Stephanie Martin

Breastfeeding Guide

Learn how to prepare for breastfeeding during pregnancy and find support groups for the early days and beyond.

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. This happens more quickly for some women than others. But nearly all women produce enough milk for their baby.

Preparing to breastfeed before the birth

It's good to find out as much as you can about breastfeeding before you have your baby. It will help you feel more confident when you start breastfeeding your baby.

Antenatal classes usually cover the most important aspects of breastfeeding, such as positioning and attachment, expressing, common breastfeeding problems and how to tackle them.

Find antenatal classes near you.

You can find out about breastfeeding from your midwife, from family and friends, and useful helplines and websites.

There are lots of groups and drop-ins, some specially designed for pregnant women who want to know more about breastfeeding. You can find out more by asking your midwife, health visitor, local peer supporter or GP. Or visit your local Children's Centre.

Breastfeeding Essentials

You will need at least two nursing bras. If you later decide you want to express milk, a breast pump along with other feeding equipment may be useful. 

Skin-to-skin contact

Having skin-to-skin contact with your baby straight after the birth will help to keep them warm and calm, and steady their breathing. 

Skin to skin means holding your baby naked or dressed only in a nappy against your skin, usually under your top or under a blanket.

Skin-to-skin time can be a bonding experience for you and your baby. It's also a great time to have your first breastfeed. If you need any help, your midwife will support you with positioning and attachment.

Skin-to-skin contact is good at any time. It will help to comfort you and your baby over the first few days and weeks as you get to know each other. It also helps your baby attach to your breast using their natural crawling and latching on reflexes.

If skin-to-skin contact is delayed for some reason – for example, if your baby needs to spend some time in special care – it doesn't mean you won't be able to bond with or breastfeed your baby.

If necessary, your midwife will show you how to express your breast milk until your baby is ready to breastfeed. They will also help you have skin-to-skin contact with your baby as soon as it's possible.

Skin-to-skin after a caesarean

If your baby is born by caesarean, you should still be able to have skin-to-skin contact with your baby straight after the birth.

lactation.com

Colostrum: your first milk

The fluid your breasts produce in the first few days after birth is called colostrum. It's usually a golden yellow colour. It's a very concentrated food, so your baby will only need about a teaspoonful at each feed.

Your baby may want to feed quite often, perhaps every hour to begin with. They'll begin to have fewer, longer feeds once your breasts start to produce more "mature" milk after a few days.

The more you breastfeed, the more your baby's sucking will stimulate your supply and the more milk you'll make.

Your let-down reflex

Your baby's sucking causes milk stored in your breasts to be squeezed down ducts towards your nipples. This is called the let-down reflex.

Some women get a tingling feeling, which can be quite strong. Others feel nothing at all.

You'll see your baby respond when your milk lets down. Their quick sucks will change to deep rhythmic swallows as the milk begins to flow. Babies often pause after the initial quick sucks while they wait for more milk to be delivered.

Occasionally this let-down reflex can be so strong that your baby coughs and splutters. Your midwife, health visitor or breastfeeding supporter can help with this, or see some tips for when you have too much breast milk.

If your baby seems to be falling asleep before the deep swallowing stage of feeds, they may not be properly attached to the breast. Ask your midwife, health visitor or breastfeeding supporter to check your baby's positioning and attachment.

Sometimes you'll notice your milk letting down in response to your baby crying or when you have a warm bath or shower. This is normal.

How often should I feed my baby?

In the first week, your baby may want to feed very often. It could be every hour in the first few days.

Feed your baby as often as they want and for as long as they want. They'll begin to have fewer, longer feeds after a few days.

As a very rough guide, your baby should feed at least 8 times or more every 24 hours during the first few weeks.

It's fine to feed your baby whenever they are hungry, when your breasts feel full or if you just want to have a cuddle.

It's not possible to overfeed a breastfed baby.

When your baby is hungry they may:

  • get restless
  • suck their fist or fingers
  • make murmuring sounds
  • turn their head and open their mouth (rooting)

It's best to try and feed your baby during these early feeding cues as a crying baby is difficult to feed.

Building up your milk supply

Around 2 to 4 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. Each time your baby feeds, your body knows to make more milk for the next feed. The amount of milk you make will increase or decrease depending on how often your baby feeds.

In the early weeks, "topping up" with formula milk or giving your baby a dummy can lower your milk supply.

Feed your baby as often as they want and for as long as they want. This is called responsive feeding. In other words, responding to your baby's needs. It's also known as on-demand or baby-led feeding.

In the beginning, it can feel like you're doing nothing but feeding. But gradually you and your baby will get into a pattern, and the amount of milk you produce will settle down.

It's important to breastfeed at night because this is when you produce more hormones (prolactin) to build up your milk supply.

See how to tell if your baby is getting enough milk.

Dealing with leaking breasts

Sometimes, breast milk may leak unexpectedly from your nipples. Press the heel of your hand gently but firmly on your breast when this happens.

Wearing breast pads will stop your clothes becoming wet with breast milk. Remember to change them frequently to prevent any infection.

Expressing some milk may also help. Only express enough to feel comfortable as you don't want to overstimulate your supply.

If your baby hasn't fed recently you could offer them a feed as breastfeeding is also about you being comfortable.

Help and support for breastfeeding

  • For more information on how to get comfortable and make sure your baby is properly attached, see Positioning and attachment.
  • If you are having difficulties with breastfeeding, take a look at Breastfeeding problems.
  • Ask your midwife or health visitor for help. They can also tell you about other breastfeeding support available near you.
  • Search online for breastfeeding support in your area.
  • Call the National Breastfeeding Helpline on 0300 100 0212 (9.30am-9.30pm daily). 

Got a breastfeeding question?

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Expressing and storing breast milk

Expressing milk means squeezing milk out of your breast so you can store it and feed it to your baby later.

You might want to express milk if:

How do I express breast milk?

You can express milk by hand or with a breast pump. How often you express your milk, and how much you express, will depend on why you are doing it.

Sometimes it takes a little while for your milk to start flowing. Try to choose a time when you feel relaxed. Having your baby (or a photo of them) nearby may help your milk to flow.

You may find it easier to express in the morning, when your breasts can sometimes feel fuller.

Expressing breast milk by hand

Some women find it easier to express milk by hand than to use a pump, especially in the first few days or weeks. It also means you won't have to buy or borrow a pump, or rely on an electricity supply.

Hand expressing allows you to encourage milk to flow from a particular part of the breast. This may be useful, for example, if one of the milk ducts in your breast becomes blocked.

Hold a sterilised feeding bottle or container below your breast to catch the milk as it flows.

These tips may help:

  • Before you start, wash your hands thoroughly with soap and warm water.
  • Some mothers find gently massaging their breasts before expressing helps their milk to let down.
  • Cup your breast with one hand then, with your other hand, form a "C" shape with your forefinger and thumb.
  • Squeeze gently, keeping your finger and thumb near the darker area around your nipple (areola) but not on it (don't squeeze the nipple itself as you could make it sore). This shouldn't hurt.
  • Release the pressure, then repeat, building up a rhythm. Try not to slide your fingers over the skin.
  • Drops should start to appear, and then your milk usually starts to flow.
  • If no drops appear, try moving your finger and thumb slightly, but still avoid the darker area.
  • When the flow slows down, move your fingers round to a different section of your breast, and repeat.
  • When the flow from one breast has slowed, swap to the other breast. Keep changing breasts until your milk drips very slowly or stops altogether.

Watch a video about expressing milk by hand, on the UNICEF website.

Expressing milk with a breast pump

There are two different types of breast pump: manual (hand-operated) and electric.

Different pumps suit different women, so ask for advice or see if you can try one before you buy.

Manual pumps are cheaper but may not be as quick as an electric one.

You may be able to hire an electric pump. Your midwife, health visitor or a local breastfeeding supporter can give you details of pump hire services near you.

The suction strength can be altered on some electric pumps. Build up slowly. Setting the strength to high straightaway may be painful or damage your nipple.

You may also be able to get different funnel sizes to fit your nipples. The pump should never cause bruising or catch your nipple as it is sucked into the funnel.

Always make sure that the pump and container are clean and sterilised before you use them. 

Storing breast milk

You can store breast milk in a sterilised container or in special breast milk storage bags:

  • in the fridge for up to five days at 4C or lower (you can buy cheap fridge thermometers online)
  • for two weeks in the ice compartment of a fridge
  • for up to six months in a freezer

Breast milk that's been cooled in the fridge can be carried in a cool bag with ice packs for up to 24 hours.

Storing breast milk in small quantities will help to avoid waste. If you're freezing it, make sure you label and date it first.

Defrosting frozen breast milk

Breast milk that's been frozen is still good for your baby and is better than formula milk.

It's best to defrost frozen milk slowly in the fridge before giving it to your baby. If you need to use it straightaway you can defrost it by putting it in a jug of warm water or holding it under running warm water.

Once it's defrosted, use it straightaway. Don't re-freeze milk that has been defrosted.

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 putting the bottle in a jug of warm water or holding it under running warm water.

Once your baby has drunk from a bottle of breast milk it should be used within the hour and anything left over thrown away.

Don't use a microwave to heat up or defrost breast milk. This can cause hot spots, which can burn your baby's mouth.

Breast milk if your baby is in hospital

If you're expressing breast milk because your baby is premature or sick, ask the hospital staff caring for your baby for advice on how to store it.

Read our guest blog post Challenges of Breastfeeding a Preemie

Having difficulty expressing?

If you are finding it difficult or uncomfortable to express your breast milk:

References nhs.uk

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