Breastfeeding advice and guidance

Breastfeeding for the first time

Breastfeeding is natural, but mothers and babies need help to learn how to breastfeed successfully. Your midwife or health visitor can help you start breastfeeding your baby.

Skin to skin contact

It is important to hold your baby in skin to skin contact immediately after birth. Your midwife usually gives you the baby to hold in skin to skin contact.

During skin to skin contact:

• the midwife places your baby on your tummy so their head is near your breast
• you gently caress your baby
• your baby can see your face
• there is no interruption as you get to know your baby

You should keep this contact for an hour after birth or until your baby finishes their first feed.
This contact helps:

• keep your baby warm and calm
• regulate your baby’s breathing and heartbeat
• you give the first breastfeed

You and your baby can enjoy skin to skin contact at ant time in those first few days and when your baby is older. The hormone oxcytocin is released during skin to skin contact and it helps to calm both you and your baby and really helps with breastfeeding.

Staying with your baby

In the first six months, it’s best if your baby stays with you all the time, including at night. Place your baby in a cot to sleep in your bedroom. The safest place for your baby to sleep is in a cot at your bedside. By staying with your baby, you learn about your baby and become a more confident mother. It also helps establish successful breastfeeding more quickly.

Many women choose to breastfeed their baby while lying in bed. It's very important that you do this as safely as possible. Never sleep with your baby on a sofa or armchair. Sharing a bed with your baby increases the risk of sudden infant death syndrome (SIDS). For more information see here.

Attaching your baby to breastfeed

The way you attach your baby to your breast is important so that feeding is comfortable and your baby gets milk. Our section on attachment explains this in more detail.

Signs your baby is getting enough breast milk

When your baby is two days old, they will have two or three wet nappies a day and their poo will have changed from black meconium to brown. When they are a week old, they will be having about six wet nappies a day and at least two yellow, slightly runny poos a day. If your baby is getting enough milk, they should regain their birth weight in the first two weeks. Your midwife or health visitor will check how feeding is going and will carry out a feeding assessment using a feeding assessment form.

Responsive breastfeeding

Babies usually want to feed between eight and 12 times in 24 hours and will generally breasfeed for between five and 40 minutes before coming off the breast themselves. You can't overfeed a breastfed baby and you can offer to breastfeed for many reasons other than hunger, such as for calming and comforting you and your baby. If in doubt, it is always appropriate to offer a breastfeed. Feeding your baby often helps you to keep up a good milk supply.

Responsive feeding is a term used by midwives and health visitors. It simply means responding to your baby's early feeding cues and not waiting until your baby is crying and upset before offering a breastfeed.

Babies can ask to be fed by displaying feeding cues such as;

• stretching and moving their bodies
• smacking their lips and sticking their tongue out
• sucking their fingers and hands

Timing your breastfeeds

If you use a timetable or routine to breastfeed, this disrupts the natural demand and supply mechanism for breast milk. For example, giving your baby a certain number of minutes on each breast every three or four hours can stop you producing enough milk.

Deciding not to breastfeed

Breast milk has an ‘inhibitory factor’. A build-up of this factor slows down your production of milk. You stop producing breast milk if you don’t breastfeed or express milk.

Giving your baby breast milk and formula milk

While breastfeeding, it's best if you can avoid giving your baby formula milk at least for the first six months. This is because giving bottles of formula will mean your baby is less interested in breastfeeding, so your body will produce less breastmilk. Introducing formula will also alter the healthy bacteria in the baby's digestive system and reduce their protection against infection. Formula can also cause problems with cow's milk allergy in some babies.

If you do decide to introduce bottles of formula, try to keep the number of bottles and amount you give to as little as possible and keep breastfeeding frequently, especially during the night in order to boost your milk producing hormones.

Giving your baby a dummy

A dummy can confuse a baby learning to breastfeed. If your baby gets used to a dummy, they suck less effectively and get less milk from the breast.

Drinking alcohol if you breastfeed

If you drink alcohol, some of it passes to your baby when breastfeeding. Alcohol can affect how easily your baby feeds. It is sensible to drink no more than two units of alcohol a week when breastfeeding.

Smoking if you breastfeed

It is best not to smoke if you’re breastfeeding as your breast milk will contain nicotine. This increases your risk of infection, which can lower your milk supply and cause mastitis. There is also an increased risk of sudden infant death syndrome (SIDS) for the baby of a mother who smokes.

Taking medicine if you breastfeed

Prescription and over the counter medicine can affect breastfeeding. If your GP prescribes medication, tell them you’re breastfeeding. If you buy over the counter painkillers or cold and flu remedies, ask the pharmacist about breastfeeding and any effects from taking the medication.

Taking illegal drugs and breastfeeding

You should not use any recreational drugswhen you are breastfeeding. Cocaine is particularly toxic and you must not breastfeed for 48 to 72 hours after using cocaine. Never use any street drugs. If you are receiving treatment for drug addiction, prescribed Methadone appears to be safe while breastfeeding.