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C O P Y

Client Publ ic Heal th England Date 11.04.2017

Project Start4Li fe BFF Master Copy Author Lauren Rogers

Job Number 781229395-001 Version 001

Build

Build – in Blocks

Welcome1

Hi {{fb_first_name}}, I’m your Start4Life BreastFeeding Friend – but you can call me your BFF. I’m

not a real person but lots of real people have provided the information that I use to answer your

questions. ☺

First of all, congratulations for choosing to breastfeed...🎉 There are many benefits for you and

your baby...

So, as your BFF, I can help with common questions and teach you about breastfeeding topics, but

and I can also send you regular tips, would you like that {{fb_first_name}}? Answers to your

questions are automated, like a robot, so call me ‘bot’.

If after talking to ‘bot’ you need to speak to a ‘real person’ please call your midwife or health visitor

or the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm, 7 days a week)

Yes please Maybe later

Default

Sorry {{fb_first_name}}, I didn’t quite get that. I’m just a bot, after all. 🤖

1

I’m afraid I’m not the best with long phrases, or single words, but I can understand short phrases

like “Baby getting enough milk” or “Enough milk”.

We can also try looking at list of common questions, breastfeeding topics or the settings and

shortcuts info.

Common questions

Breastfeeding topics

Settings & shortcuts

Miscellaneous

Welcome2 (yes please)

Great! Remember you can type SETTINGS anytime to unsubscribe.

If you need extra advice, or have any worries at all, visit the Start4Life website, and don’t forget you

can talk to a human via the National Breastfeeding Helpline*, or chat to your midwife or health

visitor. Remember, when it comes to taking care of your baby, there are no silly questions.

Start4Life website

Call Helpline

* 9.30am to 9.30pm, 7 days a week. To find out what your helpline call will cost, type the number

into Ofcom’s number checker tool.

Call costs guide

Breastfeeding is something you and your baby have to learn together so it's quite natural to have

lots of questions. 🤔

Do you need help with one of these common questions? Scroll to the right to see more options. ➡

2

https://www.ofcom.org.uk/phones-telecoms-and-internet/advice-for-consumers/costs-and-billing/how-much-does-a-phone-call-really-cost

https://www.nhs.uk/start4life

Remember you can type HELP anytime and I’ll bring these up again.

Latching

on Attaching

baby on the

breast

Enough

milk?

Expressing

milk

Painful

breasts

Crying

and

colic

Drugs &

Breastmilk

Baby’s

weight

Introducing

a bottle

Something

else

Welcome2 (maybe later)

No problem. Remember you can type SETTINGS anytime to subscribe for breastfeeding tips.

If you need extra advice, or have any worries at all, visit the Start4Life website, and don’t forget you

can talk to a human via the National Breastfeeding Helpline*, or chat to your midwife or health

visitor. Remember, when it comes to taking care of your baby, there are no silly questions.

Start4Life website

Call Helpline



Call costs guide

Breastfeeding is something you and your baby have to learn together so it's quite natural to have

lots of questions. 🤔


3



Remember you can type HELP anytime and I’ll bring these up again.

Latching on

Attachin

g baby

on the

breast

Enough

milk?

Expressing

milk

Painful

breasts

Crying

and

colic

Drugs &

Breastmilk

Baby’s

weight

Introducing

a bottle

Something

else

Settings (router)

Remember you can use these shortcuts anytime:

• HELP for the list of common questions.

• TOPICS for the menu of breastfeeding topics.

• CALL for extra advice information and talking to someone.

• SETTINGS for managing your subscription to breastfeeding tips, and a reminder of

shortcuts.

Settings (subscribed)

You are subscribed to receive breastfeeding tips.

Select 'Unsubscribe' to stop receiving breastfeeding tips.

Unsubscribe Never mind

Confirmed (unsubscribe)

Done. You are now unsubscribed for breastfeeding tips.

Is there anything else you would like to do?

No thanks Common questions Breastfeeding topics

4

Confirmed (never mind)

Okay. Is there anything else you would like to do?


Settings (not subscribed)

You are not currently subscribed to receive breastfeeding tips.

Select 'Subscribe' to start receiving breastfeeding tips.

Subscribe Not right now

Confirmed (subscribe)

Done. You are now subscribed for breastfeeding tips.

Is there anything else you would like to do?


Confirmed (not right now)

Got it. Is there anything else you would like to do?


Small talk (hello)

Oh, hello {{fb_first_name}}.

Is there anything I can help you with?

Common questions Breastfeeding topics No thanks

Small talk (goodbye)

Bye! 👋

5

Small talk (no thanks)

No problem. 😊

Remember you can use these shortcuts anytime:

• HELP for the list of common questions.

• TOPICS for the menu of breastfeeding topics.

• CALL for extra advice information and talking to someone.

• SETTINGS for managing your subscription to breastfeeding tips, and a reminder of

shortcuts.

Helpline

No problem. Like I say, I’m just a bot, but there are real-live humans out there who’d be more than

happy to help Call any of these if you have any queries or concerns…

National Breastfeeding Helpline – 0300 100 0212* (9.30am to 9.30pm, 7 days a week)

Call Helpline

Start4Life – 0300 123 1021* (9am to 8pm, 7 days a week)

Call Start4Life

Association of Breastfeeding Mothers – 0300 330 5453*

Call abm

La Leche League – 0345 120 2918*

Call La Leche League

National Childbirth Trust (NCT) – 0300 330 0700*

Call NCT

6

* To find out what your helpline call will cost, type the number into Ofcom’s number checker tool.

Call costs guide

Breastfeeding Video

Breastfeeding videos

Watch new mums talk about their breastfeeding experiences and share tipsideas.

Watch videos

Small talk (thank you)

You're welcome {{fb_first_name}}. 😊

Remember, if you ever need a BFF, I’m always here to help.

End of conversation

I’m all set (router)

*no copy*

I’m all set (subscribe)

Great, glad I could help. 👍

Remember, if you ever need a BFF, I’m always here.

In the meantime, I can also send you regular breastfeeding tips, would you like that

{{fb_first_name}}?

Yes please Not right now

I’m all set (feedback)

7

https://www.nhs.uk/start4life/breastfeeding-videos

Great, glad I could help. 👍

Remember, if you ever need a BFF, I’m always here.

And if you have something to tell us or would like to rate us, we would love you to do so by tapping

Manage on the top right and use the option for sending feedback.

Back to 2.1

Don’t worry, I’m here to help. These are your previously selected options, or you can scroll up. ⬆

Back to 'General breastfeeding guides'

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Back to 'Breastfeeding topics'

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Back to 2.4


Back to 'Looking after my baby's well-being'

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8


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9

Back to 3.1.3


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10

Back to 'Building confidence'

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11

Back to 'Dealing with’overcoming difficulties'the challenges

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12


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13

Back to 3.4.1


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14

Back to 'Whether things can affect my milk'

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1Conversation mode

1.1 Common questions

Ok. If you need extra adviceinformation, or have any worries at all, visit the Start4Life website, and

don’t forget you can talk to a human via the National Breastfeeding Helpline*, or chat to your

midwife or health visitor. Remember, when it comes to taking care of your baby, there are no silly

questions.

Start4Life website

Call Helpline



Call costs guide


Latching on Enough Expressing Painful Crying Drugs & Baby’s Introducing Something

15



Attachin

g baby

on the

breast

milk? milk breasts and

colic

Breastmilk weight a cup or

bottle

else

1.1.1 Painful breasts

OK, here's all the info I have on that – hopefully it's what you're looking for.

Sore nipples

Show me

Engorged breasts

Show me

1.1.2 Baby’s weight


Your baby's weight

Show me

Topping up with EBM/formula

Show me

1.2 Breastfeeding topics

OK. There’s a lot of info out there on breastfeeding, so let’s see if we can narrow it down for you.

Which topic would you like to look into?

Remember you can type TOPICS anytime and I’ll bring these up again for you.

16

General breastfeeding guides

Show me

Dealing withOvercoming difficultiesthe challenges

Show me

Looking after my well-being

Show me

Looking after my baby's well-being

Show me

Benefits of breastfeeding

Show me

Watch breastfeeding videos

Show me

2 Breastfeeding topics

2.1 General b/f guides

Lots’ of women around the world will be getting the hang of breastfeeding today just like you

Breastfeeding’s a tricky business and– most mums of them need support and a friend to help them

hand to get the hang of it. We’re only human, after all.

Well, I’m not. But you know what I mean.

17


Anyway, how can I help?

I'm new to breastfeeding

Show me

Latching onAttaching baby on the breast

Show me

Understanding my milk supply

Show me

Expressing milk

Show me

Introducing a bottle

Show me

Building confidence

Show me

Call the National Breastfeeding Helpline (9.30am to 9.30pm, 7 days a week)

Call Helpline

Call costs guide

2.2 Dealing w/ difficulties

Breastfeeding a new baby’s never an easy ride, is it? But hopefully I can make things a bit smoother.

18

Francesca Entwistle, 18/04/17,

Should Latching be changed to attached throughout


So what are you having a problem with – your breasts, or your breast milk?

Painful breasts

Show me

Milk supply issues

Show me


Call Helpline

Call costs guide

2.3 My well-being

Taking care of yourself is just as important as taking care of your baby – and luckily I’m here to help

you do both.

So, what are you wondering about?

My diet

Show me

My lifestyle

Show me

What to do if I'm not feeling well

Show me

What to do if I'm feeling down

19


Show me


Call Helpline

Call costs guide

2.4 Baby’s well-being

That little angel can be a big worry sometimes, but I'm sure everything's fine. So, how can I help?

Remember, if I can’t help, don't hesitate to call your midwife, health visitor or the National

Breastfeeding Helpline.

Knowing my baby's feeding well

Show me

Understanding why my baby's crying

Show me

Understanding reflux

Show me

Whether things can affect my milk

Show me


Call Helpline

Call costs guide

20


2.5 Benefits of b/f


The benefits of breastfeeding

Show me

How long to breastfeed for

Show me


3.1.1 New to breastfeeding


Skin-to-skin

Show me

What to expect from your first feed

Show me

Knowing your baby's getting enough milk

Show me

Your baby's weight

Show me

21

Feeding premature babies & twins

Show me

Breastfeeding after a caesarean

Show me

3.1.2 Latching on Attaching baby on the breast


Latching on properlyEffective attachment

Show me

Using aWhat about dummies?y

Show me

3.1.3 My milk supply


Increasing your supply

Show me

Things that can affect your supply

Show me

Breast size & breastfeeding

22

Show me

How to introduce other foods stop breastfeeding

Show me

3.1.4 Expressing milk


How to express milk

Show me

Storing expressed milk

Show me

Feeding with expressed milk

Show me

3.1.5 Intro a cup or bottle

*no copy - N/A - goes straight to 4.1.16*

3.1.6 Building confidence


How your partner can help

Show me

Breastfeeding in public

Show me

23

3.2 Difficulties Overcoming challenges

3.2.1 Painful breasts


Sore nipples

Show me

Engorged breasts

Show me

Leaking milk

Show me

Blocked ducts & mastitis

Show me


Show me

Breastfeeding & thrush

Show me

3.2.2 Understanding m M ilk supply issues


24

Increasing your supply

Show me


Show me

Breast size & breastfeeding

Show me

How to introduce other foods stop breastfeeding

Show me


Show me

3.3 My well-being

3.3.1 My diet


Drinking tea & coffee

Show me

Drinking alcohol

Show me

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Taking vitamin D

Show me

What to eat

Show me

3.3.2 My lifestyle


Smoking & breastfeeding

Show me

Exercise & breastfeeding

Show me

Getting pregnant while breastfeeding

Show me

3.3.3 Not feeling well


Breastfeeding if you're sick

Show me

Taking medication while breastfeeding

Show me

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Show me

3.3.4 Feeling down


The baby blues

Show me

Postnatal depression

Show me


3.4.1 Baby feeding well



Show me

Your baby's weight

Show me


Show me

27

Understanding tongue-tie

Show me

3.4.2 Why my baby’s crying


What crying means

Show me

Understanding colic

Show me

Using a dummyWhat about dummies?

Show me

3.4.3 Reflux

*no copy - N/A - goes straight to 4.4.8.*

3.4.4 Things affect my milk



Show me

Drinking alcohol

Show me

28

Peanut allergies

Show me


Show me


Show me


4.1.1 Skin-to-skin

Skin-to-skin

Skin-to-skin is really important. It’s the name given to holding your baby against your skin straight

after birth, and it’ll help keep them calm, warm, and steady their breathing and will help you to

bond with your baby.

And it may well do the same for you too. 💆

Their first hour in the world is also a great time to experience your first breastfeed, as your newborn

will be alert and need a feed. Plus your midwife will be there to help if you need it.

So in those first few days, try to get as much skin-to-skin time as possible. Your baby will always be

happier if you keep them near you, and breastfeeding them whenever they’re hungry will remind

your body to produce plenty of milk.

Is that what you were looking for {{fb_first_name}}, or is there something else I can help you with?

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I’m all set

Go back to menu

4.1.2 What to expect

What to expect from your first feed

When you have your baby in skin to skin they will naturally try to find their way to the breast and

start feeding. Your midwife can help you get into the best potion for you both to enable this to

happen uninterrupted.

{link to meeting baby for the first time video https://www.unicef.org.uk/babyfriendly/baby-

friendly-resources/video/meeting-baby-for-the-first-time/}

The milk you produce in the first few days after birth is a little strange tooamazing. It’s called , in

fact, it isn’t even milk – it’s colostrum, a golden-yellow, highly-concentrated food that your baby will

only need about a teaspoonful of at each feed – it will provide the baby with food and protection..

Because they need so little, they might want to feed quite often, perhaps once an hour to begin

with. It may seem a lot, but after a few days they should start needing fewer, longer feeds, once

your breasts are producing more "mature" milk.

Watch out for your baby’s feeding cues – waking, licking their lips, sucking their fists or fingers, , and

moving their head from side to side and opening their mouth (rooting). Try to respond to their cues

early, before they start to cry and feed them whenever they ask. {link to the attachment video

‘What effective attachment looks like’ https://www.unicef.org.uk/babyfriendly/baby-friendly-

resources/video/what-effective-breastfeeding-looks-like/}

As strange new as it all may seem at first, you’ll soon get used to it. And remember, the more you

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

make to help them grow healthily. 😊

I have more information about your let-down reflex.

30

Show me more Back to menu

How will I know if my milk is coming in?

When you breastfeed, you’ll probably may notice feel a tingling feeling – that’s your milk flowing

down ducts towards your nipples, otherwise known as the let-down reflex. For some mums, it can

be quite strong. For others, it can feel like nothing.

You'll know when your milk lets down, as your baby’s quick sucks will change to deep, rhythmic

gulps. Or they’ll pause for a bit to wait for more milk to be delivered.

SometimesLater on for some mothers, the let-down reflex can be so strong that your baby starts to

splutter, but hopefully our tips on what to do when you have too much breast milk can help. If not,

have a chat with your midwife, health visitor or breastfeeding supporter.

Chat to them if your baby starts falling asleep before the deep swallowing stage too, as they may

not be properly attached to your breast.

However, if your milk lets down when your baby cries, or you have a warm shower, that’s perfectly

normal.


I’m all set

Go back to menu

4.1.3 Enough milk


Lots of mums wonder if their baby’s feeding well and getting enough milk, but if you’re comfortable

while you’re breastfeeding, and your baby seems happy and , has wet and dirty nappies, you’re

probably doing fine.

31

It's very rare that mums don't make enough breast milk for their babies, so it may just take a bit of

time before you feel confident that you are. And generally, your baby will let you know if they’re not

getting what they want, although wet and dirty nappies are also a good indication, as is hearing your

baby swallow.

I have more information on how to tell if your baby is getting enough milk in the first few days.


The best way is to see if they’re back to their birth weight, or above, by 2 weeks (it's normal for

babies to lose some of their birth weight until then).

In their first two weeks though, it’s a bit of messy job, as it all comes down to their toilet habits.

In the first 48 hours, they’re only likely to have 2 or 3 wet nappies. But from day 5 onwards, they

should step it up to at least 6 a day – put the nappy in the palm of your hand it should feel heavy.

And remember, it’s perfectly normal for breastfed babies to pass loose stools. If you need help

telling whether a nappy’s “wet” or not (especially if you use disposables), add 2–4 tablespoons of

water to one, to get an idea of what to look and feel for.

Consistency is a good indicator too. At first, their poo should be black and tar-like. By day 3 it should

be lighter, runnier and greener. And from day 4 until a few weeks in, it should be yellow, and about

at least 2 poos a day, the size of a £2 coin or more.

Sorry to have to have to go into detail like that. 💩

Most babies pass lots of poo and this is a good sign. Remember it’s normal for breastfed babies to

pass loose stools {link to start4Life leaflet graphic of stooling p.g. 17 on old leaflet}

If you need help telling whether a nappy’s “wet” or not (especially if you use disposables), add 2–4

tablespoons of water to one, to get an idea of what to look and feel for.

32

And if you’re still not sure if your baby’s feeding well, just have a quick check to see they're in the

right position using the link below, ring the breastfeeding helpline {insert number} or have a chat

with your midwife or health visitor.

I have more information on other signs that your baby's getting enough milk.


Here are some other signs that your baby’s getting enough milk…

• They start feeding with a few quick sucks, followed by long, rhythmic ones, and swallowing with

occasional pauses

• You can hear and see your baby swallowing

• Your baby's cheeks stay rounded, not hollow, while sucking

• They seem calm during feeds, and content after

• Your baby comes off the breast on their own at the end of a feed

• Their mouth is wet after feeds

• Your breasts feel softer after feeds

• Your nipple looks and feels more or less the same after a feed, not flattened, pinched, or white or

painful

• You sometimes feel sleepy and relaxed after a feed

I have more information on how often to breastfeed.


How often you should breastfeed is another common question, and the truth is it depends on your

baby, but as a rough guide, they should feed at least 8 times every 24 hours during the first few

weeks. Their stomach’s the size of a walnut, so it’s all about little and often, even after a good feed.

33

Helpfully, iIt’s not possible to overfeed or spoil a breastfed baby. So you can feed them if you think

they’re hungry, upset, need comfort, if your breasts feel full, or if you just fancy a cuddle and sit

down with your feet up.

Here are a few of a baby’s typical “feed me” signs…

• Getting restless

• Sucking their fist or fingers

• Making murmuring sounds

• Turning their head and opening their mouth (rooting)

If you see these signs, it’s best to try feeding them before they start crying, as it’s difficult to feed

them after they start. Crying is their final way of telling you they’re hungry, so keep them close and

watch out for the cues.

I have more information on how long each breastfeed should last.


And as for how long each breastfeed should last, again, every baby’s different, so really it’s up to

them. Some want short, frequent feeds, others prefer longer meals – or a mix of the two. If you let

them finish the first breast, then offer the second, they’ll let you know if they’re still hungry.

If you're worried your baby’s feeding all the time though, you may need a bit of help with

positioning and attachment. Just chat to your midwife, health visitor or breastfeeding specialist, or

call the National Breastfeeding Helpline on 0300 100 0212.

{link to responsive feeding video

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/video/breastfeeding-and-

relationships-in-the-early-days/}


I’m all set

34

Back to menu


Your baby's weight

Your baby’s weight all depends on their birth weight, and how long they’ve been out in the world,

as it’s perfectly normal for them to lose some weight in the first few days.

In terms of when your baby will be weighed, usually it starts with a few times in the first couple of

weeks, just to make sure everything’s OK, then becomes less frequent – no more than once a month

up to six months of age, once every two months from 6 to 12 months, and once every three months

after their first birthday. 🎂

Your baby will only be weighed more than this if you ask, or if there are any concerns about their

health or growth.

And finally, a little fact for you – four out of five healthy babies are back to (or above) their birth

weight by 14 days. So give it some time, and if you’re still worried, call the Helpline {add number} or

chat to your midwife or health visitor.


I’m all set

Back to menu

4.1.5 Sick or P p remature & twins babies

Feeding premature babies & twins sick and premature babies

If your baby is born sick or premature, breastmilk can help them get better. It is important to get

breastfeeding going as soon as possible – ideally start to express your breast milk within the first

35

couple of hours after birth – ask your midwife or neonatal nurse for help {link to hand expression

video https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/video/hand-expression/}

Obviously, premature babies need a bit more protection than those who hit their due date, but

that’s where breast milk’s benefits come into their own…

It protects your newborn from infections, particularly stomach problems, which premature babies

can be more prone to.

It contains specific proteins, hormones and nutrients that help them grow and develop.

And it’s easier for their little stomachs to digest than formula milk, as your body creates it specially

for them.

Expressing in the early days is often easier by hand, and helpfully, your midwife or breastfeeding

supporter can show you how. Collect it in a small sterile cup, then store it in a syringe for easier

feeding.

Don’t worry if you only produce a few drops at first – when you hand express regularly, you’ll start

making more. And don’t forget, no matter how much milk you express, every single drop is

beneficial to your baby. Expressing 8–10 times a day is recommended, including at least once at

night.

Once you’re producing more milk, you could try moving onto a breast pump. If your baby’s in a

neonatal unit, the hospital will usually be able to lend you an electric pump, and show you how to

use it, or you can hire one.

Then eventually, once you’re both ready, you’ll be able to start breastfeeding. 😊

Breast milk is the best milk your baby can get so keep going – you’re doing a

great job to help them grow and get better. {Insert emoji smiley face}

If your baby’s premature, but you’re both able to breastfeed, then go for it. Whether they’re born

early or not, breast milk will benefit their health as well as your own.

Breastfeeding twins

36

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/video/hand-expression/

And as for breastfeeding twins – even triplets isn’t a problem. Breastfeeding’s actually a great way

to soothe your babies, and build a strong bond between you all. Some mums feed both at the same

time, but you may prefer one after the other, or simply whenever one gets hungry.

If you’d like a bit of extra advice information on this topic, take a look at Tamba’s website or LLL

Breastfeeding twins http://www.lalecheleague.org/faq/twins.html.

Visit Tamba website

Obviously, premature babies need a bit more protection than those who hit their due date, but

that’s where breast milk’s benefits come into their own…

It protects your newborn from infections, particularly stomach problems, which premature babies

can be more prone to.

It contains specific proteins, hormones and nutrients that help them grow and develop.

And it’s easier for their little stomachs to digest than formula milk, as your body creates it specially

for them.

Sometimes your baby might be too small or sick to breastfeed. So instead, start expressing breast

milk soon after they're born, to get your supply going. Expressing 8–10 times a day is recommended,

including at least once at night. 🌝

I have more information on expressing milk for a premature baby.


Expressing in the early days is often easier by hand, and helpfully, your midwife or breastfeeding

supporter can show you how. Collect it in a small sterile cup, then store it in a syringe for easier

feeding.

37

https://www.tamba.org.uk/

Don’t worry if you only produce a few drops at first – when you hand express regularly, you’ll start

making more. And don’t forget, no matter how much milk you express, every single drop is

beneficial to your baby.

Once you’re producing more milk, you could try moving onto a breast pump. If your baby’s in a

neonatal unit, the hospital will usually be able to lend you an electric pump, and show you how to

use it, or you can hire one.

Then eventually, once you’re both ready, you’ll be able to start breastfeeding. 😊


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4.1.6 B/f after a caesarean


If you are going to have a planned caesarean section, it might be helpful to express some breast milk

for the baby and keep it in the fridge in case the baby needs it – ask your midwife for help {link to

hand expression video}.

After the birth of your baby ask your midwife to help you have However your baby was delivered,

breastfeeding is always recommended, so make sure you get a skin-to-skin cuddle with your baby as

soon as you're able to. Ask your midwife to see if you can have one this in theatre, or in the

recovery room {link to meeting baby for the first time video}.

Holding your baby and having lots of skin-to-skin contact will help them get comfortable with being

put to the breast, as well as stimulate your milk supply, so it’s important to do it as often as

possible.

As for positioning, some mums who’ve had a caesariancaesarean find the "rugby hold" or lying on

your side – where your baby's body is to the side of yours, supported by your arm – is better than

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having them lie against your stomach while feeding, so you may want to give it a try (see what I did

there? 🏉. Regular pain killers after a caesarean can make it more comfortable for you. But iIf

you’re experiencing any pain, please talk your midwife.


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4.1.7 Latching on properly Attaching effectively


If your baby seems satisfied after a feed, then they’re probably already latching on

properlyattaching well. . But don’t worry if they’re not – bBreastfeeding’s a skill, one that you and

your baby will learn together, and like any skill, it can take a bit of time to get used to. So try not to

put too much pressure on yourself.

If they’re not full after a feed,baby is not happy and content after a feed or you’re finding

breastfeeding painful, these photos may help or watch this video our latching on guide may be able

to help.{link to what effective breastfeeding looks like

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/video/what-effective-

breastfeeding-looks-like/}

See our guide

4.1.7.1 How to b/f

<image1>

1. Hold your baby’s whole body close with his nose

level with your nipple.

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<image2>

2. Let your baby’s head tip back a little so that his top lip can brush against your nipple. This should

help your baby to make a wide open mouth.

<image3>

3. When your baby’s mouth opens wide, his chin is able to touch your breast first, with his head

tipped back so that his tongue can reach as much breast as possible.

<image4>

4. With his chin firmly touching your breast and his nose clear, his mouth is wide open. There will be

much more of the darker skin visible above your baby’s top lip than below his bottom lip. Your

baby’s cheeks will look full and rounded as they feed.

As with all my advice though, If that doesn’t help, or you have any other concerns, remember you

can always talk to your midwife, health visitor or breastfeeding specialist. I promise I won’t be

offended. 😉 {insert breastfeeding helpline number}


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4.1.8 Using a dummy What about dummies?

Using a dummy

It can be tempting to let your little angel one suck on a dummy, especially if they’re being a

particularly loud little angel 👼when they are cring and seem unsettled. But try to resist – babies

who use a dummy before they’ve learnt to breastfeed (usually around 1 month4-6 weeks) can have

trouble remembering how to latch onattach.

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They may also be less likely to feed when they need to, which means they won’t take in as much

milk, which can affect your milk supply and they won’t get all the benefits. So all in all, it’s best to

wait till they’ve got the hang of breastfeeding.


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4.1.9 Increase milk supply

Increasing your breast milk supply

Luckily, your body’s an expert at knowing when to make milk – you just need to get into a rhythm

first.💃 The more you feed, the more you’ll produce, so try to breastfeed as often and as much as

your baby needs.

There are a couple of other things you can do to help build up your supply too. Firstly, try not to top

up with formula milk, or give your baby a dummy – one tells your body to produce less milk, the

other tells your baby to feed less often.

And secondly, make the most of those 2am night feeds. You actually produce more hormones

(prolactin) at night, so breastfeeding then will help keep your supply high.


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4.1.10 Affect Making breast milk supply


Firstly, it’s important to note that your own well-being can have a big impact on your baby’s – so

finding some time to take care of yourself will help you take care of them 💆 And wWhere your milk

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supply’s concerned, there are other factors that can also have an effect. Talking to someone, one to

one, can help you to understand your own milk supply. …

These are common reasons for low milk supply:

• Poor attachment and positioningBaby not attached effectively at the breast

• Not breastfeeding often enough (remember baby will typically feed 8-10 times in 24 hours in the

early days).

Other reasons:

• Drinking alcohol and smoking

• Previous breast surgery, particularly if your nipples have been moved

• Having to be away from your baby after the birth (because they were sick or premature, for

example)

• Illness in you or your baby

• Using formula or a dummy before breastfeeding’s established

• Using nipple shields – although this may be the only way to breastfeed with damaged nipples, and

is better than stopping altogether

• Some medications, including dopamine, ergotamine and pyridoxine

• Anxiety, stress or depression

• Your baby having trouble with tongue-tie

If you’re experiencing any of these and need a way to stimulate your supply, frequent gentle

expression by hand can help. Ask your midwife, health visitor for help or call the national

breastfeeding helpline – {insert number}


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4.1.11 Breast size

Does Bbreast size & breastfeedingmatter?

Whether your breasts are big or small, their size won’t affect your milk at all (did I mention I’m a

part-time poet? 🎵). Everything works on a supply and demand basis, so if your baby needs

foodfeeds, your body will produce itmilk.

If you’ve had implants, you should also be fine to breastfeed, but it does depend on their size and

placement, as well as the type of surgery you had. Some problems can include not being able to

breastfeed, or producing a bit less milk – but your baby certainly won't be harmed if you breastfeed

with implants.

Breast reduction surgery, on the other hand, makes breastfeeding difficult, as it separates the

nipples from the underlying milk ducts, so talk to your GP if you’d like more information.advice. {link

to BfN drugs in breastmilk https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-

in-breastmilk/}


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4.1.12 How to introduce other foods stop

How to reduce/stop breastfeeding and introduce other foods

While it’sIt is recommended that you only give your baby breast milk for their first six months, and

thereafter alongside other foods for that doesn’t mean you should stop after their first six months.

Breastfeeding will still benefit you both, so carry on as long as you and your baby would ’d like

(ideally around 2 years).

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Gradually introduce other foods, while still giving breast milk, will make sure your baby gets all the

nutrients they need. If you are breastfeeding, you don’t need to introduce formula milk. You can

introduce supermarket ‘cow’s milk’ from 1 year old.

If your baby is under 1 year, and you are ready to reduce or stop breastfeeding, maybe you are

going back to work, you might want to express and store your breast milk for your baby when you

are not together the carer can give your breast milk via bottle or cup. {link to returning to work S4L

leaflet}.

Alternatively, you may decide to reduce the amount of breast milk the baby receives and decide not

to express your milk, if the baby is under 6 months you will need to give baby formula feed from a

bottle until they are ready to eat other foods or (if they’re over six months) a formula can be given

via a beaker {link to Start4Life bottle feeding leaflet and Unicef Responsive bottle feeding leaflet.

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/leaflets-and-posters/simple-

formula-guide-for-parents/}

One way to do this is to drop one feed at a time, usually a day time feed, to help prevent your

breasts becoming over full and/or mastitis.

Even if they’re eating solid foods from 6 months, babies still need the nutrients that breast or

formula milk gives them. Cow’s milk isn’t suitable as a main drink for babies under one (although

adding cow’s milk to foods, like mashed potatoes, is fine).

If you are ready to stop, gently phasing out breastfeeding will give you and your baby time to get

used to the idea. It also gives your body time to get used to it, which will help prevent problems like

engorged breasts and mastitis.

I have more information on how to phase outintroducing other foods. breastfeeding.

Show me more Go back to menu

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https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/leaflets-and-posters/simple-formula-guide-for-parents/


An effective way of phasing is to drop one feed at a time, usually a daytime feed. If your baby’s

younger than one, you’ll need to replace it with a formula feed from a bottle or (if they’re over six

months) a beaker. 🍼

If baby is they’re more than one year old though, and enjoying a variety of foods and drinks, they

won’t normally need a replacement milk feed. {link to Start4Life Introducing solids leaflet}

Once you and your baby are settled into a pattern of having one less breastfeed, you can think

about dropping another one – usually after a week or so – and continue that way till they are

weaned off completely. In reality, your baby will guide you. Sometimes baby’s will have periods

when they breastfeed less and then return to more breastfeeds if given the opportunity (e.g. if they

are feeling poorly or tired)


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4.1.13 How to express

How to express milk

If you want to express, you’ve got three expressing options – by hand, with a manual breast pump,

or with an electric pump. No one’s better than the other, so just use whichever method you’re most

comfortable with and works best for you.

However, it is recommended that you wait until your little one’s a little older before regularly

expressing milk – it’ll give them more time to get used to breastfeeding.

When you do start expressing, some mums find it can take a while for their milk to start flowing, so

try to find a time and place that makes you nice and relaxed. Having your baby (or a photo of them)

nearby may also help get things going.

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Oh, another little trick is to try expressing in the morning, when your breasts can sometimes feel

more full. {link to hand expression video

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/video/hand-

expression/}


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4.1.14 Store expressed

Storing expressed breast milk

There are two ways to store breast milk – in a sterilized container, or in special breast milk storage

bags. And depending on where you store it, it’ll last for different lengths of time…

• In the fridge (usually at the back, never in the door), it’ll last for up to five days at 4°C or lower

• In the ice compartment of a fridge, it’ll keep for two weeks

• And in the freezer, it’ll be fine for up to six months

If you choose to freeze it, just make sure you label and date it first so you know how long it’s been in

there. And when you defrost, do it in the fridge and use it straight away.

{link to Off to the Best Start start4life pages on storing breast milk}


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4.1.15 Feed expressed

Feeding with expressed breast milk

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Depending on how you stored your breast milk, there are different ways to use it. If you left it in the

fridge, you can simply feed it straight to your baby (if they’re happy having it cold), or you can warm

it up to body temperature.

To warm it up, just put the bottle in a jug of warm water, or hold it under running warm water.

Never use a microwave to heat up or defrost breast milk, as it can cause hot spots which will burn

your baby's mouth.

If you froze your milk, defrost it slowly in the fridge before giving it to your baby. If you need to use

it right away, you can slowly defrost it using the same methods as before – in a jug of warm water,

or under running warm water.

Once your breast milk’s defrosted, use it immediately – don't re-freeze milk that’s been defrosted.


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4.1.16 Intro a cup/ bottle

Introducing a cup or bottle

Breastfeeding’s a skill – one that can take you and your baby up to 6 weeks to get the hang of. But

once you have, you’ll usually be able to offer bottles of expressed milk (or formula) alongside

breastfeeding. 🍼

Do If you introduce formula milk bear in mind though that introducing a bottleit will probably

reduce the amount of breast milk you make, and teach your baby a different way to suckle (the

methods aren’t the same for breast and bottle) – both of which can make breastfeeding more

difficult, especially in the first few weeks.

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If you're going back to work, start introducing bottles a few weeks beforehand to help your baby

(and your body) adjust. Although if they’re six months old or more, and can already drink milk from

a cup, you may not even need to.

If you choose to introduce formula, combining it with breastfeeding is better for you and your baby

than switching to just using formula (that way you can both keep enjoying the benefits).

It's also best to introduce it gradually, to give your body time to reduce your milk supply, and give

your baby's body time to adjust to getting both breast milk and formula.

{link to maximising breastmilk video https://www.unicef.org.uk/babyfriendly/baby-friendly-

resources/video/maximising-breastmilk/}

Useful information about bottle feeding:

Feed your baby when they show signs of being hungry: look out for

feeding cues before they start to cry.

Hold baby close in semi-upright position so you can see their face and

reassure them by looking in their eyes and talking to them during a feed.

Begin by inviting the baby to open their mouth and take the teat.

Gentle insert the teat into their mouth keeping the bottle only slightly

tipped to prevent the milk flowing too fast

Follow baby’s cues, give them regular breaks so that they can pace their

own feed.

Let them tell you when they’ve had enough, forcing them to finish the

bottle can be distressing and be overfed.

{link to Start4Life bottle feeding leaflet and Unicef

https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2015/10/

simple-formula-guide.pdf}

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If you are using formula milk remember baby only needs ‘first infant milk for the

first year’ and then they can have supermarket milk when they are one year old

(there is no need for follow-on formula).


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4.1.17 Partner help

How your partner can help

Evidence shows that you’re more likely to breastfeed for longer with a partner’s and family support,

and that’s good news for your baby, so try to get them involved. Your partner may not be able to

help with the actual breastfeeding, but they can help in other ways…

(You may want to make sure he/she hears this bit.)

• Attending antenatal or breastfeeding sessions – some sessions are even organised especially for

dadspartners, so ask your midwife or local Children's Centre for more info.

• Giving emotional and practical support – try making time for each other when you can, and do the

little things that make you both feel cared for and included. It can be a good time to plan who are

going to be your ‘breastfeeding support friends’

• Arranging paternity leave – talk to employers about this early on, so you can plan it to best suit

your family’s needs.{insert link to S4L going back to work leaflet}

• Making life easier – for example, bringing mum dinner if the baby wants to feed at the same time,

or arranging for family or friends to keep her company while dad’s her partners at work.

• Making life easier – for example, bringing mum dinner if the baby wants to feed at the same time,

or arranging for family or friends to keep her company while dad’s at work. *DUPE*

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• Doing things around the house – that way, mum can focus on taking care of the baby and getting

breastfeeding off to a good start.

• Providing some stress relief – if you already have young children, keeping them entertained while

mum’s feeding the baby can be a godsend.

• Getting involved in baby care, time for skin to skin contact and – changing nappies, giving them a

bath, and getting them ready for bed are great ways to get close to your baby, and give mum a

break.

• Bottle-feeding your babyGiving expressed breastmilk – after a few weeks, if mum’s mum may

want to able to express her breast milk and your partner , dad can start helping out with feeds, and

experience the bonding for himself.

So as you can see, there are quite a few reasons why getting support from a partner can be a really

good thing. 👫 {insert emoji of same sex couple too}

{link to video

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/video/dads/}


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4.1.18 B/f in public

Breastfeeding in public

At first, many mums prefer to only breastfeed in private, which is fine. But as time goes on and it

becomes an everyday thing, you’ll probably feel more confident about breastfeeding while you’re

out and about.

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And you’re perfectly entitled to do so – whether you’re in a café or on the bus home, in the UK it’s

illegal to ask a breastfeeding woman to leave a public place. So no one should ever make you feel

uncomfortable for doing so.

I have a few tips to help you breastfeed out and about.


• Plan ahead – before you head out, have a think about where you’ll feel comfortable breastfeeding

when your baby gets hungry- a children’s centre or breastfeeding café is a good place to start, or

feed with a breastfeeding friend.

• Work out what to wear – some mums prefer loose tops and a soft, non-underwired bra that are

easy to pull up; others wear two stretchy tops, so one can be lifted while the other keeps their

tummy covered.

• Try a sling or scarf – some slings are designed to let you breastfeed while your baby’s still in them,

or you might like to use a scarf or muslin cloth to cover your chest.

• Avoid the loos – you wouldn't eat in there, so don't feel your baby should either.

Remember, when it comes to where you breastfeed, the law is on your side. 👮

Ultimately, just wear whatever, and go wherever, makes you feel most comfortable, so that you and

your newborn can enjoy your time together.

You don’t need to stop breastfeeding just because you’re going back to work or study. You can get

advice on the different ways to keep giving your baby breast milk as well as tips on talking to your

employer or course provider by reading our guide.

See our guide

Listen to mum’s talking about breastfeeding out and about https://www.nhs.uk/start4life/breastfeeding-

videos

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http://campaignstorage.blob.core.windows.net/start4life/development/uploads/ckeditor/attachments/18/2903771_Breastfeeding_after_returning_to_work_or_study_v2_0_accesible.pdf?sr=b&sp=r&sv=2013-08-15&st=2015-10-15T09%3A28%3A11Z&se=2115-10-15T10%3A38%3A11Z&rscd=inline%3B+filename%3D2903771_Breastfeeding_after_returning_to_work_or_study_v2_0_accesible.pdf&sig=kQSghTRltFgEWWcAdbI7FPow2%2BqQS%2F2IKpg8i9S76hg%3D


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4.2 Difficulties Overcoming challenges

4.2.1 Sore nipples

Sore nipples

It’s normal to feel strong sensations as your baby starts to suck, but if breastfeeding’s painful, that’s

usually a sign they’re not latching on properlythat baby is not attaching effectively. If that’s the case,

our guide may be able to help.

See our guide

Sore nipples normally can sometimes occur about three to seven days intowhen breastfeeding, but

with the right support, it can often be sorted, so do contact your midwife, health visitor or specialist

if you need to.

The best way to prevent sore nipples is to ensure your baby is effectively

attached {link to attachment video}

If your nipples are sore Hhere are a few other tricks you may find useful as well…

• Let your nipples dry before you get dressed again

Ask your midwife, health visitor or breastfeeding support worker to watch a breastfeed, to

see if baby is effectively attached.

• If you use breast pads, change them after each feed

• Don't use soap, as it dries out your skin

• Wear a cotton bra so that air can circulate

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• Treat any cracks or bleeding with a bit of expressed breastmilk or white soft paraffin, such as

Vaseline, this can help with healing


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4.2.2 Overfull and E e ngorged

EFull and engorged breasts

If your breasts feel tight, hard or painful, it’s possible that they’re overfull or engorged, which is a

fancy word for being overly-full..

Engorgement can happen for many reasons, but in the early days it may happen if baby has been

slow to start feeding and your ’s usually due to your milk coming in. , and your baby not feeding as

much as they perhaps need to. Newborns need feeding little and often, so it can take a few days for

your milk supply to match their demand.

If your breasts are painful, ask the midwife for some pain killers, try some warm flannels or take

shower to help your milk to flow. Hand expression may also help to take off some milk and relieve

the pressure so you can attach the baby effectively. The baby will then relieve the engorgement

through breastfeeding.

To help prevent engorgement try to offer your baby the breast whenever he/she asks or when you

feel the need e.g. when baby shows feeding cues, when baby is sad or lonely, when you feel you

want a cuddle, when your breasts feel full, when you want to sit down – you can’t overfeed a

breastfed baby. There is no reason not to breastfeed and responding to you and your babies need

for food and love will help overcome the engorgement and prevent them becoming overfull again.

Even if you’re 6 weeks in and you’ve got positioning and attachment sorted, engorgement can still

happen, especially if your baby hasn't fed for a while. So if it’s becoming a problem – either because

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your baby’s finding it harder to attach to the breast properly, or it’s over-stretching your nipples and

possibly making them painful – talk to your midwife or health visitor.


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4.2.3 Leaking milk

Leaking milk

Leaking breast milk happens to most some mums – often unexpectedly – so if you need a quick fix,

pressing the heel of your hand gently but firmly on your breast should stop it. ✋

Offering your baby a feed (if they haven’t had one recently) can also help, as can hand expressing

.some milk, but only express enough to feel comfortable, so you don't overstimulate your supply.

And don’t forget, breast pads are designed to stop any sneaky leaks getting through to your clothes

– just make sure you change them frequently. to prevent infection.


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4.2.4 Blocked ducts

Blocked ducts & mastitis

If your breast doesn’t drain properly during a feed (perhaps because your baby isn't effectively

attached properly), this can lead to a blocked duct, which may feel like a small, tender lump in your

breast. and mastitis.

Signs of mastitis (you may not have all of them):

Red area on part of the breast

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Lumpy breast, hot to touch

Whole breast aches

Full like symptoms – aching, temperature, shivery, tearful

It's important to deal with aunblock the duct blocked duct quickly as it could lead to mastitis – an

inflammation which can make the breast feel hot and painful, and make you feel very unwell very

quickly with eventually lead to flu-like symptoms.

Ask a midwife, health visitor of breastfeeding support worker to check if baby is effective ely

attached as mastitis starts with poor milk drainage.

Keeping breastfeeding is the quickest way to get better.

One way to do this is to kKeep feeding from the affected breast, to try to relieve the duct. If

possible, position your baby with their chin pointing towards the lump, so they can feed from that

part of your breast. There are a few other things you can try too…

• Wear loose clothes or bras, so your milk can flow freely from every part of your breast

• Use a warm flannel or shower to encourage your flow

• Gently massage the lump towards your nipple while your baby feeds

If none of these help though, please talk to your midwife or health visitor. And if you experience any

mastitis symptomsflu like symptoms, and don’t feel better within 12–24 hours, call your GP or out-

of-hours service as soon as possible, as you may need antibiotics.

{link to BfN Mastitis leaflet http://www.breastfeedingnetwork.org.uk/wp-content/dibm/BFN

%20Mastitis%20feb%2016.pdf}


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4.2.5 Latching on properly Attaching effectively

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If your baby seems satisfied after a feed, then they’re probably already effectively attached.

Breastfeeding’s a skill, one that you and your baby will learn together, and like any skill, it can take a

bit of time to get used to.

If baby is not happy and content after a feed or you’re finding breastfeeding painful, these photos

may help or watch this video may be able to help.{link to what effective breastfeeding looks like

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/video/what-effective-

breastfeeding-looks-like/}

If your baby seems satisfied after a feed, then they’re probably already latching on properly. But

don’t worry if they’re not – breastfeeding’s a skill, one that you and your baby will learn together,

and like any skill, it can take a bit of time to get used to. So try not to put too much pressure on

yourself.

If they’re not full after a feed, or you’re finding breastfeeding painful, our latching on guide may be

able to help.

See our guide

4.2.5.1 How to b/f

<image 1>

1. Hold your baby’s whole body close with his nose level with your nipple.

<image 2>

2. Let your baby’s head tip back a little so that his top lip can brush against your nipple. This

should help your baby to make a wide open mouth.

<image 3>

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3. When your baby’s mouth opens wide, his chin is able to touch your breast first, with his

head tipped back so that his tongue can reach as much breast as possible.

<image 4>

4. With his chin firmly touching your breast and his nose clear, his mouth is wide open. There

will be much more of the darker skin visible above your baby’s top lip than below his

bottom lip. Your baby’s cheeks will look full and rounded as they feed.

As with all my advice information though, If that doesn’t help, or you have any other concerns,

remember you can always talk to your midwife, health visitor or breastfeeding specialist. I promise I

won’t be offended. 😉


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4.2.6 B/f & thrush

Thrush & breastfeeding

Sometimes breastfeeding mums experience breast and nipple pains because of a thrush (candida)

infection in the breast, which can then lead to their babies developing thrush in their mouth.

These infections sometimes happen when your nipples become cracked or damaged, allowing the

candida fungus to get into your nipple or breast. They can also happen when you or your baby have

had antibiotics, as antibiotics reduce the number of helpful bacteria in your body, allowing the

fungus to flourishgrow.

These are some of the signs that you may have thrush…

• You start feeling pain in both nipples or breasts after feeds, having had no pain beforehand

• The pain is quite severe, and lasts for up to an hour after every feed

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• However, if any of the following apply, it's unlikely to be thrush…

• You’ve always experienced pain while breastfeeding

• The pain only affects one nipple or breast

• You have a fever

• There’s a warm, red patch on one of your breasts

If you think you or your baby has a thrush infection, see your health visitor or GP. They’ll be able to

arrange for swabs to be taken from your nipples and your baby's mouth, to see if any thrush is

present. They’ll also make sure other causes of breast pain are ruled out before you start treatment

for thrush.


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4.2.7 Increasing milk supply

Increasing your breast milk supply

Luckily, your body’s an expert at knowing when to make milk – you just need to get into a rhythm

first.💃 The more you feed, the more you’ll produce, so try to breastfeed as often and as much as

your baby needs.

There are a couple of other things you can do to help build up your supply too. Firstly, try not to top

up with formula milk, or give your baby a dummy – one tells your body to produce less milk, the

other tells your baby to feed less often.

And secondly, make the most of those 2am night feeds. You actually produce more hormones

(prolactin) at night, so breastfeeding then will help keep your supply high.


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4.2.8 Affect supply Making breast milk

Making breast milk


Where your milk supply’s concerned, there are factors that can also have an effect. Talking to

someone, one to one, can help you to understand your own milk supply. These are common reasons

for low milk supply:

• Baby not attached effectively at the breast

• Not breastfeeding often enough (remember baby will typically feed 8-10 times in 24 hours in the

early days).

Other reasons:



• Having to be away from your baby after the birth (because they were sick or premature, for

example)






expression by hand can help. Ask your midwife, health visitor for help or call the national

breastfeeding helpline – {insert number}

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Firstly, it’s important to note that your own well-being can have a big impact on your baby’s – so

finding some time to take care of yourself will help you take care of them 💆 And where your milk

supply’s concerned, there are other factors that can also have an effect…

• Poor attachment and positioning

• Not breastfeeding often enough



• Having to be away from your baby after the birth (because they were premature, for example)



• Using nipple shields – although this may be the only way to breastfeed with damaged nipples, and

is better than stopping altogether


• Anxiety, stress or depression



expression by hand can help.


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4.2.9 Breast size

Breast size & breastfeedingDoes breast size matter?

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Whether your breasts are big or small, their size won’t affect your milk at all (did I mention I’m a

part-time poet? 🎵). Everything works on a supply and demand basis, so if your baby needs

foodfeeds, your body will produce itmilk.

If you’ve had implants, you should also be fine to breastfeed, but it does depend on their size and

placement, as well as the type of surgery you had. Some problems can include not being able to

breastfeed, or producing a bit less milk – but your baby certainly won't be harmed if you breastfeed

with implants.

Breast reduction surgery, on the other hand, makes breastfeeding difficult, as it separates the

nipples from the underlying milk ducts, so talk to your GP if you’d like more information. {link to BfN

drugs in breastmilk https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-

breastmilk/}advice.


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4.2.10 How to stop introduce other foods

How to reduce/stop breastfeeding and introduce other foods

It is recommended that you only give your baby breast milk for their first six months, and thereafter

alongside other foods for as long as you and your baby would like (ideally around 2 years).

Gradually introduce other foods, while still giving breast milk, will make sure your baby gets all the

nutrients they need. If you are breastfeeding, you don’t need to introduce formula milk. You can

introduce supermarket ‘cow’s milk’ from 1 year old.

If your baby is under 1 year, and you are ready to reduce or stop breastfeeding, maybe you are

going back to work, you might want to express and store your breast milk for your baby when you

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are not together so the carer can give your breast milk via a bottle or cup. {link to returning to work

S4L leaflet}.

Alternatively, you may decide to reduce the amount of breast milk the baby receives and decide not

to express your milk, if the baby is under 6 months you will need to give baby formula feed from a

bottle until they are ready to eat other foods or (if they’re over six months) formula can be given via

a beaker {link to Start4Life bottle feeding leaflet and Unicef Responsive bottle feeding leaflet.

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/leaflets-and-posters/simple-

formula-guide-for-parents/}

One way to do this is to drop one feed at a time, usually a day time feed, to help prevent your

breasts becoming over full and/or mastitis.

I have more information on introducing other foods.

How to stop breastfeeding

While it’s recommended that you only give your baby breast milk for their first six months, that

doesn’t mean you should stop after their first six months. Breastfeeding will still benefit you both, so

carry on as long as you’d like.

Even if they’re eating solid foods, babies still need the nutrients that breast or formula milk gives

them. However, cow's milk – which formula’s made from – isn't suitable as a main drink for babies

under one, so that’s why breast milk is recommended (although adding cow’s milk to foods, like

mashed potatoes, is fine).

If you are ready to stop, gently phasing out breastfeeding will give you and your newborn time to

get used to the idea. It also gives your body time to get used to it, which will help prevent problems

like engorged breasts and mastitis.

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An effective way of phasing is to drop one feed at a time, usually a daytime feed. If your baby’s

younger than one, you’ll need to replace it with a formula feed from a bottle or (if they’re over six

months) a beaker. 🍼

If they’re more than one year old though, and enjoying a variety of foods and drinks, they won’t

normally need a replacement feed.


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4.2.11 Topping up

Topping up with formula

It’s best not to top up, simply because your breast milk’s so good for your baby. It contains every

nutrient they need for their first six months, and ingredients you just don’t find in formula.

Plus it develops as your baby develops, guaranteeing they get the right mix of those ingredients at

every stage. 👼

Topping up maywill also affect how much of this magicalbreast milk you producemake. It can take

up to 6 weeks for you and your newborn to settle into breastfeeding, and feeding them formula

before then could reduce your supply. Having said that, it’s still better to combine breastfeeding

with formula feeds, rather than switching to just using formula.

{insert maximising breastmilk video https://www.unicef.org.uk/babyfriendly/baby-friendly-



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4.3 My well-being

4.3.1 Drinking tea & coffee


Caffeine – in any form – can get into your breast milk, and if it passes onto your baby, it may make

them restless. Because of that, it’s best to keep your caffeine intake under 300mg a day, so here are

a few averages to help you stick to that…

• Filter coffee: 140mg per mug

• Instant coffee: 100mg per mug

• Tea: 75mg per mug

• 50g plain chocolate: up to 50mg per bar

• Cola drink: 40mg per can

• Energy drink: up to 80mg per can

It’s best to avoid energy drinks altogether if you can, as they can have really high caffeine contents.

And don’t forget, caffeine’s also in some cold and flu medicines, so always check the label.

If you fancy going caffeine-free, try decaffeinated tea and coffee, herbal teas, 100% fruit juice

(although no more than one 150ml glass a day, as it’s high in sugar) or mineral water. Your baby will

thank you for it. 😴


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4.3.2 Drinking alcohol

Drinking alcohol

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Having the odd glass is unlikely to harm your baby, but remember anything you eat or drink can get

into your breast milk, including alcohol. So a good rule of thumb is no more than two units (a large

glass of wine) once or twice a week. 🍷

Studies have shown that regularly drinking more than two units a day can affect your baby’s

development, so it’s always good to keep an eye on how many are in your drink – just use Alcohol

Concern’s unit calculator.

Unit calculator

If you do go over, don’t beat yourself up, but it is best to wait two to three hours for each unit

you’ve had before breastfeeding again – it’ll give the alcohol time to leave your system.

Alternatively, you could always express a bit of milk for your baby before you have a drink.


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4.3.3 Taking Vitamin D

Taking vitamin D

It’s recommended that all pregnant and breastfeeding women take a daily supplement of 10 mcg of

vitamin D. So to make sure you have enough, your doctor will give you a free 12-month prescription

– just take your maternity exemption certificate with you. 📃


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4.3.4 What to eat

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Should there be a reference here to the requirement that babies receive vitamin D from birth?

https://www.alcoholconcern.org.uk/unit-calculator

What to eat

You don’t need to eat a special diet to be able to breastfeeding.

As well as a daily dose of vitamin D, it’s a good idea to eat a healthy balanced diet. Breastfeeding

uses up to 500 extra calories a day, so keeping everything balanced will really benefit you and your

baby.

These things would get you off to a great start…

• A variety of at least five portions of fruit and veg a day, whether fresh, frozen, tinned or dried –

but don’t have more than one 150ml glass of 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 birth, some mums experience bowel problems and

constipation, and fibre helps with both

• Protein, such as lean meat and chicken, fish, eggs, nuts, seeds, soya foods and pulses – it’s also

best to have at least two portions of fish a week, including some oily fish

• Dairy foods, such as milk, cheese and yoghurt – these contain calcium, as well as being a good

source of protein

• Plenty of fluids – water (you can add slices of fruit for flavour) or skimmed or semi-skimmed milk

are good choices, so have a glass nearby when you settle down to breastfeed

I have more information on eating peanuts and breastfeeding.


While peanuts are a good source of protein, some mums are anxious about eating them. However,

they needn’t be, as peanuts – or foods containing peanuts – are absolutely fine (unless you’re

allergic to them, of course!).

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There's also no clear evidence to suggest eating peanuts while breastfeeding affects your baby's

chances of developing an allergy. But as always, if you have any questions or concerns, do talk to

your GP, midwife or health visitor.


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4.3.5 Smoking & b/f

Smoking & breastfeeding

Firstly, if you do smoke, don’t stop breastfeeding. As a new mum, not smoking is the best thing you

can do to look after your health. However, breastfeeding will still protect your baby from infections,

and provide nutrients they can't get from formula milk.

It obviously takes a lot of willpower and support to quit, but if you can, it’ll help keep your baby safe

of the following…

• Sudden infant death syndrome (SIDS, or cot death)

• Breathing problems

• Ear disease and deafness

• Behavioural problems

However, if you or your partner can't quit, you should still try to keep your home smokefree, to help

protect your baby's health. It’s a good idea to ask friends and family not to smoke near them too.

Lastly, it's also important not to share a bed with your baby (co-sleep) if you or your partner

smokes. This is known to raise the risk of cot death, as is co-sleeping after drinking alcohol, or taking

medication that makes you sleep more heavily.

There’s lots of friendly support available to help you quit – just visit the NHS Smokefree website, or

contact your local stop smoking service (click the link to find out more).

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Stop smoking service

I have more information on e-cigarettes (vaping).


Using e-cigarettes (vaping) is a lot safer than smoking, and helps keep you smokefree, but it still isn't

risk-free. Like nicotine, e-liquid and vapour can contain toxic substances, although they’re at much

lower levels than cigarettes.

There aren’t any e-cigarettes that are licensed as medicines, so if you want help to quit and stay

smokefree, it’s recommended you only use licensed NRT products. But – as with cigarettes – don’t

stop breastfeeding if you vape, as the benefits still outweigh any potential harm.


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4.3.6 Exercise & b/f

Exercise & breastfeeding

Exercise is beneficial for everyone, including breastfeeding mums. 💪 However, the amount you

should do depends on how you feel.

If you’re used to exercise, and feel fit and well, talk to your midwife, health visitor or GP about

getting started. Here are a few rough guidelines for now though…

• If you had a straightforward birth, you can give gentle exercise a go, such as walking, stretching

and pelvic floor exercises as soon as you feel up to it.

• If you had a caesarean, it will take your body a little longer to recover, so chat to your midwife,

health visitor or GP before starting anything too strenuous.

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http://www.nhs.uk/Service-Search/Stop%20smoking%20services/LocationSearch/1846

And for any new mum, it's usually a good idea to wait until after your six-week postnatal check

before starting any high-impact exercise, like aerobics or running. After all, we want you to be

healthy, not hurt. 😉

Your back and cup size are likely to have changed too, so don’t rely on your pre-pregnancy sports

bra and try to get measured for a new one.


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4.3.7 Getting pregnant

Getting pregnant while breastfeeding

If your baby’s under six months and you’re exclusively breastfeeding (not giving them any formula),

you're unlikely to get your period – which is why some women use breastfeeding as a form of

natural contraception.

However, if any of the following apply to you, you should use other forms of contraception…

• If your baby’s more than six months old

• If you give them anything other than breast milk, such as a dummy, formula or solid foods

• Or if your periods start again

{link to NHS choices breastfeeding an contraception}


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4.3.8 B/f if you’re sick


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Well I hope you’re not feeling poorly right now. 😟 Get well soon if you are!

In fact, if you’re unwell, your body will create antibodies which will be passed through, and those

will help protect your baby from getting the same illness.

So even if you’re vomiting or have diarrhoea, you should still breastfeed – just make sure you drink

lots of liquids to keep your fluid levels up and prevent dehydration. And if you don't feel any better

after a few days, see your GP.


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4.3.9 Taking medication


The good news is that most medicines – including those used to treat postnatal depression – are

fine to take while breastfeeding. However, don’t forget that small amounts of any drug can pass to

your baby through your breast milk. Generally the amounts are so low that very few medicines are

unsafe.

If you have a question about a specific type of medication, you can download factsheets on drugs

and feeding from the Breastfeeding Network.

BfN Drugs Factsheet

If in doubt, it’s always a good idea to check with your GP, midwife, health visitor or pharmacist, just

in case.


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https://www.breastfeedingnetwork.org.uk/drugs-factsheets/

4.3.10 B/f after caesarean


If you are going to have a planned caesarean section, it might be helpful to express some breast milk

for the baby and keep it in the fridge in case the baby needs it – ask your midwife for help {link to

hand expression video}.

After the birth of your baby ask your midwife to help you have skin-to-skin with your baby as soon

as you're able to. Ask your midwife to see if you can have this in theatre, or in the recovery room

{link to meeting baby for the first time video}.



possible.

As for positioning, some mums who’ve had a caesarean find the "rugby hold" or lying on your side –

where your baby's body is to the side of yours, supported by your arm – is better than having them

lie against your stomach while feeding, so you may want to give it a try (see what I did there? 🏉.

Regular pain killers after a caesarean can make it more comfortable for you. If you’re experiencing

any pain, please talk your midwife.

However your baby was delivered, breastfeeding is always recommended, so make sure you get a

skin-to-skin cuddle with your baby as soon as you're able to. Ask your midwife to see if you can have

one in theatre, or in the recovery room.



possible.

As for positioning, some mums who’ve had a caesarean find the "rugby hold" – where your baby's

body is to the side of yours, supported by your arm – is better than having them lie against your

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stomach while feeding, so you may want to give it a try (see what I did there? 🏉. But if you’re

experiencing any pain, please talk your midwife.


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4.3.11 The baby blues

The baby blues

In the first week after childbirth, many mums often get what's called the “baby blues”. They’re left

feeling unhappy at a time when they expect to feel overjoyed, but you should know that its causes

are perfectly natural.

Evidence suggests it’s most likely down to the sudden hormonal and chemical changes that take

place in your body after childbirth, and symptoms can include the following…

• Feeling emotional and irrational

• Bursting into tears for no apparent reason

• Feeling irritable or touchy

• Feeling depressed or anxious

Rest assured, all these symptoms are normal, and usually only last a few days. Try to get through it,

and if it lasts any longer, speak to your midwife, health visitor or GP.


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4.3.12 P/n depression

Postnatal depression

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Feeling depressed after your baby’s born can be extremely distressing, but unfortunately, it’s not

uncommon. Postnatal depression (PND) is thought to affect around 1 in 10 women, and up to 4 in

10 teenage mothers – many of whom suffer in silence.

The hormones released when breastfeeding can help to prevent postnatal depression and help you

fall in love with your baby – so getting help to get breastfeeding off to a good start and to continue

is important for you and your baby.

PND is a serious issue, so the first thing to note is if you think you have it, don’t face it alone. It's not

a sign that you're a bad mother or can’t cope – it’s an illness, and you should get help, just like you

would if you had the flu.

It usually occurs within 2–8 weeks, though sometimes it can happen as late as a year after the birth.

Some of the milder symptoms, such as tiredness, irritability or loss of appetite, are normal if you've

just had a baby, and rarely stop you leading a normal life.

I have more information on the signs of postnatal depression.


Postnatal depression can become a problem if you start feeling more and more disheartened.

Looking after yourself or your baby may become too much, and there are other emotional signs as

well…

• Loss of interest in your baby

• Feelings of hopelessness

• Not being able to stop crying

• Feelings of not being able to cope

• Not being able to enjoy anything

• Memory loss or being unable to concentrate

• Excessive anxiety about the baby

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There are physical signs that you should look out for too…

• Panic attacks

• Sleeplessness

• Extreme tiredness

• Aches and pains

• Generally feeling unwell

• Anxiety

• Loss of appetite

I have more information on the getting support for postnatal depression.


If you’re struggling with any of these, talk to someone you trust, like a partner or friend. Or ask your

health visitor to pop round – many are trained to recognize postnatal depression, and have

techniques that can help, or know someone who can.

Milder cases of PND can be treated with counselling, either by your health visitor or a therapist. But

more severe cases often require antidepressants, which may require seeing a specialist.

It's also important to see your GP (if you don’t feel up to making an appointment, ask a friend to do

it for you). Let them know if you're breastfeeding too, so that you continue to get the help and

support you need and – if you need antidepressants, they'll prescribe some that are suitable.

You may also find it helpful to contact the Association for Post-Natal Illness, or the National

Childbirth Trust.

Visit APNI website

Visit NCT website

Link to Best Beginnings Baby Buddy App films on postnatal depression

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https://www.nct.org.uk/

Finally, your local children's centre can put you in touch with your nearest postnatal group,

breastfeeding support groups and peer supporters. These groups let you chat with new mums who

are going through the same thing, and are there to provide support, social activities, and help with

parenting skills if you need it.


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4.4.1 Enough milk


Lots of mums wonder if their baby’s feeding well and getting enough milk, but if you’re comfortable

while you’re breastfeeding, and your baby seems happy, and has wet and dirty nappies, you’re

probably doing fine.

It's very rare that mums don't make enough breast milk for their babies, so it may just take a bit of

time before you feel confident that you are. And generally, your baby will let you know if they’re not

getting what they want, although wet and dirty nappies are also a good indication, as is hearing your

baby swallow.

I have more information on how to tell if your baby is getting enough milk in the first few days.


The best way is to see if they’re back to their birth weight, or above, by 2 weeks (it's normal for

babies to lose some of their birth weight until then).

In their first two weeks though, it’s a bit of messy job, as it all comes down to their toilet habits.

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should step it up to at least 6 a day – put the nappy in the palm of your hand it should feel heavy If

you need help telling whether a nappy’s “wet” or not (especially if you use disposables), add 2–4


At first, their poo should be black and tar-like. By day 3 it should be lighter, runnier and greener.

And from day 4 until a few weeks in, it should be yellow, and at least 2 poos a day, the size of a £2

coin or more.


Most babies pass lots of poo and this is a good sign. Remember it’s normal for breastfed babies to

pass loose stools {link to start4Life leaflet graphic of stooling p.g. 17 on old leaflet}


right position using the link below, ring the breastfeeding helpline {insert number} or have a chat

with your midwife or health visitor.


should step it up to at least 6 a day. And remember, it’s perfectly normal for breastfed babies to

pass loose stools.

Consistency is a good indicator too. At first, their poo should be black and tar-like. By day 3 it should

be lighter, runnier and greener. And from day 4 until a few weeks in, it should be yellow, and about

2 poos a day.


If you need help telling whether a nappy’s “wet” or not (especially if you use disposables), add 2–4



right position using the link below, or have a chat with your health visitor.

I have more information on other signs that your baby's getting enough milk.

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Here are some other signs that your baby’s getting enough milk…

• They start feeding with a few quick sucks, followed by long, rhythmic ones, and swallowing with

occasional pauses

• You can hear and see your baby swallowing

• Your baby's cheeks stay rounded, not hollow, while sucking

• They seem calm during feeds, and content after

• Your baby comes off the breast on their own at the end of a feed

• Their mouth is wet after feeds

• Your breasts feel softer after feeds

• Your nipple looks and feels more or less the same after a feed, not flattened, pinched or white

• You sometimes feel sleepy and relaxed after a feed

I have more information on how often to breastfeed.


How often you should breastfeed is another common question, and the truth is it depends on your

baby, but as a rough guide, they should feed at least 8 times every 24 hours during the first few

weeks. Their stomach’s the size of a walnut, so it’s all about little and often, even after a good feed.

It’s not possible to overfeed or spoil a breastfed baby. So you can feed them if you think they’re

hungry, upset, need comfort, if your breasts feel full, or if you just fancy a cuddle and sit down with

your feet up.

Helpfully, it’s not possible to overfeed a breastfed baby. So you can feed them if you think they’re

hungry, if your breasts feel full, or if you just fancy a cuddle.

Here are a few of a baby’s typical “feed me” signs…

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• Getting restless

• Sucking their fist or fingers

• Making murmuring sounds

• Turning their head and opening their mouth (rooting)

If you see these signs, it’s best to try feeding them before they start crying, as it’s difficult to feed

them after they start. Crying is their final way of telling you they’re hungry, so keep them close and

watch out for the cues.

I have more information on how long each breastfeed should last.


And as for how long each breastfeed should last, again, every baby’s different, so really it’s up to

them. Some want short, frequent feeds, others prefer longer meals – or a mix of the two. If you let

them finish the first breast, then offer the second, they’ll let you know if they’re still hungry.

If you're worried your baby’s feeding all the time though, you may need a bit of help with

positioning and attachment. Just chat to your midwife, health visitor or breastfeeding specialist, or

call the National Breastfeeding Helpline on 0300 100 0212.


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Your baby's weight

Your baby’s weight all depends on their birth weight, and how long they’ve been out in the world,

as it’s perfectly normal for them to lose some weight in the first few days.

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They’ll be weighed at every stage though, to make sure they get back to birth weight by 2 weeks.

And if your baby doesn’t, you’ll have support on hand to help.

In terms of when your baby will be weighed, usually it starts with a few times in the first couple of

weeks, just to make sure everything’s OK, then becomes less frequent – no more than once a month

up to six months of age, once every two months from 6 to 12 months, and once every three months

after their first birthday. 🎂

Your baby will only be weighed more than this if you ask, or if there are any concerns about their

health or growth.

And finally, a little fact for you – four out of five healthy babies are back to (or above) their birth

weight by 14 days. So give it some time, and if you’re still worried, call the Helpline or chat to your

midwife or health visitor.


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4.3.3 Top up formula

Topping up with formula

It’s best not to top up, simply because your breast milk’s so good for your baby. It contains every

nutrient they need for their first six months, and ingredients you just don’t find in formula.

Plus it develops as your baby develops, guaranteeing they get the right mix of those ingredients at

every stage. 👼

Topping up will affect how much breast milk you make. It can take up to 6 weeks for you and your

newborn to settle into breastfeeding, and feeding them formula before then could reduce your

supply. Having said that, it’s still better to combine breastfeeding with formula feeds, rather than

switching to just using formula.

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{insert maximising breastmilk video https://www.unicef.org.uk/babyfriendly/baby-friendly-


Topping up may also affect how much of this magical milk you produce. It can take up to 6 weeks for

you and your newborn to settle into breastfeeding, and feeding them formula before then could

reduce your supply. Having said that, it’s still better to combine breastfeeding with formula feeds,

rather than switching to just using formula.


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4.4.4 Tongue-tie

Understanding tongue-tie

Tongue-tie is when the strip of skin that attaches a baby’s tongue to the floor of their mouth

(frenulum) is shorter than usual. It affects between 4–11% of babies, and can stop the tongue

moving freely, making it harder to breastfeed.

However, the good news is that tongue-tie’s easily treated. ✌

Here are some of the signs that your baby may have tongue-tie…

• Having difficulty attaching to the breast, or staying attached for a full feed

• Feeding for a long time, having a short break, then feeding again

• Feeling unsettled and being hungry all the time

• Not gaining weight as quickly as they should

• Making a "clicking" noise while they feed – this can also be a sign that they may need help with

positioning and attachment

• While tongue-tie can cause problems for your baby, it can also cause problems for you, including…

• Sore or cracked nipples

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• Low milk supply

• Mastitis (inflammation of the breast), which may keep recurring

I have more information on the treatment options for tongue-tie.


If you suspect your baby has tongue-tie, talk to your midwife, health visitor or GP about treatment –

it's very simple, and takes just a few seconds. Most babies who get treatment find breastfeeding

easier afterwards, and it doesn’t seem to hurt them – some babies even sleep through it, and carry

on breastfeeding immediately after the procedure.

Unfortunately, tongue-tie treatment’s not available everywhere on the NHS, so use the link below

to see if it is in your area. If not, there are also private tongue-tie practitioners who can help.

Tongue-tie services


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4.4.5 What crying means

What crying means

Crying is the very last sign that your baby needs feeding. So, if try to look out for their feeding cues;

waking, sucking their fingers and fists, moving their head, licking their lips and putting their tongue

out (rooting) if you can, try to breastfeed them then, before they cry – it often leads to a much

calmer feed (and a much calmer mummy). 😌

Remember, keep them in the same room as you and close, so you can catch those and watch out for

feeding cues – you’ll soon learn which signs mean dinner timewhen to put to the breast, if in doubt

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http://www.tongue-tie.org.uk/tongue-tie-practitioners-nhs.html

pop them on, they will tell you if they don’t want to nurse – they want a nappy change or to be

talked to etc.


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4.4.6 Colic

Understanding colic

Crying for a feed is one thing, but if your baby won’t stop – and otherwise seems healthy – they may

have colic. It’s a common problem (around 1 in 5 babies gets it) that starts when they’re a few

weeks old, and usually stops by four months, or six months at the latest.

Their outbursts may look and sound like your baby’s in distress, but medically, it’s rarely anything to

worry about. They should continue to feed and gain weight normally, and eventually, it’ll pass.

Remember, all that crying doesn't mean your baby’s unwell, you're doing something wrong, or your

baby’s rejecting you – it’s just colic. 😌

Here are a few of the symptoms to look out for…

• Intense crying bouts

• Crying in the late afternoon or evening, lasting several hours

• Your baby's face getting red and flushed when they cry

• Your baby clenching their fists, bringing their knees to their tummy, or arching their back while

crying

Looking after a colicky baby can be very frustrating and distressing, so it’s important to look after

your own well-being too. If possible, ask friends and family for support, take regular breaks, and get

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I have not looked at this one in detail.

some rest. You can also talk to support groups like Cry-sis on 0845 122 8669 (9am–10pm, seven

days a week).


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4.4.7 Using a dummy What about dummies?

Using a dummy

It can be tempting to let your little one suck on a dummy, especially when they are cring and seem

unsettled. But try to resist – babies who use a dummy before they’ve learnt to breastfeed (usually

around 4-6 weeks) can have trouble remembering how to attach.


milk, which can affect your milk supply and they won’t get all the benefits. So all in all, it’s best to

wait till they’ve got the hang of breastfeeding.

It can be tempting to let your little one suck on a dummy, especially when they are crying and seem

unsettled. 😢 But try to resist – babies who use a dummy before they’ve learnt to breastfeed

(usually around 1 month) can have trouble remembering how to latch on.


milk, and won’t get all the benefits. So all in all, it’s best to wait till they’ve got the hang of

breastfeeding.


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4.4.8 Reflux

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I haven’t looked at this one in detail

Understanding reflux

Understandably, seeing your baby bring their milk back up can be a bit worrying, but it needn’t be.

In most cases, it’s perfectly natural. It’s known as reflux, or posseting, and it’s just your baby’s way

of messily removing any milk they don’t need.

The first thing you should know is that reflux is very common, and will usually pass by their first

birthday. These are some of the symptoms you might see…

• Spitting up milk

• Refusing feeds

• Gagging or choking

• Hiccups or coughs

• Excessive crying

• Frequent ear infections

But as long as your baby’s otherwise happy, healthy and gaining weight appropriately, there

shouldn’t be any cause for concern.

I have more information on some other, more serious signs you should look out for.


• Reflux starting after 6 months

• Reflux lasting more than a year

• Projectile vomiting

• Excessive crying

• Green or yellow vomit

• Blood in vomit or poo

• Persistent diarrhea

• Swollen stomach

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• High temperature (37.5°C+)

• Weight loss

• Arching back during or after a feed

• Drawing legs to tummy after a feed

If you come across any of these, it may mean your baby needs tests or treatment, so please contact

your midwife, health visitor or GP.


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Caffeine – in any form – can get into your breast milk, and if it passes onto your baby, it may make

them restless. Because of that, it’s best to keep your caffeine intake under 300mg a day, so here are

a few averages to help you stick to that…

• Filter coffee: 140mg per mug

• Instant coffee: 100mg per mug

• Tea: 75mg per mug

• 50g plain chocolate: up to 50mg per bar

• Cola drink: 40mg per can

• Energy drink: up to 80mg per can

It’s best to avoid energy drinks altogether if you can, as they can have really high caffeine contents.

And don’t forget, caffeine’s also in some cold and flu medicines, so always check the label.

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If you fancy going caffeine-free, try decaffeinated tea and coffee, herbal teas, 100% fruit juice

(although no more than one 150ml glass a day, as it’s high in sugar) or mineral water. Your baby will

thank you for it. 😴


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Drinking alcohol

Having the odd glass is unlikely to harm your baby, but remember anything you eat or drink can get

into your breast milk, including alcohol. So a good rule of thumb is no more than two units (a large

glass of wine) once or twice a week. 🍷

Studies have shown that regularly drinking more than two units a day can affect your baby’s

development, so it’s always good to keep an eye on how many are in your drink – just use Alcohol

Concern’s unit calculator.

Unit calculator

If you do go over, don’t beat yourself up, but it is best to wait two to three hours for each unit

you’ve had before breastfeeding again – it’ll give the alcohol time to leave your system.

Alternatively, you could always express a bit of milk for your baby before you have a drink.


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4.1.11 Peanut allergies

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https://www.alcoholconcern.org.uk/unit-calculator

Peanut allergies

While peanuts are a good source of protein, some mums are anxious about eating them. However,

there's no clear evidence to suggest eating peanuts – or foods containing peanuts – while

breastfeeding affects your baby's chances of developing an allergy.

So just try to have a healthy balanced diet, and if you’ve got any questions or concerns, talk to your

GP, midwife or health visitor.


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Well I hope you’re not feeling poorly right now. 😟 Get well soon if you are!

In fact, if you’re unwell, your body will create antibodies which will be passed through, and those

will help protect your baby from getting the same illness.

So even if you’re vomiting or have diarrhoea, you should still breastfeed – just make sure you drink

lots of liquids to keep your fluid levels up and prevent dehydration. And if you don't feel any better

after a few days, see your GP.


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The good news is that most medicines – including those used to treat postnatal depression – are

fine to take while breastfeeding. However, don’t forget that small amounts of any drug can pass to

your baby through your breast milk. Generally the amounts are so low that very few medicines are

unsafe.

If you have a question about a specific type of medication, you can download factsheets on drugs

and feeding from the Breastfeeding Network.

BnF Drugs Factsheets

If in doubt, it’s always a good idea to check with your GP, midwife, health visitor or pharmacist, just

in case.


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4.5 Benefits of b/f

4.5.1 Benefits of b/f

The benefits of breastfeeding

When doctors everyone says breastfeeding gets you and your baby off to a great start, they really

do mean it. Breastfeeding has short and long term benefits for you, your baby and your family. For

starters, your milk is tailor-made for your baby, so it’s the only food that can give them all the

nutrients they need for their first 6 months, and if continued with other foods after this will carry on

to help your child to grow up strong and healthy into adulthood.

It alsoBreast milk boosts your newborn’s ability to fight illness and infections like; diabetes, obesity,

chest and urine infections and diarrhoea – something that formula (which is made from cows’ milk)

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https://www.breastfeedingnetwork.org.uk/drugs-factsheets/

simply can’t do. It also lowers a mother’s risk of breast cancer and may reduce the risk of ovarian

cancers.

Breastfeeding releases the ‘love’ hormone ‘oxytocin’ and will help you fall in love {insert heart

emoji} and And as for bonding with your baby – well you can’t get much closer than breastfeeding

skin-to-skin. 🙏 Each feed will bring you closer, both physically and emotionally, and many mums

even find that having their baby so close makes it easier to recognize respond to their needs.


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4.5.2 How long to b/f

How long to breastfeed for

There’s no hard and fast rule about this, but if you can, it’s best to breastfeed your baby for their

first six months, just because your milk is everything they need so good for them at that age. After 6

months, it’s then best to breastfeed alongside solid foods and water (which they’ll need to help

digest the solids). 🍼 🍴

How long you keep breastfeeding for though is totally up to you. In fact, many mums breastfeed

into their baby's second year and beyond (alongside other foods, of course), as you both still get the

benefits.


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Set-up AI

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It is a set of keyphrases and corresponding bot replies. A chatbot will understand user phrases

similar to those you’ve set up and reply with a text or a block.

If user says something similar to:

Thank you; thanks; cheers; ta

Bot replies with BLOCK:

Small talk (thank you)


Video; videos


Breastfeeding video


Colic; colicky


4.4.6 Colic


Cry; crying; tears


4.4.5 What crying means


How long; 6 months; six months; extended


4.5.2 How long to b/f


Benefits; why breastfeed; nutrients; cancer;

breast cancer; ovarian cancer; bonding


4.5.1 Benefits of b/f

If user says something similar to: Bot replies with BLOCK:

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Reflux; spit up; spitting up; spit up milk; spitting

up milk; possetting

4.4.8 Reflux


Tongue tie; tongue-tie


4.4.4 Tongue-tie


Depression; depressed; postnatal depression;

suicide; suicidal


4.3.12 P/n depression


Baby blues; feeling down; feeling low; feeling

blue


4.3.11 The baby blues


Medication; drugs; medicine; antibiotics;

antidepressants; nurofen; ibuprofen; painkillers;

paracetamol




Illness; flu; cold; sick; ill; unwell




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Pregnant; contraception; conceive; pregnancy;

period 4.3.7 Getting pregnant


Exercise; stretching; walking; pelvic floor

exercises; running; aerobics; gym; training;

sports; fitness; exercising


4.3.6 Exercise & b/f


Smoking; tobacco; smoke; fag; vaping; vape; e-

cigs; e-cigarette; nicotine; smokefree; cigarette


4.3.5 Smoking & b/f


Eat; diet; food; calories; protein; carbohydrate;

fat; peanut; nuts; allergy; allergies


4.3.4 What to eat


Vitamin; vitamins; vitamin d; supplement


4.3.3 Taking Vitamin D


Alcohol; booze; wine; beer; spirits; drinking




Tea; coffee; caffeine; cola; coke; energy drink;

filter coffee; instant coffee; espresso; decaf;



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decaff; decaffeinated


Topping up; top up; top-up; formula;

combination; combination feeding; SMA;

Aptamil; switch; infant


4.2.11 Topping up


Thrush; candida; fungus; candida fungus


4.2.6 B/f & thrush


Duct; ducts; block; blocked; blocked ducts;

mastitis; lump; inflamed; inflammation; Mastitis;

Mastytus


4.2.4 Blocked ducts


Leak; leaky; leaking; leaks; leaking milk; leaky

breasts; drip; dripping; ooze; oozing; pads


4.2.3 Leaking milk


Engorged breasts; full breasts; engorgement;

swollen


4.2.2 Engorged


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Nipples; sore nipples; cracked nipples; bleeding

nipples; painful nipples

4.2.1 Sore nipples


Public; breastfeeding in public; public place;

work; return to work; returning to work; return

to study; study; returning to study


4.1.18 B/f in public


Partner; husband; boyfriend; dad; father; wife;

girlfriend; family; support; OH; DH


4.1.17 Partner help


Introduce; introducing; bottle; bottles


4.1.16 Intro a bottle


Defrost; re-freeze; microwave; thaw; thawed


4.1.15 Feed expressed


Store; storage; storing; freeze; freezing; store

milk; storing milk; milk storage; freeze milk;

freezing milk


4.1.14 Store expressed


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How to express; expressing milk; pump;

expressing; pumping 4.1.13 How to express


Stop breastfeeding; stop milk; weaning; weaned;

years old; year old


4.1.12 How to stop


Breast size; small breasts; large breasts;

implants; breast reduction; breast

augmentation; boob job


4.1.11 Breast size


Increase milk supply; increase supply; increasing

milk supply; increasing supply; more milk;

produce more milk


4.1.9 Increase supply


Dummy; pacifier; comforter; soother


4.1.8 Using a dummy


Latch; latching; latching on; position;

positioning; uncomfortable; attachment


4.1.7 Latching on properly


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Caesarean; c-section; c section; scar

4.1.6 B/f after caesarean


Premature; premie; twins; triplets; multiples


4.1.5 Premature & twins


Weigh; weight; weighed; losing weight; gaining

weight; healthy weight; weight loss; weight gain;

birth weight; heavy; measure




Getting enough milk; enough milk; feeding well;

feeding enough; poo; stools; nappy; nappies;

meconium; hungry; amount; frequent; bowel


4.1.3 Enough milk


First feed; let-down; let down; let-down reflex;

let down reflex; colostrum; first milk; newborn;

kangaroo


4.1.2 What to expect


Skin-to-skin; skin to skin


4.1.1 Skin-to-skin


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Settings; subscribe; unsubscribe; shortcuts;

tutorial; setting Settings (router)


Call; phone; helpline; hotline


Helpline


Topics


1.2 Breastfeeding topics


Help; common questions; questions; FAQ; FAQs


1.1 Common questions


Goodbye; I have to go; see you; bye; see you

later; talk later


Small talk (goodbye)


Hello; how are you; nice to meet you; nice to see

you; nice to talk to you; what is up; what’s up;

hiya; hi; hey


Small talk (hello)

Broadcast

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Schedule for a specific time at user’s time zone under the following conditions:

<subscription> is <yes please> <subscribe> <never mind>

March 25 th 9am

333 users receive these posts

Good feels good

If you and your baby are happy during feeds, you’re no doubt doing fine. But if you’re a bit

uncomfortable, just make sure your baby’s in the right positioneffectively attached.

See our guide

March 27 th 9am


Vitamin D every day

Don’t forget your daily dose of Vitamin D, to make sure your baby gets all the nutrients they need.

For a free 12 – month prescription, talk to your GP.

Find out more

March 29 th 9am


Healthy happy mummy

Did you know that breastfeeding uses up to 500 calories a day? A healthy lifestyle can really benefit

you and your baby, so keep taking care of yourself.

Healthy diet ideas

March 31 st 9am

98


Getting your little one to latch onattach

Don’t worry if you and your baby haven’t got the hang of breastfeeding yet – these things take time.

And don’t forget, our latching-oneffective attachment guide is a click away.

See the guide

April 2 nd 9am


No dummy from mummy

Try not to give your baby a dummy before they’re used to breastfeeding – they may find it harder to

latch onattach. If they are struggling, our guide could help:

See the guide

April 4 th 9am


Breastfeeding with all the benefits

Did you know breastfeeding reduces your risk of getting breast and ovarian cancer? Just one of the

many ways it helps look after you and your baby.

See all the benefits

April 6 th 9am


Feed their defences

Did you know breastfeeding helps protect your baby from infections and other diseases? So with

every feed, you’re helping them get off to a great start.

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See more benefits

April 8 th 9am


Hungry but happy

Don’t worry if it feels like your baby keeps needing to feed – in the first few weeks, feeding 8 times

or more each day is perfectly normal.

Find out more

April 10 th 9am


Keep the coffee in check

Remember, caffeine can pass onto your baby through your breast milk, and may keep them awake.

So if you can, swap coffee and tea for decaf or a soft drink.

Get more tips

*Users hereafter TBC*

April 12 th 9am

Is wine fine?

Like caffeine, alcohol can get into your breast milk and affect your baby’s health. So take a quick

look at our recommended limits and keep it to a minimum.

Get the guidelines

April 14 th 9am

Pain-free feeds

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Sore nipples are a common problem, and often happen because your baby’s not positioned

properlyeffectively attached. But luckily, there are ways to make things more comfortable.

Find out more

April 16 th 9am

No pain, all gain

How’s the breastfeeding going? Hopefully all’s well, but if you’re in any discomfort, it’s always worth

checking to see if your baby’s latching on properlyeffectively attached.

See our guide

April 18 th 9am

Sore no more

If you’re experiencing sore nipples (as many mums do), massaging some of your milk onto them

may help. And there are other things you can try too.

Get more tips

April 20 th 9am

Leaking creeping up on you?

Unexpectedly leaking milk is a very common problem, but from regular feeds to breast pads, there

are things you can do to keep it under control.

Find out more

April 22 nd 9am

Stick with it – it’s worth it

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Your breast milk gives your baby all the nutrients they need for their first 6 months and thereafter

with other foods. So if you can, keep the feeds coming.

See more benefits

April 24 th 9am

Feel free to feed

Did you know it’s impossible to overfeed a breastfed baby? So whether they’re hungry or just want

a cuddle, you can feed them as often as you like.

See signs of hunger

April 26 th 9am

Express yourself

Expressing some milk can let your partner get involved in feeding, and give you a break. Here are a

few pointers on how to get started.

See our guide

April 28 th 9am

Making more milk

How much milk you produce comes down to how often you breastfeed – your body’s clever like

that. However, there are some things you can do to boost your supply.

Check out our tips

April 30 th 9am

Feeling full?

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Engorged, overly-full breasts are a common problem. They can feel hard, tight and painful, so here

are a few tips on how to prevent it.

Find out more

May 2 nd 9am

Bigger isn’t better

Did you know breast size has no effect on breast milk supply? Almost every mum makes enough

milk for their baby, but there are ways to maximise your supply.

Find out more

May 4 th 9am

No rush to mush

Solid foods should be introduced after the first 6 months, to give your baby’s digestive system time

to develop. In the meantime, your milk's all they need.

Find out more

May 6 th 9am

Rags at the ready

During and after feeds, it’s normal for your baby to bring up some milk (known as posseting or

reflux). But there are other reactions you should watch out for.

Find out more

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