Breastfeeding

Why breastfeed?

It’s never too early to start thinking about how you're going to feed your baby. Today, most women are choosing to breastfeed.

• Breast milk is the only natural food designed for your baby.
• Breastfeeding protects your baby from infections and diseases.
• Breast milk provides health benefits for your baby.
• Breastfeeding provides health benefits for mum.
• It’s free.
• It’s available whenever and wherever your baby needs a feed.
• It’s the right temperature.
• It can build a strong physical and emotional bond between mother and baby.
• It can give you a great sense of achievement.

Health benefits for your baby

Breastfeeding is the healthiest way to feed your baby. Exclusive breastfeeding (giving your baby breast milk only) is recommended for around the first six months (26 weeks) of your baby's life. After that, giving your baby breast milk alongside other food will help them continue to grow and develop.

Breastfeeding is good for babies. Breastfed babies have:

• less chance of diarrhoea and vomiting and having to go to hospital as a result
• fewer chest and ear infections and having to go to hospital as a result
• less chance of being constipated
• less likelihood of becoming obese and therefore developing type 2 diabetes and other illnesses later in life
• less chance of developing eczema

Any amount of breastfeeding has a positive effect. The longer you breastfeed, the longer the protection lasts and the greater the benefits.
 
Infant formula doesn't give your baby the same ingredients or provide the same protection. Breast milk adapts to meet your baby's changing needs.

Health benefits for you

Breastfeeding doesn’t only benefit your baby. It benefits your health too. Breastfeeding is good for mums as it:

• lowers your risk of getting breast and ovarian cancer
• naturally uses up to 500 calories a day
• saves money – infant formula, the sterilising equipment and feeding equipment can be costly
• can help to build a strong bond between you and your baby

Exclusive breastfeeding can also delay the return of your periods. For more information on contraception, see Sex and contraception.

Common breastfeeding misconceptions

Many myths and stories about breastfeeding have been passed down through family and friends, but some are inaccurate or out-of-date. See how many you’ve heard, and separate fact from fiction:

Myth 1: “It’s not that popular, only a few women do it in this country”

Fact: 78% of women start breastfeeding.

Myth 2: “Breastfeeding will make my breasts saggy”

Fact: Breastfeeding doesn’t cause your breasts to sag, but the ageing process and losing or putting on weight can all have an effect.

Myth 3: “Infant formula is basically the same as breast milk”

Fact: Infant formula isn’t the same as breast milk. It's not a living product so it doesn’t have the antibodies, living cells, enzymes or hormones that protect your baby from infections and diseases later in life.

Myth 4: “People don’t like women breastfeeding in public”

Fact: Surveys actually show that the majority of people don’t mind women breastfeeding in public at all. The more it’s done, the more normal it will become.

Myth 5: “Breastfeeding is easy for some women, but some don’t produce enough milk”

Fact: Almost all women are physically able to breastfeed. It’s a skill that every woman needs to learn and practise before it becomes easy. It happens more quickly for some women than others, but nearly all women can produce the amount of milk their baby needs.

Myth 6: “If I breastfeed I can’t have a sex life”

Fact: After you've had your baby you'll decide when it's time to have sex with your partner. The same hormone that helps to release your milk for the baby (oxytocin) is also made when you have sex. When having sex you may leak a little breast milk. This is normal.

Changing from bottle to breast

If you’ve already been formula feeding for a few days but you’ve changed your mind and want to breastfeed, speak to your midwife or health visitor as soon as possible for support on how to build up your milk supply.

Clinical reasons for not breastfeeding

Occasionally, there are clinical reasons for not breastfeeding. For example, if you have HIV or, in rare cases, you're taking certain types of medication that may harm your baby. Under these circumstances when there's no alternative, bottle feeding with infant formula will be recommended. If you’re not sure whether you should breastfeed your baby, speak to your midwife or health visitor for information and support. Alternatively, you can find further sources of help in our Breastfeeding - help and support section.

 

Breastfeeding: 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, 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 doctor.

 

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 less 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. The amount of milk you make will increase or decrease depending on how often your baby feeds. In the early days, ‘topping up’ with infant formula can decrease your milk supply.

Feed your baby as often as they want. This is called baby-led feeding (it's also known as 'on-demand'). 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 hormones (prolactin) to build up your milk supply. At night, your baby will be safest sleeping in a cot in the same room as you.

 

The 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, and 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. If your baby seems to fall asleep before the deep swallowing stage check they’re effectively attached.

Sometimes you'll notice your milk flowing in response to your baby crying or when you have a warm bath or shower.

 

Leaking breast milk

Sometimes, breast milk may leak unexpectedly from your nipples. Press your hand gently but firmly on your nipple when this happens. This usually helps very quickly. Wearing breast pads will stop your clothes becoming wet with breast milk.

 

Positioning and attachment

Skin-to-skin contact

All mothers and babies should have the opportunity to have skin-to-skin contact straight after birth. This will keep your baby close, warm and calm, and it will steady their breathing.

This can be a bonding experience for mum and baby. It's also a great time to start your first breastfeed because your baby will be alert and keen to feed. If you need any help, your midwife will offer support with positioning and attachment.

Your baby will be happier if you keep them near you and feed them whenever they’re hungry. This will remind your body to produce plenty of milk.

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.

Skin-to-skin after a caesarean

If your baby is born by caesarean section, you should still be able to have skin-to-skin contact with your baby straight after the birth. Some births involve complications that mean skin-to-skin may be delayed. If this happens, it doesn’t mean that you won’t be able to breastfeed your baby. Your midwife will help you have skin-to-skin contact with your baby as soon as it's possible.

Premature and ill babies

If your baby is in a neonatal unit in hospital after the birth, you'll probably be encouraged to try Kangaroo Care. This means that when your baby is ready, you can hold your baby against your skin regularly, usually under your clothes.

This skin-to-skin contact helps you to bond with your premature baby, and it increases your milk supply.

How to breastfeed

Breastfeeding is a skill that needs to be learnt, and it can take time and practice to get the hang of it. There are lots of different positions for breastfeeding. You just need to check the following points.

• Are you comfortable? It’s worth getting comfortable before a feed. Remember when you feed to relax your shoulders and arms. 
• Are your baby’s head and body in a straight line? If not, your baby might not be able to swallow easily.
• Are you holding your baby close to you, facing your breast? Support their neck, shoulders and back. They should be able to tilt their head back and swallow easily, and shouldn’t have to reach out to feed.
• Is your baby’s nose opposite your nipple? Your baby needs to get a big mouthful of breast from beneath the nipple. Placing your baby with their nose level with your nipple will allow them to reach up and attach to the breast well.

How to attach your baby to your breast

1. Hold your baby close to you with their nose level with the nipple.
2. Wait until your baby opens their mouth really wide with the tongue down. You can encourage them to do this by gently stroking their top lip.
3. Bring your baby on to your breast.
4. Your baby will tilt their head back and come to your breast chin first. They should take a large mouthful of breast. Your nipple should go towards the roof of their mouth.

How to know that your baby is getting enough milk

• Your baby will appear content and satisfied after most feeds.
• They should be healthy and gaining weight after the first two weeks.
• Your breasts and nipples should not be sore.
• After the first few days, your baby should have at least six wet nappies a day.
• After the first few days they should also pass at least two yellow stools every day.

If breastfeeding feels a bit awkward at first, don’t worry. You and your baby may just need a little more practice. Breastfeeding is a skill that you and your baby learn together, and it can take time to get used to.

 

Breastfeeding problems

What can I do about sore and painful nipples when breastfeeding?

It can be hard to ask for help, but tackling breastfeeding problems quickly will give you more time to enjoy your baby's early days. In many cases, the solution is as simple as changing your baby’s position or feeding them more often.

If your baby is unsettled

If your baby is unsettled at the breast and doesn’t seem satisfied by feeds, it may be that they’re not attached to the breast correctly.

Sore or cracked nipples

If your nipples hurt, take your baby off the breast and start again. To do this you can slide a finger gently into the corner of the baby’s mouth until their tongue releases. Putting up with the pain could make things worse. If the pain continues or your nipples start to crack or bleed, ask a breastfeeding supporter to help you get your baby attached effectively. Pain is not normal, so ask for help and support.

The following may help:

• Squeeze out a drop or two of your milk at the end of a feed and gently rub it into your skin.
• Let your nipples dry before getting dressed again.
• Change your breast pads at each feed (if possible use pads without a plastic backing).
• Don't use soap, as it dries out your skin.
• Wear a cotton bra so that air can circulate.
• Treat any cracks or bleeding with a thin smear of white soft paraffin or purified lanolin. Put the ointment on the crack (not the whole nipple) to help it heal and prevent a scab forming.
• There's no need to stop feeding. With skilled help you should find that breastfeeding quickly becomes more comfortable again. 

Sore breasts, blocked ducts, and mastitis

An over-supply of milk can build up in your breasts for a variety of reasons. If your baby is not well attached it may be hard for them to take your milk effectively, and some parts of your breast may not be drained during a feed. This is the area of your breast that may feel sore or painful. It is worth checking to see if this is a possible cause so that you can prevent it from happening again. If you’re not sure, ask for help. Other common causes include wearing a bra that's too tight, a knock or blow to the breast, and missing a feed.

It’s important to deal with a sore breast or a blocked duct as soon as possible so that it doesn’t lead to mastitis (inflammation of the breast).

If you have mastitis you're likely to have at least two of the following symptoms:

• breast or breasts that feels hot and tender
• a red patch of skin that's painful to touch
• general feeling of illness, as if you have flu
• feeling achy, tired and tearful
• you may have an increased temperature

This can happen very suddenly and can get worse very quickly. It's important to carry on breastfeeding as this helps to speed up your recovery. If you think you might have a blocked duct or mastitis, try the following: 

• Check and improve the attachment of your baby at the breast – ask your midwife or doctor.
• Feed your baby more often.
• Let your baby feed on the tender breast first.
• If your breasts still feel full after a feed or your baby can’t feed, hand express some milk to relieve the fullness.
• Warmth on your breast before a feed can help the milk to flow and make you feel more comfortable. Try warm flannels or a bath or shower.
• While your baby is feeding, gently stroke the lumpy or tender area towards your nipple with your fingertips. This should help the milk to flow.
• Get as much rest as possible. Go to bed if you can.
• If you can, take a painkiller such as paracetamol or ibuprofen.

Mastitis may also be a sign of infection. If there's no improvement within 12 to 24 hours, or you start to feel worse, contact your doctor. If necessary, they can prescribe antibiotics that can be taken while breastfeeding.

Stopping breastfeeding will make your symptoms worse, so ask for help and support early.

Thrush

If you suddenly get sore, pink nipples after you’ve been feeding without problems for a while, you may have an infection known as thrush. Make an appointment with your doctor.

You and your baby will need treatment. You can easily give thrush to each other, so if your baby has it in their mouth you will still need some cream for your nipples or an oral thrush tablet to stop it spreading to you. You many want to ask your pharmacist for information. Some anti-fungal creams can be bought over-the-counter from a pharmacy.

Seek further information and help from your doctor if your baby continues to have symptoms.

Tongue-tie

 

Some babies are born with a tight piece of skin between the underside of their tongue and the floor of their mouth. This is known as tongue-tie and it can affect feeding by making it hard for your baby to attach effectively at your breast.

Tongue-tie is easily treated. If you have any concerns, talk to your doctor.

Common breastfeeding questions

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

If your baby doesn’t have a feed in the first hour, try skin-to-skin again, putting them to your breast as soon as possible so that they're not left without a feed in the first six hours.

Why is baby-led feeding so important?

A newborn baby’s stomach is only the size of a walnut, therefore they will need to feed ‘little and often’. This is why baby-led feeding, or ‘on-demand feeding’ is so important. Your baby can have a good feed and be hungry again quite quickly. Babies go through patterns of feeding more and less as they grow. Letting them feed when they need to will ensure that they're content and getting the milk they need, when they need it.

How long should each feed last?

Every baby is different. Some babies want frequent short feeds, and others prefer feeding for longer. Let your baby finish the first breast, then offer the second.

Can I still breastfeed if I have more than one baby?

Twins, triplets and other multiples can be breastfed. Because multiple babies are more likely to be born prematurely and have a low birth weight, breast milk is especially important for their wellbeing. When you start breastfeeding you may find it easier to feed each of your babies separately until feeding is well established and you feel confident about handling them at the same time. This may take a few weeks.

It can be really helpful to talk to other mothers who have breastfed twins, either at an antenatal session or meeting at a twins group in your area. Triplets can be breastfed either two together and then one after, or all three rotated at each feed.

Can I breastfeed after a caesarean?

Yes, you can. Make sure you get a skin-to-skin cuddle with your baby as soon as you're able to. Your midwife may help you have a skin-to-skin cuddle in theatre, or in the recovery room. If you keep your baby close to you and maintain lots of skin-to-skin contact, you’ll be able to put them to the breast often, and this will stimulate your milk supply.

Breastfeeding counsellor Ruthie suggests that “after a caesarean you might find that the ‘rugby hold’ [baby’s body is around to the side of your body supported by the arm on the same side] is preferable to having the baby lying on your stomach”. Ask your midwife for pain relief before you're likely to feed your baby so that you can feed comfortably.

If you have a planned caesarean, talk to your doctor about expressing some breast milk before you have the baby. This can be available for use afterwards if necessary, either by cup or by syringe.

How long should I breastfeed for?

Exclusive breastfeeding (with no other food or drink) is recommended for around the first six months of a baby's life. After this, breastfeed alongside other foods for as long as you and your baby wish. This might be into their second year or beyond.

Every day you breastfeed makes a difference to you and your baby. There’s no need to decide at the beginning how long you'll breastfeed for. Many mothers continue to breastfeed when they return to work or college.

How do I know if my baby's getting enough milk?

All mums want to know that their baby is feeding well. When you first start breastfeeding, you may wonder if your baby is getting enough milk. There are clear signs that you can look out for. 

Signs that your baby is feeding well:

• Your baby has a large mouthful of breast.
• Your baby's chin is touching your breast.
• It doesn't hurt you to feed (although the first few sucks may feel strong).
• If you can see the dark skin around your nipple, you should see more dark skin above your baby's top lip than below their bottom lip.
• Your baby's cheeks stay rounded during sucking.
• Your baby takes rhythmic, long sucks and swallows. It's normal for them to pause sometimes.
• Your baby finishes the feed and comes off the breast on their own.

Signs that your baby is getting enough milk:

• Your baby will appear content and satisfied after most feeds.
• They should be gaining weight after the first two weeks.
• Your breasts and nipples should not be sore.
• In the first 48 hours, your baby is likely to have only two or three wet nappies.
• From day five onwards, wet nappies should start to become more frequent, with at least six wet nappies every 24 hours.
• They should appear healthy and alert when they're awake.  

Breastfeeding help and support

If you have any questions or concerns about breastfeeding, a lot of help and support is available.

• You can ask a friend or family member who has breastfed.
• Ask your doctor.
• You can look at reliable web based resources.
• You can join a local support group.  

One-to-one support

 

Life with a new baby is often full of surprises and most people have questions or concerns. Midwives and doctors are there to help you. They can give you lots of information and support just when you need it.

Breastfeeding drop-ins, cafes and centres

These are all great places to make new friends and share the ups and downs of looking after a new baby. You'll generally meet a mix of other mums who are just starting to breastfeed, and volunteers who have breastfed their own babies in the past and have had training in breastfeeding support.

 

Dads and partners

 

As a dad you might feel that there isn’t much you can do to help your partner with breastfeeding. But a dad or partner’s role can be vital and make all the difference.

Women are much more likely to breastfeed for longer when they have their partner’s support. This leads to a greater sense of achievement for mum, and health benefits for both mum and baby. It can be a bonding experience for the whole family.

Practical ways partners can help

Go to antenatal or breastfeeding sessions. Some sessions are organised especially for dads. Learning the same information as your partner and discussing it together can be really helpful, especially in the early days when everything is very new and sometimes feels overwhelming.

Give emotional and practical support. It can be a really hard time in the early days when babies and children take up all of your energy. But it doesn’t last forever. Try to make time for each other when you can. Do little things to make each other feel cared for and included.

Arrange paternity leave. Talk to your employer about paternity leave early on so that you can plan how this best suits your family needs.
Make her life easier. It's the little things that make a big difference. For example, bring her dinner if the baby wants to feed at the same time; bring her a cup of tea and a magazine; or even arrange for family or friends to keep her company while you’re at work.

Provide some stress-relief. If you already have young children, take the stress away from mum by keeping them entertained while she feeds the baby. Do your bit around the house, and give your partner some time to relax and regain her energy.

Get involved in your baby’s care. Giving your baby their bath, changing nappies and being part of getting ready for bed are great ways of becoming close to your baby.

After a few weeks, if your partner begins to express her breast milk, you could give your baby a bottle of breast milk. Not all babies are keen to bottle feed; some prefer only to breastfeed. Very soon, at around six months, your baby will be ready to try solid foods, and you can enjoy this exciting time with them.

Breastfeeding when you're out and about

Breastfeeding in public can mean breastfeeding in front of a relative or friend in your own home, or in a public place, such as a cafe or shopping centre.

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:

Plan ahead. 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.

 

Expressing and storing your breast milk

 

Expressing breast milk

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. You may want to express milk if your breasts feel uncomfortably full or if your baby isn’t sucking well but you still want to give them breast milk. You may also want to express some 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. This shouldn’t hurt (don't squeeze the nipple directly as you’ll make it sore and unable to express).

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.

Cup feeding

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 you're planning to express your breast milk, you’ll need to use a sterilised container to put the breast milk in. You can then store your milk:

• 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

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. Never re-freeze it after you have thawed it.

If your baby is in hospital

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

Healthy lifestyle and breastfeeding

Breastfeeding and diet

You don’t need to eat anything special while you’re breastfeeding but it is a good idea for you, just like everyone else, to eat a healthy diet.

A healthy diet includes the following:

·         At least five portions of a variety of fruit and vegetables a day (including fresh, frozen, tinned and dried fruit and vegetables, and 100% unsweetened juice).

• Starchy foods, such as wholemeal bread, pasta, rice and potatoes.
• Plenty of fibre from wholemeal bread and pasta, breakfast cereals, rice, pulses (such as beans and lentils), and fruit and vegetables. After childbirth, some women have bowel problems and constipation. Fibre helps with both of these.
• Protein, such as lean meat and chicken, fish, eggs and pulses. At least two portions of fish a week is recommended, including some oily fish.
• Dairy foods, such as milk, cheese and yoghurt. These contain calcium and are a source of protein. For more detailed advice, see A balanced diet.
• Drinking plenty of fluids. Have a drink beside you when you settle down to breastfeed. Water, milk and 100% unsweetened fruit juices are all good choices.

Vitamin D supplement

While breastfeeding, it's recommended that you take supplements containing 10 micrograms (mcg) of vitamin D each day. You can get all the other vitamins and minerals you need by eating a varied and balanced diet.

Healthy snack ideas

The following snacks are quick and simple to make, and will give you energy and strength:

• fresh fruit
• sandwiches filled with salad, grated cheese, mashed salmon or cold meat 
• yoghurts and fromage frais
• hummus with bread or vegetable sticks
• ready-to-eat apricots, figs or prunes
• vegetable and bean soups
• fortified unsweetened breakfast cereals, muesli and other wholegrain cereals with milk
• milky drinks or 100% unsweetened fruit juices
• baked beans on toast or a baked potato

Foods to avoid

Eating fish is good for your health, but don't have more than two portions of oily fish a week. Oily fish includes fresh tuna (not canned tuna, because the good fats are lost in the canning process), mackerel, sardines and trout.

There's a limit for oily fish for women because oily fish can contain low levels of pollutants, which can build up in the body and affect the development of a future baby.

The general advice for all adults is to avoid eating more than one portion of shark, swordfish or marlin a week because of the mercury contained in these fish. Avoid these fish altogether during pregnancy or if you’re trying to get pregnant.

Small amounts of what you're eating and drinking can pass to your baby through your breast milk. If you think a food that you’re eating is affecting your baby and they're unsettled, talk to your doctor.

Caffeine

Drinks containing caffeine can affect your baby and may keep them awake. While your baby is young, drink caffeinated drinks occasionally rather than every day.

Caffeine occurs naturally in many foods and drinks, including coffee, tea and chocolate. It’s also added to some soft drinks and energy drinks, and to some cold and flu remedies.

It's important not to have too much caffeine. Try decaffeinated tea and coffee, herbal teas, 100% fruit juice or mineral water. Limit your intake of energy drinks, which may be high in caffeine.

Peanuts

If you'd like to eat peanuts or foods containing peanuts (such as peanut butter) while breastfeeding, you can choose to do so as part of a healthy balanced diet. Don't eat them if you're allergic to them. Ask your health professional for more information.

There's no clear evidence that eating peanuts while breastfeeding affects your baby’s chances of developing a peanut allergy. If you have any questions or concerns, discuss them with your doctor.

Alcohol

Alcohol passes through to breastfed babies in very small amounts. It’s unlikely that having an occasional drink will harm you or your baby, but it might affect how easily your baby feeds. So when breastfeeding, it's probably sensible to drink very little. For example, no more than 1 or 2 units once or twice a week.

If you intend to drink more than this on a special occasion, you might want to think about expressing milk in advance for your babysitter.

It's not safe to get drunk when you’re caring for a baby, whether they're breastfed or bottle fed. And when you’ve been drinking a fair amount of alcohol, never share a bed or sofa with your baby. If you sleep heavily, you could put your baby at risk.

One unit of alcohol is approximately a single (25ml) measure of spirits, half a pint of beer or half a standard (175ml) glass of wine, although it depends on the strength of the drink.

Breastfeeding and smoking

If you smoke while breastfeeding, your baby will be exposed to nicotine through your breast milk.

But breastfeeding will still protect your baby from infections and provide nutrients that they can’t get from infant formula. So don't stop breastfeeding if you're finding it hard to quit smoking. You can use nicotine replacement therapy (NRT) while breastfeeding.

Don't smoke in the home or car. Ask your partner, friends and family not to smoke when they’re around your baby.

If you or your partner smoke, never share the sofa or bed with your baby.

 

Breastfeeding and medicines

Many illnesses, including depression, can be treated while you’re breastfeeding without harming your baby. However, small amounts of any drug you take will pass through your breast milk to your baby, so always tell your doctor, dentist or pharmacist that you’re breastfeeding.

What medicines can I take while I’m breastfeeding?

Medicines that can be taken while breastfeeding include:

• most antibiotics
• common painkillers, such as paracetamol and ibuprofen (but not aspirin)
• hay fever medicines, such as Clarityn and Zirtek
• cough medicines (simple linctus or honey and lemon in hot water)
• asthma inhalers
• normal doses of vitamins

You can use some methods of contraception and some cold remedies, but not all. Always check with your doctor who can advise you.

It’s fine to have dental treatments, local anaesthetics, injections (including MMR, tetanus and flu injections) and most operations. You can also dye, perm or straighten your hair, use fake tan and wear false nails.

Is there anything I can't take while I’m breastfeeding?

Common drugs that are not advised include:

• aspirin
• codeine
• phenylephrine
• guaifenesin

Breastfeeding a premature baby

If your baby is born prematurely, breast milk will help their vulnerable tummy to mature and fight infection. Breast milk is easier for their stomachs to digest than infant formula. It also contains hormones and growth factors that help your baby grow and become stronger. 

 

Skin-to-skin contact

As soon as possible, you’ll be encouraged to spend time holding your baby against your skin. This is called Kangaroo Care. Your baby will be dressed just in a nappy, and then placed inside your top or blouse so that they can be held securely against your skin.

This skin-to-skin contact helps you feel close to your baby, and feel more confident with them. Your partner can enjoy skin-to-skin contact as well.

 

How to breastfeed a premature baby

If your baby is born early, it's even more important that you're supported to breastfeed. Even if you and/or your baby aren't well enough to breastfeed directly from the breast, spending as much time as possible close together helps to promote breastfeeding and boost breast milk production. Every feed that your baby consumes is valuable; some people call it ‘liquid gold’. Even if your baby is not ready to feed, you'll need to express your breast milk in order to build up your supply

Expressing milk if your baby is premature

If your baby is premature and in a neonatal unit, the hospitals will usually be able to lend you a hospital-grade electric breast pump for expressing your milk. If they can't lend you one, you can also hire one.

It's recommended that you express eight to 10 times a day, including at least once at night, to keep your milk supply up.

The staff in your neonatal unit, your midwife can advise you on how to increase your milk supply, how to encourage your milk flow, and how to use the breast pump. Always ask for help if you have any concerns or questions.

 

Other milks

The doctor may suggest that your newborn needs milk other than your own. In some hospitals, supplements are sometimes introduced if it's difficult for you to produce enough breast milk for your baby, particularly if you’ve been unwell or had to wait a while before starting to express.

Fortifiers, which contain a mixture of minerals, vitamins and protein, are sometimes used in some hospitals.

 

Moving on to breastfeeding

While holding your baby, you may notice them try to move towards your breast. Gradually, as they develop and get stronger, they will be able to breastfeed directly.

The first time you try it, the hospital staff may ask you to express first, then put your baby to your breast so that they’re not overwhelmed by the milk and become tired too quickly. At first, your baby may only lick the breast, then next time take a few sucks until they're confident feeders. This process will encourage their sucking reflex and help them get used to the new way of feeding.

Breastfeeding and going back to work

Breastfeeding exclusively (giving your baby no other food or drink) is recommended for around the first six months. After that time, breastfeeding is recommended alongside solid food. Therefore it's likely that you'll be breastfeeding when you return to work or college.

The following information may help you. There are several options. You can: 

• Arrange for childcare close to work or college so that you can breastfeed during breaks, or before and after work. The evening feed can be a wonderful way for you to relax with your baby after work or college.
• Express breast milk (taking milk from the breast by hand or using a pump) so that someone else can feed your baby while you're at work.
• Ask your employer or college for flexible working hours that are arranged around your breastfeeding needs.
• Combine breastfeeding and bottle feeding to fit around your hours.

 

Think about it early. 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.

Useful ideas

• Label and date expressed breast milk before putting it in the fridge or freezer so that your childminder knows which one to use first.
• Have a trial run with childcare before returning to work.
• If you're using milk within five days of expressing it, it's better to store it in the fridge than in the freezer. This means milk expressed at work on Thursdays can be taken home and stored in your fridge to be used on Sundays.