Breastfeeding

April 2017

Breastfeeding is best for your baby and is chosen by about half the mothers . However, for whatever reason not all mothers can manage it and they should not feel guilty or consider themselves a 'bad mother' if they do not breastfeed their baby.

Breastfeeding can be difficult in the early days so consider it as you and your baby learning a new skill. Trying it for only a few days will still pass on important antibodies which will benefit your baby and the more you can learn about breastfeeding the easier it will become and look out for local support groups in your area.

Breastfeeding is a special and unique experience for you and your baby. It has many benefits for you and your baby with breast milk containing over 400 nutrients.

The following advice will be of some help to you and seek additional help from specialist clinics in your area.

Breastfeeding statistics


In 2005 the UK infant breastfeeding survey showed that 78% of women breastfed at birth. Of these women a third had stopped by week 6 with 50% breastfeeding after 6 weeks and 26% breastfeeding by 6 months.

Breastfeeding is more likely to be achieved with first time mothers than those that have more children

Breastfeeding rates were lowest in mothers aged 20 or under and highest among mothers aged 30 or over

http://www.ic.nhs.uk/pubs/breastfeed2005

Causes of unsuccessful breastfeeding

  • Breastfeeding is not easy especially in the early days: as a new mother you may be suffering with, tiredness, exhaustion, hormonal changes, adapting to a new baby and routine, painful, swollen and engorged breasts, all of which contribute to mothers giving up.
  • On the maternity wards there can be a shortage of staff to trained to help and support new mothers and advice from different midwives can be inconsistent.
  • Complications of breastfeeding: painful breasts, engorgement, abscesses, cracked nipples... may frighten mothers.
  • Often there is a lack of information given to mothers about how to breastfeed and the benefits for them and their baby.


Stress, tiredness, anxiety and being distressed can influence the quality of breastfeeding and decrease oxytocin secretion, the hormone which is important for the production of milk.



Speak to your midwife or health visitor regarding your nearest breast feeding clinic.

Benefits of breastfeeding for the baby


Breast milk is unique as it is specifically made to meet the needs of your baby.
  • The milk's composition changes according to your baby's needs and adapts to the baby's growth and development.
  • Breast milk contains nutrients which helps the baby grow and develop: it contains the correct amount of vitamins, proteins, carbohydrates, salts, lipids and essential fatty acids, iron...
  • Breast milk is easily digested
  • Breast milk contains antibodies which protect the baby from upper respiratory tract infections, gastro-intestinal infections and helps protect against asthma, eczema, childhood diabetes, childhood obesity. Breast milk protect your baby before it can produce its own antibodies.

It contributes to reducing allergies


It reduces allergies, particularly in high-risk families, with an unquestionable reduction in the risks of eczema.
  • Breastfeeding can also protect against the risks of having asthma: studies have found that breastfeeding makes baby's more resistant to allergens in the environment.


Prevention of allergies in children

Other advantages and benefits


  • It is permanently on tap being immediately available, in sufficient quantity and at an ideal temperature
  • Breastfeeding is special and unique providing a certain closeness and intimacy between mother and baby .
  • Breastfeeding seems to decrease the number of sudden infant deaths.
  • It is free therefore economic because it avoids the purchase of formula milk.

Changes in breast milk after giving birth

  • Colostrum
    • The colostrum is the milk produced by a mother between the 1st and the 5th day after the birth.
    • It is produced in small concentrated amounts and is full of special immunoglobulins and antibodies that help fight against disease.
    • It is high in protein and low in fat and meets the baby's nutritional needs in the first few days.
  • Transition milk is produced as a result of your baby suckling on the colostrum. It usually arrives between the 3rd and the 15th day and is the "onset of lactation": a feeling of heat and congestion occurs in the breasts; begins and ends after about 24 hours; it is caused by an surge of blood and liquid in the breasts.
    • It is produced between the 3rd and the 15th day.
    • It is particularly rich in lipids and carbohydrates.
    • It is more fluid.
  • Mature milk: your milk becomes mature at the end of the 2nd week. It is produced from the 15th day and offers all the necessary elements for the baby's proper development.


The composition of the milk varies within a feed : at the beginning of a feed it is more watery and lighter - this is to quench your baby's thirst. This watery milk is known as 'foremilk'. The milk then thickens and contains more lipids and calories thus satisfying your baby. This thicker milk is known as 'hind' milk

The breast takes approximately 90 minutes to refill and is usually empted by your baby after a feed. Your breasts will adapt to the necessary production for each feed.

Benefits of breastfeeding for the mother


  • Breastfeeding helps you to lose weight, shedding those extra pounds and fat stores gained in during the last months of pregnancy: breastfeeding increases energy needs. Eating a normal healthy diet will help you shed those extra pounds.
  • Reduces your risk of having breast cancer, cervix or ovary cancer.
  • Reduction in the risks of having osteoporosis...
  • Breastfeeding even if for 15 days will benefit the mother and her baby because oxytocin is secreted, a hormone which helps you relax.


To promote your milk supply you are encouraged to breast feed as soon as your baby is born, even with a Caesarean section birth. It is known that to have early 'skin to skin' contact with your baby will help with the onset of lactation.




Some drugs given during labour are contraindicated in breastfeeding.


Small tips worth knowing about breastfeeding

  • Studies have found that skin-to-skin contact with your baby can influence and stimulate your milk production. Skin-to-skin should be carried out at birth and as often as you can following delivery. Even several weeks after birth you and your baby with benefit from skin-to-skin contact.
  • Avoid using a bottle or dummy during the first month. It can confuse your baby and affect how she latches on which may affect your milk supply. Also bottle feeding requires less effort and babies can quickly become lazy and may reject the breast as a bottle is an easier option.
  • Breastfeeding does not damage the breasts, if correct latching on is achieved.
  • Breastfed baby's will take what they need - feeding on demand ensures your baby will not go hungry.
  • Babies will develop their own technique and routine when feeding: some babies will feed and empty a breast quickly in 5 to 10 minutes and others will take longer. With time and practice most babies become more efficient at feeding.
  • Breast size does not affect the production of milk
  • Having a caesarean section can delay the onset of lactation by a day or two, but this is not a barrier to breastfeeding as it can be easily achieved.
  • Alternate your breasts at each feed. Always empty one breast before starting on the other and if the second breast if not emptied start with this breast at the next feed.
  • Avoid, long periods in between feeds. If your baby is slow to regain its birth weight, feed every 3 hours, and set an alarm in the night to maintain this.
  • Expressing milk can be done by hand or by using a breast pump.
    • Fresh expressed breast milk can be stored in the following ways;-
      • At room temperature for 6 hours
      • In the fridge between 5 to 10 degrees C for 3 days
      • In the fridge between 0 to 4 degrees C for 8 days
      • Ice compartment of fridge 2 weeks
      • In the freezer at -18 degrees C for 6 months
      • Defrosted milk in the fridge use within 12 hours
      • Defrosted outside the fridge - use immediately


Do not put milk in the door of refrigerator which is not cold enough.

Check the temperature of the refrigerator properly using a thermometer.

If you become unwell you may have to avoid breastfeeding seek medical advice first.

How do I know breastfeeding is going well?

For the mother

  • The uterus contracts and you may experience some period type pains
  • Feeling thirsty
  • Feelings of heat and or tingling sensations in the feeding breast.
  • Feeling peaceful and calm at the end of a feed.

For the baby

  • Your baby is contented and settled after the feed
  • Your baby has abundant, yellow and lumpy daily stools.
  • Your baby is gaining weight

Do not to worry

  • If your breasts are heavy, swollen and sensitive towards the 3rd or 4th day after delivery: this is the onset of lactation: you should offer both breasts during the same feed.
  • Breastfed babies are slower to gain weight than those who are bottle-fed formula. Your health visitor will monitor your baby's growth using a growth charts.

Good positions for breastfeeding


Getting in a good position is crucial. If you are comfortable and have good posture it will be easier for your baby to latch on.

Correct positioning and latching on;-
    • ensures comfort for you and your baby.
    • allows your baby to feed better
    • helps avoid cracked nipples.
    • facilitates your baby to drain the breast effectively avoiding blocked ducts and possibly mastitis.

Good posture for the mother is important

  • There are a number of positions to try; sitting, lying down, under arm positioning of the baby all of which should be comfortable and safe for you and your baby.
  • Use cushions to support your back, and to rest your baby on.
  • Ensure the baby's head is properly placed if you are lying down
  • If you're unsure ask for help and guidance.


The baby's jaw and facial muscles must be regular, in a suck, suck swallow pattern. If the baby is nipple sucking it's cheek muscles will be active and this is incorrect latching on. If feeding is painful or neither you or your baby are comfortable then break the seal by gently inserting your little finger between your nipple and baby's mouth, stop feeding for a few moments and start again.

The baby's feeding positions

  • It is important that your baby's head and body are in a straight line - this aids swallowing.
  • Hold your baby close to you, supporting his neck and shoulders and he should be able to tilt his head back easily and not have to reach to feed.
  • Start by aiming the baby's nose to nipple. Wait until your baby opens his mouth wide and his tongue is positioned downwards and baby's chin touching your breast - this allows your baby to take a big mouthful of breast.
  • The baby must take the areola in its mouth and not only the nipple.
  • Take care not to occlude your baby's nose with your nipple.
  • Regular sucking action from your baby increases the production of breast milk.


Nicotine, alcohol, some drugs pass into the mother's milk and can be ingested by the baby.



It is contraindicated for a mother infected with the HIV virus to breastfeed. Formula feeding is recommended.

Seek advice from your doctor if you are infected with Hepatitis B or C

Problems encountered during breast feeding

Lack of milk


A drop in milk production can be linked to anxiety, tiredness and exhaustion by the mother - becoming more anxious and stressed about the amount of milk produced can make the situation worse. It is crucial to get rest and try other techniques outlined below. After a few days, milk production usually reverts to its normal levels.

A crying baby can be a sign that it's still hungry and not had enough milk to drink.

What should be done
  • Frequent skin-to-skin contact - this helps to stimulate milk production
  • Ensure baby is correctly latched on.
  • Relax and rest - this is more important than you think
  • Make sure you drink sufficiently
  • Give the breast more frequently: the more the breast is stimulated the more it produces milk.

Engorged breasts

  • Following the birth of your baby, lactation starts or your milk 'comes in'. You can expect your breasts to become swollen, full, tender and painful, this is because the blood supply to your breasts increases. This only last for a few days and once your baby is correctly latched on and feeding often it will settle.
  • Breasts can sometimes be engorged because milk is not managing to make its way correctly to the nipple. This can be due to poor technique for latching on, clothing or poor positioning of the baby pressing on the breast preventing the flow of milk, a blocked milk duct, a breast abscess or mastitis.
  • In these cases, the whole or partial breast are tense, hard and painful .
  • Engorged breasts are a temporary problem therefore you should not stop breastfeeding.


What you should do if your breasts are engorged
  • Do not stop feeding this will make you problem worse.
  • Do not to reduce the frequency or the duration of the feeds. Your breasts still require stimulation to help produce your milk.
  • Take care that you have been correctly fitted for a nursing bra and that clothes are no too tight - all of which can obstruct a milk duct causing engorgement.
  • Feed in priority from the most engorged breast first.
  • Do not sleep on your tummy
  • Do not leave too long between each feed
  • Whilst in a hot shower try emptying your breasts by massaging them, from the outside inwards towards the nipple, without stimulating the areola. This helps relieve breast congestion
  • To rest and relax a lot
  • See your Midwife, Health Visitor or GP is symptoms persist.


Engorged breasts can cause a lymphangitis (infection of the lymph channels), which begins with warm red blotches on the breasts and a fever. You will feel unwell which usually leads you to consult a doctor.

Avoid the use of a breast pump because although there is some temporary relief, stimulating the breasts will encourage the production of more milk.

Cracked nipples


Cracks are often caused by your baby not latching on correctly. Other causes include dry skin conditions.
  • Watch your baby when feeding that he's not nipple feeding or sucking for comfort.
  • Washing daily with just water is sufficient to keep your breasts clean. Avoid over cleaning you breasts and nipples.
  • Do not use soap, creams or lotions on your breasts apart from those recommended for breastfeeding use such as Lanolin ointment.
  • Lanolin ointment is safe to use on your nipples without harming your baby and helps your cracked nipples recover and heal themselves.
  • Silicone shields can be bought to protect the nipples when feeding.
  • Seek some help from your local breastfeeding clinic, as it is important you correct poor positioning and achieve latching on successfully.
  • Do not pull your baby off the breast, correctly de-latch your baby by inserting your little finger between your nipple and his mouth.
  • Consult your GP if the cracks and bleeding persist.

Mastitis


A mastitis is inflammation and infection of breast tissue of milk ducts. It causes
  • Inflammation, redness and pain in the breast
  • Muscle pains
  • Fever
  • Tiredness


If your have symptoms of mastitis you need to consult a doctor quickly get antibiotics.


What to eat when breastfeeding?


  • Continue with the good healthy eating habits acquired during pregnancy
  • Food must be balanced and varied .
  • You can eat almost anything - in moderation.
  • Limit soya and soya products - they contain Phytoestrogens which their side effects are unclear and it is unknown if present in breast milk.
  • Avoid eating peanuts if you have an allergic background or if there is one or more people suffering from this allergy in your family. For more advice see your GP or an allergy specialist.
  • Increase your consumption in dairy products: consume on average 1 dairy product at each meal.
  • Drink a lot, 2 to 3 litres daily as your need for water increases during breastfeeding, milk being mainly being made up of water.
  • Do not skip meals
  • Dieting without medical advice should be avoided. Dieting may affect the composition of your milk.
  • Limit your caffeine intake for example coffee, tea, cola and chocolate as caffeine enters your breast milk; drink a maximum of 3 cups of coffee a day.
  • Do not drink alcohol
  • Do not smoke
  • Do not take any medicine without consulting your doctor.


Babies quickly use up your vitamin D supply, taking vitamin D supplements, is often recommended and necessary whilst breastfeeding.


Weaning your baby from the breast


Weaning can be major change for you and your baby, being both emotional and liberating.
  • There are no rules on when to wean.
  • Weaning your baby off the breast must be done gradually so that your breasts adapt and do not end up engorged. Gradual withdrawal can be beneficial for your baby too.
  • Some mothers choose when to wean their babies and some wait for their baby to decide. It can take anything from 3 weeks to 6 months to wean so allow time and patience.
  • Giving your baby a feeding bottle for the first time can be difficult causing anxiety and upset for both you and your baby. Some recommend that the father gives the first feeding-bottle.

Speak to your health visitor for advice regarding your choice of formula milk and they can advise you on a weaning plan.



Weaning can be done in various ways :
  • Do it gradually to allow your baby to become accustomed the baby to the feeding-bottle.


Example of a weaning over 13 days if the baby feeds 5 times per day
  • Remove feeds one by one .
  • Start with the less significant feeds first, for example, those in the middle of the day
  • Then remove the evening feed, then the morning one.
  • Leave 7 days between each removed feed to wean over a period of 5 weeks.
  • Weaning should take place when the time is right for you and your baby. Sometimes returning back to work can prompt weaning, but be patient and allow time for your baby and you to adjust.

Breastfeeding and work


The thought of returning back to work and being separated from your baby can be daunting and distressing. It is therefore important to plan ahead and take the following points into consideration.
  • Tell your employer that you will still be breastfeeding when you return to work so that a risk assessment can be carried out as recommended by the Health and Safety Exectutive (HSE). This is to make sure you are not exposed to harmful substances or too much stress.
  • Think about getting your baby used to feeding from a bottle at least 2 - 4 weeks before you start back at work. Some babies take a bit of practice if they haven't tried drinking from a bottle before.
  • It is also a good idea to start expressing milk several weeks before starting back a work. This gives you a supply of milk that you can freeze,
  • It is possible to continue breastfeeding before and after work just as you would normally offer a feed.




National Breastfeeding Helpline Tel 0300 100 0212
http://www.nationalbreastfeedinghelpline.org.uk

The breastfeeding Network Tel 0870 900 8787
http://www.breastfeedingnetwork.org.uk

La Leche League Tel 0845 120 2918
http://www.laleche.org.uk

NCT Breastfeeding Line Tel 0300 330 0771
http://www.nct.org.uk

Association of Breastfeeding Mothers
http://www.abm.me.uk

The Breastfeeding Network Supportline in Bengali/Sylheti
Tel 0844 856 4003

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Latest update on June 15, 2010 at 05:42 AM by Janey39.
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