Many women find it hard to imagine using their breasts to feed a baby and it can be even harder if your family and friends haven’t breastfed. The best way to gain confidence and find out more about breastfeeding is to meet mums that are doing it and meet health professionals that can offer you help and advice.
Breast milk protects your baby against many health conditions.
Babies have a limited immune system and they can’t fight infections on their own so all of your infection-fighting antibodies are passed on through your breastmilk, helping to boost your baby’s immune system.
Your breastmilk helps to coat the lining of your baby’s gut and contains enzymes that can kill harmful bacteria.
While your baby is feeding they are building up the muscles that help drain the ears, reducing the risk of ear infections. These muscles are not developed as well when babies are bottle fed, as babies suck differently from a bottle.
Unlike bottle feeding, breastfeeding allows your baby to satisfy their own appetite, an important skill that will last a lifetime! The very first milk you will feed your baby is called colostrum and is packed full of nutrients and antibodies, which unlike bottle feeding, doesn’t stretch your baby’s tummy more than it should. The fact that your breastmilk is constantly changing helps your baby recognise when to stop feeding and it helps them to learn to control their own appetite.
Benefits to mother
The benefits of breastfeeding for you are reduced risk of
- Ovarian cancer
- Breast cancer
As well as helping you to develop a strong bond with your baby, breastfeeding is great for your health and losing weight. Women who choose to breastfeed produce hormones that help the womb contract back to its original size more quickly, leaving them with a flatter tummy.
Breastfeeding mums also burn up to 500 extra calories a day, helping them to lose weight and feel great. Come along to a breastfeeding support group to find out more.
Breastfeeding support groups
There are many breastfeeding drop-in support groups across Stoke-on-Trent and Staffordshire for pregnant and breastfeeding mums. Anyone who is interested in finding out about breastfeeding or helping a breastfeeding mum is welcome.
Times, dates and venues may be subject to change. Please ring before attending your first group.
If you gave birth at University Hospital of North Midlands
- 24hr infant feeding support helpline for all mothers discharged from University Hospital North Midlands 01785 230059
- Royal Stoke Breastfeeding Co-ordinators 01782 672212 or bleep through main switchboard 01782 715444 bleep 15811. Please go to uhnm.nhs.uk or contact the venue directly
- Royal Stoke Breastfeeding Antenatal Classes. Learn about breastfeeding before the birth, held on the Midwifery Birthing Unit. Call 01782 672200 to book
If you gave birth at University Hospitals of Derby and Burton NHS Foundation Trust
24hr infant feeding support helpline for all mothers discharged from Queens Hospital, Burton-upon-Trent, telephone 01543 412905.
Antenatal breastfeeding workshops
Please ring before attending your first class.
Wednesday - 1st Wednesday of the month - 10.00 – 12.00, antenatal class, Samuel Johnson Hospital, Lichfield, WS13 6EF. To book contact 01283 566333 ext 4351
Thursday – 2nd and 4th Thursday of the month, Waterloo Street, Burton. Telephone 01283 566333 ext 4351
Breastfeeding support groups
Please use contact details to check parent-led groups are still running
09.30 - 11.00 Charnwood Children's Centre, Purcell Ave, Lichfield, WS13 7PH. 01543 431586
10.30 - 12.00 Stoke Library, Stoke Local Centre, South Wolfe Street, ST4 4SZ. 0300 303 3298
10.30 - 12.00 Westfield Children's Centre, Buccleuch Road, Longton, ST3 4RF. 0300 303 3298
11.00 - 12.30 Springfields Health & Wellbeing Centre, Rugeley WS15 2FH. 01543 431586
13.30 - 15.30 FAB Mums Norton, Norton Children’s Centre, ST6 8JW. 0300 303 3298
13.00 - 14.30 Landywood Children's Centre, Holly Lane, Great Wyrley, WS6 6AQ. 0300 303 3923
13.30 - 15.00 Codsall Library, Wolverhampton Road, Codsall, WV8 1PX. 0300 303 3923
13.30 - 14.30 Silkmore Children's Centre, Exeter Street, Stafford, ST17 4EG. 01785 221047
Medication and breastmilk
You may be concerned if you need to take any medication whilst you are breastfeeding. The Breastfeeding Network has provided information on drugs in breastmilk to help you make informed decisions or you can take the information to your GP to discuss together.
Visit the Breastfeeding Network Drug Helpline for more information.
Medical information on breastfeeding
Breastfeeding should be pain-free and enjoyable! However, some women are affected by medical problems that can make breastfeeding difficult or painful. The majority of conditions can be quickly and effectively treated and very few conditions requires that the mother gives up breastfeeding.
If you have any of the symptoms below, or any other problems with breastfeeding, we would urge you to continue to feed your baby and contact your midwife, health visitor or GP immediately.
- A red area on part of the breast often the outer, upper area, which is painful to touch
- A lumpy breast which feels hot to touch
- The whole breast aches and becomes red
- Flu-like symptoms-cold, shivery and aching bodily
If you have the above symptoms please contact your own GP if you are concerned.
For further advice on medication please contact your pharmacist or GP.
- Ibuprofen (400 mg) will reduce the inflammation, relieve pain and reduce temperature. Take 400mg three times a day after food. ( If you are asthmatic please consult your G.P)
- Paracetamol will relieve pain and reduce temperature but has no anti inflammatory action. Take two 500mg tablets four times a day.
- Continue feeding even on the affected side, this will help your recovery.
- Antibiotics may be needed, if no improvement in 24 hours please contact your G.P.
- Do not stop breastfeeding during mastitis. This can make Mastitis much worse; continuing to breastfeed will help recovery and will not harm the baby.
Thrush of the breast
- Sudden start of breast and or nipple pain after some days or weeks of pain free breastfeeding
- The nipple may be itchy or extra sensitive, pale or reddened
- Shooting pains deep within the breast AFTER feeding. Pain can be SEVERE and can last up to an hour
- Cracked nipples which don’t heal
- Permanent (not transient) loss of colour in the nipple or areola
- Pain occurs in both breasts because baby transfers infection
- History of recent antibiotic use
- Baby with oral symptoms of thrush
- Maternal symptoms of vaginal thrush at delivery
- Nappy rash which does not clear with simple treatment
There may be no obvious signs of infection on the breast but this does not necessarily mean that you don’t need to be treated
The treatment of both mother and baby is essential even if only one shows symptoms of thrush as thrush can be passed between mum and baby.
Treatment of mother
For further advice on medication please contact your pharmacist or GP.
- A smear of Miconazole 2% to the nipple and areola area after each feed. Any cream that can be seen should be gently wiped off before the next feed, but there is no need to wash the residue off
- For inflamed/red nipples, a mild steroid cream can be used to help healing, such as Miconozole 2% plus Hydrocortisone 1%
- The mother may need additional analgesia until symptoms improve to enable her to cope with the pain caused by thrush
- If there is no improvement or deep breast pain develops, oral treatment of Fluconizole can be given alongside topical treatment of mother and baby which is on prescription from your G.P, please contact them
- If pain/symptoms have been present for some time a longer course or higher dose of Fluconizole may be required
Treatment of baby
For babies over 4 months old
Oral Miconazole gel applied to baby’s oral mucosa and tongue four times a day. The gel should be applied gently in small amounts with a clean finger until all mucosal surfaces have been coated
For babies under 4 months old
Nystatin oral suspension.
Please note that there are other causes of nipple pain, including:
- Poor attachment
- Tongue Tie
- Reynaud’s Syndrome
- White Spot
- Bacterial Infection
If you have nipple pain and you are not sure what the cause might be, contact your midwife, health visitor or GP.
Baby feeding correctly?
When you baby is well attached
- Your baby’s chin will be touching the breast
- Your baby’s mouth will be wide open
- You might not be able to see the areola (the darker area around the nipple) at all, or there will be more showing above the baby’s top lip
- You might be able to see that the baby’s lower lip is curled back, although if your baby’s well positioned you might not be able to see
- Your baby’s cheeks will be round and full and shouldn’t look sucked in or dimpled at all.
- There won’t be any smacking or slurping sounds
At first your baby’s suck might be quite fast but they will become slower and longer as you feed.
You may feel quite a strong, drawing sensation, which might be a bit uncomfortable at first but it should be painless after a while.
When your baby’s all full up, they should come off the breast feeling sleepy and satisfied.
Signs that your baby isn’t well attached
- Your baby’s cheeks are drawn in and dimpled
- Experiencing pain while you are feeding
- Your baby’s sucking rhythm doesn’t change and remains quick throughout the feed
- If your baby is restless and keeps coming away from your breast, there is a problem with attachment
Skin to skin contact
Having skin-on-skin contact as soon as possible after you’ve given birth is a really good idea.
Having this close contact as early as possible keeps your baby calm, regulates their breathing and heartbeat and makes the first time you breastfeed easier.
Is my baby getting enough milk?
The best way to tell if your baby is getting enough milk is to take a look at their nappy.
After the first few days your baby will be having around six wet nappies a day. Your baby’s poo will change a lot during their first week, starting off black to dark brown and then turning to a runny, mustard coloured poo.
After the first couple of weeks the best way to tell if your baby is getting enough milk is by monitoring their weight gain.
If you do have any concerns please contact your Midwife or Health Visitor.
Storing and expressing breastmilk
Expressing milk means squeezing milk out of your breast so that you can store it and feed it to your baby at a later time.
You might want to express milk
- if you have to be away from your baby. This could be because your baby is ill or premature, or because you’re going back to work.
- if your breasts feel uncomfortably full or if your baby isn’t sucking well but you still want to give them breast milk.
- to use with your baby's first solid foods.
How do I do it?
You can express milk by hand or with a breast pump. Different pumps suit different women, so ask for advice or see if you can try one before you buy it. Always make sure that the container or pump is clean and has been sterilised before you use it.
Expressing by hand
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
- Before you start, wash your hands thoroughly with soap and warm water, and gently massage your breast
- Cup your breast just behind your areola (the darker part of your breast)
- 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). See how this is done in the video at the bottom of the page
- 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
- When no more drops come out, move your fingers round and try a different section of your breast, and repeat
- When the flow slows down, swap to the other breast. Keep changing breasts until the milk drips very slowly or stops altogether
- If the milk doesn’t flow, try moving your fingers slightly towards the nipple or further away, or give the breast a gentle massage
- Hold a sterilised feeding bottle or container below your breast to catch the milk as it flows
Watch a video on how to hand express and about the times when hand expression might be useful to you.
Sometimes your baby may need extra milk or find it hard to feed from your breast. In this case, your midwife may suggest that you give your baby some expressed milk in a cup.
This should be done under the supervision of a midwife until you feel confident enough to avoid the risk of your baby choking.
Storing breast milk
You can store breast milk in a sterilised container:
- In the fridge for up to five days at 4°C or lower
- For two weeks in the ice compartment of a fridge
- For up to six months in a freezer
Breast milk must always be stored in a sterilised container. If you use a pump, always sterilise it before and after use.
Defrosting frozen breast milk
If you have frozen your milk, defrost it in the fridge before giving it to your baby. Once it’s defrosted, use it straight away. Milk that's been frozen is still good for your baby and better than formula milk. Don't re-freeze milk once it's thawed.
Warming breast milk
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.
Don’t use a microwave to heat up or defrost breast milk as it can cause hot spots, which can burn your baby's mouth:
- If your baby is in hospital
- If you're expressing milk because your baby is premature or ill, ask the hospital staff caring for your baby for information about storing it, as the hospital will have its own guidelines
Expressing and Returning to Work
The first few days
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.
Before the birth
It’s 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.
Antenatal sessions should cover the most important aspects of breastfeeding, such as positioning and attachment, expressing, common questions and concerns, and how to overcome them. You can find out more from your Midwife.
Although the health benefits of breastfeeding are overwhelmingly clear, the reality is that many parents don’t get the practical information and support they need to start breastfeeding or to continue as long as they wish. Nine out of ten women who have stopped breastfeeding before six months say they wished they could have carried on for longer, and many say they stopped because of a lack of information and support.
The DVD ‘From Bump to Breastfeeding’: follows real mothers and their babies and shows new parents how to get started breastfeeding; provides practical answers to the common problems. This valuable resource, which is endorsed by five Royal Colleges, has been designed to motivate and enable the next generation of mothers to make a supported choice to breastfeed and can be viewed in seven languages including Urdu, Bengali and Somali.
Immediately after your baby is born
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.
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's 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 more often when your milk comes in, in a few days. The more you breastfeed the more milk you'll produce. The time between feeds will vary, and you and your baby will settle into a pattern, which may change from time to time.
How often will my baby feed?
All babies are different, and it may depend on the type of birth you've had. Your baby should feed within the first hour after birth to get off to a good start. Babies then sometimes have a sleep and will start to give you signs that they're ready for the next feed. These signs include:
- starting to move about as they wake up
- moving their head around
- finding something to suck, usually their fingers
Building up your milk supply
Around two to four days after birth you may notice that your breasts become fuller and warmer. This is often referred to as your milk ‘coming in’. Your milk will vary according to your baby’s needs. It will look thin compared with colostrum, but gets creamier as the feed goes on.
Each time your baby feeds, your body knows to make the next feed. Feed your baby as often as they want. This is called responsive feeding (it's also known as 'on-demand' or 'baby-led'). Let your baby decide when they’ve had enough. It's not necessary to time the feeds. In the beginning, it can seem that you're doing nothing but feeding, but gradually, you and your baby will get into a pattern of feeding, and the amount of milk you produce will settle.
It's important to breastfeed at night because this is when you produce more of the hormone prolactin, which helps build up your milk supply. At night, your baby will be safest sleeping in a cot in the same room as you.
Help and support
If you're very uncomfortable or sore, ask for help. Midwives, health visitors and trained volunteers can offer information and practical help with breastfeeding. Talk to your midwife or health visitor about the information and support available in your area.
Helping your partner to breastfeed
Partners play an important role in supporting mothers who decide to breastfeed. Support and encouragement are a ‘must’ so that baby and mum can feel comfortable. Sometimes you may want to ask questions and don’t always feel you can or don’t wish to upset your partner if they have decided they are going to breastfeed and you’re not sure about it.
What you can do to help
It’s normal to feel like a bit of a spare part at first but there are plenty of ways to get involved and play your part:
- Give compliments - this really is vital to keep your partner happy and positive. It is important you tell her how well she is doing and offer your support and love.
- Encourage your partner to eat and drink regularly so she feels more able to cope
- Listen and talk honestly about how you feel
- Be involved with the baby in other ways so that the care is shared.
- You can also help with housework and any other siblings
Do I really make a difference?
Partners play a big part in the mother’s decision to breastfeed, so if you’re positive then your partner should feel more comfortable and proud to breastfeed. A woman is more likely to choose to breastfeed if she is certain her partner is positive about it too.
I’m worried that I’ll feel pushed out
It’s normal to feel a bit left out when everything seems to be about the baby and your partner’s doing all the feeding; this can take a little while to get used to. You may sometimes feel jealous or left out as mother and baby form a very close relationship. However, breastfeeding is only one way of caring for your baby.
You can still be involved by:
- Changing nappies
- Taking for walks
- Lay baby on your chest, skin to skin
Once your partner is breastfeeding successfully then she might be able to express some milk so that you can feed your baby too. It’s really important not to introduce formula to replace breastfeeding, as it will affect the amount of milk your partner produces and there might not be enough milk for your baby.
I feel uncomfortable about my partner breastfeeding in public
Many worry about this and by discussing this together you can agree how to handle it. Once baby is born and you are used to seeing breastfeeding it may not be an issue. There is usually little or no breast showing when baby is feeding. Visit the ‘Breastfeeding Friendly Places’ section for more information.
Will breastfeeding affect our sex life?
Tiredness may affect this more. There are a few things you need to know below but there is no reason why you can’t still enjoy sex whilst breastfeeding is taking place:
- A women’s vagina is a little drier during breastfeeding so using a lubricant gel can help
- Any breast stimulation can cause milk to flow so keep a towel handy
- Sometimes it is better if you have sex after the baby has had a feed
- Your partner may enjoy sex more and is more comfortable with her body as a result of giving birth and breastfeeding
Do I need to know much about breastfeeding?
You may find it helpful to know how breastfeeding works and what is normal behaviour for breastfed babies. Here are some useful facts:
- Baby will be happier if he's fed as soon as he shows signs of being hungry
- Breastfed babies usually feed frequently (at least 2 - 3 hourly) in the early weeks, especially during the evenings, but every baby is individual
- Some babies are slow feeders at first, but they get quicker as they get older
- The more the baby feeds, the more milk the mother makes
- Babies are usually less windy, and put on weight better, if they finish feeding from the first breast before being offered the second
- A mother will enjoy feeding more if she is comfortable and relaxed
- The baby needs to open his mouth really wide, have the nipple in the back of his mouth and have his chin against his mother's breast to feed well, as he massages the milk out with his tongue
- Nipple soreness or pain during feeding is generally a sign that baby is not getting a large enough mouthful of breast.
Breastfeeding premature babies
Giving birth to a preterm baby can be a frightening and traumatic time for parents. Fears about the wellbeing of your baby and the sense of emergency within the delivery room can result in you and your partner feeling excluded and powerless. Understandably, the health of your baby will take precedent at this time and the nurses and medical staff will be focusing on ensuring that your baby’s condition is stabilised.
However even very preterm babies sometimes go through an initial period of stability and there may be an opportunity for you to hold him in skin-to-skin contact for a short period of time. This can help stabilise his breathing and heart rate and stimulates mothering hormones which will help you to produce breastmilk. If you are unable to have skin-to-skin contact at this time, you can look forward to when you and your baby are well enough to enjoy skin contact on the neonatal unit.
Breastfeeding is extra-important if your baby is born preterm or is ill
- They can be vunerable to infections
- They need the milk that is specifically designed for them
When babies are born early, often this can mean that the physical changes that happen in your breasts to enable you to breastfeed have not yet fully completed. Therefore in order to get a good milk supply started it is really important that you start to express your milk as soon as possible after the birth of your baby.
Even though you may be feeling exhausted, anxious and frightened if your baby was born prematurely, gently expressing milk by hand as soon as you are able (but preferably within the first couple of hours after birth) will help to switch on your milk supply. Ask a member of staff to show you how to hand express your milk. It is important to express your milk at least 8 times in 24 hours including once during the night to maximise the amount of milk you produce. If you have a large glass of water before you go to bed at night your bladder will be sure to wake you up and you can then fit in an expression.
You don’t have to express to a strict routine, but if you think about how a baby would feed (two or three times close together followed by a longer gap) this flexibility can help you fit in the eight or more expressions needed for an effective milk supply. Having something to remind you of your baby (photos, sound recording, item of clothing that will have his smell) will help your milk to ‘let down’. Practicing relaxation techniques and gentle breast massage will also help. Remember, providing your breastmilk for your baby is a valuable and unique contribution to helping him grow and develop during this crucial time.
Depending on how early your baby is born he may need to remain in the neonatal unit for a prolonged period of time. This can be a stressful and demanding time for you and your family. Frequent visits to the hospital and the ongoing regime of expressing and storing breastmilk can be very tiring and you may feel as if there is no time left for normal family life.
But remember that the breastmilk you're providing serves an invaluable function, providing your baby with both nutrition and protective factors which are essential for babies, particularly those exposed to hospital-acquired infections.
Preterm and very low birth weight babies are at increased risk of infection in the early days because their gut is underdeveloped. This allows pathogens and allergens to migrate into the baby’s system. Breastmilk not only helps to seal the gut but also promotes gut growth and maturity. This is often referred to as ‘priming’ the gut. Anti-infective and anti-inflammatory factors in breastmilk also protect against infection and inflammatory-based diseases.
As your breastmilk production becomes more established, there is more flexibility to the expressing regime. Double pumping is not only effective at removing milk but will really help to reduce expressing time. Cluster expressing (expressing 2-3 times within a short timeframe to allow a longer gap later) can help you to manage your time better. Night time expressions are important but again you can be more flexible about these as your milk production becomes more established. Spending as much time as possible in skin contact with your baby will really help you maintain your milk production.
Remember to use a sterilised container to put the milk in. You can store milk in the fridge for up to five days at 4°C or lower (usually at the back). Breast milk can be stored for two weeks in the ice compartment of a fridge or for up to six months in a freezer. Defrost frozen breastmilk in the fridge and once thawed use it straight away.
Breastfeeding friendly places
During your baby’s early 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.
Before you go out, it can help to think about where you will feel comfortable breastfeeding when your baby gets hungry. Ask breastfeeding friends or your health visitor if they know of a spot, such as a cafe, that they’ve found to be breastfeeding-friendly.
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 in such a way that you can breastfeed while your baby is still in the sling. Ask your health visitor for more information. Some mums feel more comfortable laying a scarf or muslin cloth over their chest while they’re breastfeeding.
Take someone with you
Sometimes, it helps to go with a friend who has an older baby and can take you to places that she already knows would be comfortable for you to sit and feed. Or go with someone else, such as your mum, partner, sister or friend so that there’s always someone to talk to.
Avoid the loos
Don’t feel that you should sit in a public toilet to breastfeed. You wouldn’t eat in there, so don’t feel that your baby should.
Know your rights
You shouldn’t ever be made to feel uncomfortable about breastfeeding in public. In fact, the Equality Act 2010 has made it illegal for anyone to ask a breastfeeding woman to leave a public place such as a cafe, shop or public transport
Out and about in Staffordshire and Stoke - where can I breastfeed?
Check the business is still trading before making a special journey
Returning to work
The World Health Organisation recommends exclusive breastfeeding for around six months, and there are benefits to continuing breastfeeding for up to two years after this.
Every mum’s circumstances are different and there are lots of ways you can incorporate breastfeeding into your working life, whether it’s using nearby childcare, expressing milk or working flexible hours, there’s a solution to suit each mum.
It’s a good idea to let your employer know as early as possible that you intend to breastfeed so you both of you have time to prepare. Before you go back to work, write to your employer/tutor to let them know. 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.
Information for employers
Employers have certain legal obligations to breastfeeding mothers. Supporting breastfeeding has business benefits too.
- reduced absence due to child sickness (breastfed babies are generally healthier)
- increased staff morale and loyalty, and a subsequently higher rate of return to work
- lower recruitment and training costs
- an extra incentive to offer potential employees
How can employers help?
Employers can have a policy to support breastfeeding.
- a break allowance for mothers to express milk
- provision of a clean, warm and private room (not the toilet) for expressing
- a secure clean fridge to store expressed milk
- flexible working hours for breastfeeding mothers
Let your employees know about your policy before they start their maternity leave.
Expressing milk for your baby to be given by a carer when you’re at work
With a little forward planning it is perfectly possible to continue to combine breastfeeding and working. If a mother intends to return to work very soon after the baby is born (for example if they are self-employed) then it is essential the she ensures that breastfeeding is well established and she feels confident with feeding before she starts back at work.
Depending on the times you’re at work, you might need to express your milk at work so that your baby has enough milk for the following day. Expressing can also be important to stop your breasts getting too full and to keep up your milk supply.
You can express by hand or use a pump to express milk. How often you need to express will depend on how much milk your baby needs and how often they feed. Expressing milk can take between 10 and 40 minutes: every mum is unique.
You should discuss with your employer how you are going to manage expressing at work. There are health and safety guidelines protecting breastfeeding mums at work and employers have a duty to ensure they comply.
Working flexible hours
You could talk to your employer about the option of working flexible hours, allowing you to work around your breastfeeding times. Or, you could negotiate shorter working hours in the short term until your baby needs fewer feeds during the day.
Combining breastfeeding and formula feeding
You can breastfeed your baby when you are together, and leave formula milk for them while you’re at work. Most mothers who decide on this option find that once breastfeeding is well established their breasts quickly adapt, and that they have plenty of milk to feed their baby at evenings and weekends.
What does the law say?
It is for the mother to decide how long she wishes to breastfeed. Returning to work doesn't mean that she has to stop. On returning to work, she should give her employer written notification that she's breastfeeding. Her employer must then conduct a specific risk assessment.
The Workplace Regulations and Approved Code of Practice 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. It is not suitable to use toilets for this purpose.
Caring for your baby at night
The safest place for your baby to sleep is in a cot by the side of your bed. This means you can hear your baby and respond to her needs before she starts crying or becoming distressed, you can reach your baby easily.
It is normal for babies and young children to wake in the night, take a look at the short video below which demonstrates the results of research from Swansea University.
Listen for the early feeding cues:
- Sucking fingers
- Murmuring sounds
There may be times when your baby remains unsettled after feeds, placing your baby in skin to skin contact with you and gently rocking can provide comfort. Your partner can help with this too.
If you are breastfeeding you can offer your breast again even if your baby has just fed. Babies find suckling comforting and there is no risk of overfeeding a breastfed baby. If you have had a particularly disturbed night, try to take time out to rest during the daytime. Visitors can wait – or help by taking over chores or looking after other children while you and your baby catch up on sleep.
To keep your baby safe and to reduce the risk of sudden infant death, (some times called cot death) always make sure:
- You put baby down on their back to sleep, never on the front or side
- The cot is beside the parent’s bed for at least the first six months
- The mattress is firm and flat
- Your baby is not overdressed or covered with too much bedding (no more than you would yourself)
- The bedding must not be able to cover the baby’s head
- The room is not too hot (16- 20 degree C is ideal)
- The room on which the baby sleeps is a smoke free zone
Normally, the tongue is loosely attached to the base of the mouth with a piece of skin called the frenulum. In babies with tongue-tie, this piece of skin is unusually short, holding the tongue down and restricting its movement.
Tongue-tie affects 3-10% of newborn babies.
Tongue-tie doesn't always cause problems. Sometimes, the skin anchoring the tongue may be so thin that it soon breaks on its own.
However, in some cases tongue-tie is severe and the tongue is almost fused to the base of the mouth. This can prevent babies from effectively feeding properly whether it is breast or bottle fed which then can go on to cause problems for the mother.
Problems tongue-tie can cause
Babies with severe tongue-tie will not be able to open their mouth wide enough to latch onto their mother's breast.
They cannot get any milk, so they end up sliding off the breast and chomping on the nipple with their gums. The mother's nipples soon become sore and the baby fails to gain much weight.
To breastfeed successfully, the baby needs to latch onto the breast tissue and nipple needs to sit at the back of the babies throat in the soft palette area, and the baby's tongue covers the lower gum so the nipple is protected from damage.
A tongue-tied baby may also find bottle feeding hard. They cannot form a seal around the teat of the bottle, so milk leaks out as they suck. Air can sometimes get in and is swallowed, causing the baby to become windy and irritable.
Snipping the skin to free up the tongue is known as tongue-tie division or frenuloplasty. It is a simple and painless procedure that usually resolves the problems mentioned above straight away.
The National Institute for Health and Clinical Excellence (NICE) supports the use of tongue-tie division as it is safe and there is some evidence that it can improve breastfeeding. The Baby Friendly Initiative provides a list of hospitals where tongue-tie can be divided.
How tongue-tie division is carried out
Please contact your Midwife or Health Visitor if you have any concerns regarding your baby's feeding. Your baby may need referring.
The baby’s head is held securely and sharp scissors are used to snip the piece of skin. This only takes a few seconds and the baby won't feel much pain. Some babies sleep through it, while others just cry for a few seconds.
There should be little or no blood loss, and you can start feeding your baby immediately.
A white patch may form under the tongue, which takes 24-48 hours to heal but does not bother the baby.