastfeeding twins
- NHS Choices – advice on expressing and storing breastmilk
- NHS Choices – advice on breastfeeding in public
- Maternity Action – information on your rights in relation to breastfeeding in public. You can also ring their advice line: 0808 802 0029
- NHS Choices – breastfeeding and returning to work
- Start 4 Life leaflet – breastfeeding after returning to work or study
- Maternity Action – information about your rights in relation to breastfeeding and returning to work
- Acas guidance on how employers need to accommodate breastfeeding in the workplace
- Feeding Your Baby – leaflet giving an overview of your feeding choices
- Association of Tongue-tie Practitioners – information about tongue tie and signposting to available support
- National Breastfeeding Helpline, open every day from 9.30am – 9.30pm: 0300 100 0212
- National Childbirth Trust (NCT) – breastfeeding and antenatal support, including information about their breastfeeding helpline, open every day from 8am – 10pm: 0300 3300 770
- The Breastfeeding Network – breastfeeding helpline, open every day from 9.30am – 9.30pm: 0300 100 0210
- Bengali/Sylheti Supporter line: 0300 456 2421
- Drugs in breastmilk helpline 0844 412 4665 (answerphone on the line)
- La Leche League – 24 hour breastfeeding helpline: 0845 120 2918
- Association of Breastfeeding Mothers (ABM) – breastfeeding helpline: 0870 401 7711
- Unicef’s Baby Friendly initiative
- Start4Life- Breastfeeding