At Lancashire Teaching Hospitals NHS Foundation Trust we currently have Stage 2 Baby Friendly Accreditation and are working towards achieving Stage 3 very soon. It is important to us to support women and their families in their baby feeding choice and in building close and loving relationships.
See the World Health Organisation breastfeeding page
In addition to the information on this page you can always contact your midwife or health visitor to discuss any concerns.
The Infant Feeding Specialist Midwife is available for additional advice and support on 07591 988 954.
- Feeding your baby
At Lancashire Teaching Hospitals NHS Foundation Trust we currently have Stage 2 Baby Friendly Accreditation and are working towards achieving Stage 3 very soon. It is important to us to support women and their families in their baby feeding choice and in building close and loving relationships.
The World Health Organisation (WHO) and UNICEF recommend that babies are exclusively breastfed for the first 6 months of life – meaning no other food or liquids are provided, including water. From the age of 6 months, complementary foods should be added in whilst continuing to breastfeed for up to 2 years and beyond
Here is a link to the World Health Organisation breast feeding page.
- Optimising your feeding journey
The early hours and days of the feeding journey often map out the following weeks, and early optimisation can help bonding, brain development and feeding outcomes. See below key dates in your pregnancy and important moments to help you work towards your goals.
Timing
Action
Week 16
Milk production begins
Weeks 29-34
Attend infant feeding sessions
Week 34
Discuss feeding plans with your midwife
Week 37
Consider harvesting colostrum
Birth & Postnatal
Ongoing infant feeding support
During the pregnancy:
16 weeks
At 16 weeks lactogenesis, which means the production of milk begins. It is recommended to begin actively bonding with your baby from 16 weeks. When parents feel bonded with their baby during pregnancy, this can help with being really tuned in to your babys needs and feeding cues once they are born.
Feeling bonded during pregnancy also releases the hormone Oxytocin and reduces the stress hormone Cortisol. This results in a less stressful environment for your baby during pregnancy and helps grow their brain really well.
Ways to start actively bonding with your baby during pregnancy:
- Talk and Sing: Because they can hear you, speak or sing to your bump using a tuneful, sing-song voice. It helps them recognise your voice early on and after birth too.
- Touch and Stroke: Massage or gently stroke your abdomen. Babies often respond to the physical pressure of a hand on the bump.
- Tune In: Dedicate a few quiet minutes each day to relax, clear your mind, and just focus on your baby's movements and presence.
- Involve Partners: Encourage partners or siblings to talk and touch the bump so the baby gets used to their voices, too.
Start to have a think about feeding your baby and read through the information provided by your midwife at your 16 week appointment
29 – 34 Weeks
This is the best time to try and attend some Infant Feeding information sessions. These can be online or face to face. Here at LTHTR we have video infant feeding sessions which you can find below:
Our Health Visiting Service also offer virtual infant feeding sessions which you can find out more about by asking your Health Visitor or contacting 0300 247 0040
If you are choosing to birth at LTHTR but your local Trust differs, they may also provide Infant Feeding sessions you can attend. Please contact your local trust for further information about these.
34 weeks
At 34 weeks you should have a discussion with your midwife, filling in any gaps in your knowledge or bringing with you any specific questions you have.
37 weeks
At 37 weeks colostrum harvesting can begin. Please see the colostrum harvesting video and if you have any questions discuss with your Midwife.
Here is a leaflet - Expressing your milk antenatally - Information and advice for mothers-to-be
TIP: If you are on the antenatal ward for induction, ask your midwife to provide you with some collection syringes and express on the ward to help your oxytocin levels!
NB: If you have diabetes, harvesting colostrum is advised from 36 weeks. Please speak to your midwife to find out more.
- The value of breastfeeding
Breastfeeding has many health benefits for you and your baby. Your new baby will seek the breast not only for food, but also comfort and reassurance.
As you hold, cuddle and talk to your baby they will release hormones that help support their brain development and build their relationship with you.
You cannot spoil a baby by holding them or responding to their needs and you cannot overfeed a breastfed baby.
Being able to sit and rest whilst feeding or cuddling your baby, will also ensure you can enjoy their newness!Value of breastfeeding
- Reduction in infections for babies
- Reduction in diabetes
- Reduction in obesity
- Protection for Mums own health
You can see more about the benefits of breastfeeding in the video below:
Here are more links to sites about the benefits of breastfeeding
https://www.unicef.org.uk/babyfriendly/about/benefits-of-breastfeeding/
- Getting breastfeeding off to a good start
One of the best ways to get feeding off to a good start is to have skin to skin immediately following the birth of your baby. Not only will this help your baby with their breathing and temperature, it will also help them with their natural feeding cues. Ideally at least an hour is advised to have a cuddle in skin to skin and until they have completed their first feed – regardless of method.
Skin to skin will also provide your baby with lots of good bacteria from your skin which will help build their immunity.
If you are unable to have skin to skin immediately, your partner or family member can do this until you are able to and when you are able, it can be commenced with you.
Skin to skin is also encouraged on the neonatal unit so if your baby needs care on our unit, please talk to your nurse about how to facilitate this.
- How to know breastfeeding is going well
After the first 24 hours, babies should generally all follow a similar pattern.
You want to feed your baby when they show feeding cues, when they are sad, need comfort or want to connect. You also want to feed your baby when your breasts feel like they want to be drained, if they become heavy or full, or simply because you want to sit and feed your baby.
It is important to know a breastfed baby cannot be overfed and frequent stimulation in the first few days and weeks will tell your body how much milk to make and ensure a good and adequate milk supply.
In 24 hours, babies should feed between 8 – 12 times with the feeds lasting between 5 - 40 minutes (for each breast). This is of active and rhythmically suckling. Following this suckling your baby should spontaneously come off the breast themselves. Following coming off the first breast the second should be offered each time. Your baby may or may not want to take it and either is ok.
Pain is common but this does not mean it is normal.
Any pain should be reported to your MW and a full feed watched to help you make adjustments to make it painfree. Pain can be your bodies way of telling you that your baby is not on the breast effectively, and if you continue to feed whilst it is painful, this can lead to damage, not enough milk getting to your baby, your breasts not being drained effectively and mastitis.
Nappy output
One of the ways to monitor if your baby is taking in enough milk as well as making sure they are having enough feeds is to monitor their nappies.
For the first week, your babies nappies will change and then be pretty consistent until about 4 – 6 weeks.
The amount of poos your baby has and the colour is very important. Ideally from Day 4, your baby should be passing at least 2 yellow coloured poos. If this is not the case, please speak with your midwife for a feeding assessment and further support.
Your baby should be having by day 7, 6 or more heavy wet nappies every day. Prior to this, they should be having the number of wet nappies that correlates to their day of life (for example, at 2 days of age, they should be having at least 2 wet nappies per day).
You can find more detail here:
- Feeding cues
It is normally easier to feed your baby when they are calmer so it is really useful if you can recognise their feeding cues when they are first ready to feed. In the early days and weeks – you may be surprised just how much your baby wants to feed, but we do encourage responsively feeding your baby.
Early cues include:
- Rooting
- Moving / wriggling
- Sucking fingers / putting fist to mouth
- Stretching
Late cues include crying or getting very upset and red / agitated. Babies will show the early hunger cues before they start crying. If you are trying to feed your baby when recognising late cues, it is best to calm your baby and then feed them.
Some ways to calm your baby include:
- Skin to skin
- Singing
- Stroking
- Cuddling
- How to attach to the breast
Attaching at the breast
It is important that positioning and attachment is effective to ensure that not only do you not get sore but also that baby gets all the milk they need to grow. This video helps explain the importance of effective attachment and what to look for as you baby feeds:
To get a good position you might find using the acronym CHINS helpful:
C = Close – hold your baby super close with no arms or blankets between you and your baby
H = Headfree – ensure nothing is touching the head of your baby such as your hand, fingers, crook of your arm or a pillow. This allows your baby to tilt their head back well which will open their mouth as wide as possible allowing a deep and effective attachment.
I = Inline – hold your baby so that their whole body is inline. You don’t want any twisting at all. One way to check is to ensure their ears, shoulders and hips are all inline.
N = Nose to nipple – You want to start the feed with your nipple ending up at your babys nose. This would generally mean that their chin is touching prior to opening their mouth. This allows the nipple to go to the rear of the roof of the mouth
S = Sustainable – make sure you are comfortable!
This Global health video also can assist with ensuring your baby is attached at the breast well. The Global Health video can also be access in multiple languages which can be selected from the website: https://globalhealthmedia.org/videos/attaching-your-baby-at-the-breast/
4 things should be in place to achieve a deep effective latch -
- Chin leading with head tilted back
- Bottom lip attaching well away from the base of the nipple
- Wide open mouth
- Nipple pointing up towards the rear of the roof of the mouth
Some useful links for getting breastfeeding going well can be accessed here:
https://www.breastfeedingnetwork.org.uk/sign-of-effective-attachment/
- Do you need help with feeding?
If you require the help of your community midwife, you can call the mobile number they have provided, or liaison: 01257 27 5193
Health Visiting Services: 0300 247 0040
NCT Lancashire Infant Feeding Support: 0208 529 025
https://lancashireinfantfeeding.nct.org.uk/
National Breastfeeding Helpline:
0300 100 0212 (also available in Welsh and Polish)
0300 456 2421 (available in Bengali and Sylheti)
You can also contact the infant feeding team on 07591 988 954 if you have any specific concerns.
- Bottle feeding
If you have decided to bottle feed your baby, please use the information on this page to do so as safely as possible.
You may have decided to feed your own expressed milk in a bottle, or decided to feed only formula milk. You may have decided to offer formula in addition to your own milk. If this is what you decide, it is important to try and continue to provide as much breastmilk as possible, so your baby to benefit from the health benefits breast milk provides. If you wish to return to full breastfeeding at any time, please ask your midwife for further help and information.
If you have chosen to formula feed, at Lancashire Teaching Hospitals Trust, we encourage you to give your baby their first feed whilst remaining in skin to skin following birth even if choosing to formula feed as this helps to start building a close and loving relationship. Holding your baby in skin to skin for at least an hour or until after their first feed also helps them adapt to life outside the womb better.
If you have chosen to formula feed, please be aware that at Lancashire Teaching Hospitals, we cannot store opened bottles of formula in our fridges. Therefore, all parents who choose to formula feed, will need to bring in ‘First Milk Starter Packs’ into hospital with them.
If you choose to breastfeed, you do not need to bring any formula with you. If your baby requires formula for any medical reasons, you can still express your milk and resume / continue exclusive breastfeeding following medical use of formula.
You can find more information in regards to safely making up formula feeds here: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2008/02/start4life_guide_to_bottle_-feeding.pdf
Further information regarding types of formula milk can be found at First Steps Nutrition Trust Website by following this link: https://www.firststepsnutrition.org/parents-carersResponsive Formula Feeding
- Sit and cuddle your baby with lots of eye contact during the feed
- Encourage rooting
- Invite your baby to take the teat in their mouth
- Pace the feed by removing the teat at various times, or alter angle of bottle to give them a break from the flow of milk, or when baby appears to want to take a break
- Never force a full feed
- Alternate sides you hold your baby when feeding
- Limit the number of people who feed your baby
Type of Formula milk
It is advised that your baby remains on First stage infant milk up to the first 12 months of life – there is no need to purchase follow on milk at any age
After 12 months, you can stop formula and offer Cows milk or a suitable alternative
All formulas are nutritionally similar and there is no best brand. You can look over the contents at this website of all formulas on offer in the UK: https://infantmilkinfo.org/type-of-infant-milk/
Formula preparation machines, Cooling Flasks and Formula Tablets
We get asked lots of questions regarding these additional products to the formula market. Unfortunately we are unable to say if these are safe to use and therefore cannot advocate their use and advise to follow the recommended method of making up Formula powder as found in the link above.
You can find further information from First Steps Nutrition Trust and their evidence base here: https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/624edeb6873c47686bd34825/1649335991943/Bacterial+contamination_April+22.pdf
- Starting solid foods
It can be confusing knowing when and how to start solids with your baby.
Introducing solid foods, also known as complementary feeding, starts when your baby is around 6 months old. For further information, please follow this link: https: //www.nhs.uk/start4life/weaning/ - Returning to work
It is perfectly possible to continue Breastfeeding when returning to work. For further information and tips, please follow these links: https: //www.breastfeedingnetwork.org.uk/breastfeeding-help/returning-to-work/ https: //www.nhs.uk/start4life/baby/breastfeeding/going-back-to-work/ You can access breast and bottle feeding information from UNICEF in the following languages
- Arabic
- Bengali
- Hindi
- Lithuanian
- Mandarin
- Polish
- Romanian
- Slovak
- Turkish
- Urdu
By following this link: https: //www.unicef.org.uk/babyfriendly/baby-friendly-resources/foreign-language-resources/
