From how to get started to where to seek guidance, read our essential breastfeeding guide and feed your baby with confidence.
Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Claire Chamberlain
Whether you are a new or a soon-to-be mum, the way in which you feed your baby is a subject that is likely to be high on your agenda right now. There is no doubt that breastmilk is the most nutritious start for your newborn, but as with learning any new skill, getting the hang of breastfeeding can take a little time for both you and your baby. Therefore, it’s important to be gentle with yourself.
Consultant and paediatrician Dr Tamara Bugembe, and midwife and co-founder of My Expert Midwife Lesley Gilchrist give us the lowdown on everything from milk production to sore nipples, to help you breastfeed your baby with confidence:
What are the benefits of breastfeeding?
Breastmilk is the perfect first food for your baby, but deciding to breastfeed also offers a host of other important health benefits – and not just for your newborn.
‘Breastfeeding is important for both mother and baby, as it enhances the bonding experience and helps to create the optimal start to family life,’ explains Lesley Gilchrist. ‘This is because several hormones are in play, the main one being oxytocin. Oxytocin is a key hormone during milk production and is also responsible for us falling in love with other humans.
‘Breastmilk is produced to suit your baby’s needs, with exactly the right balance of nutrients for the best start in life. The properties in breastmilk also help to protect your baby from illnesses and diseases, not only in infancy, but into their adult life too, such as diabetes and heart disease.’
Breastfeeding is important for both mother and baby, as it enhances the bonding experience.
There are also some important benefits for you, the mother, if you decide to breastfeed.
‘In the short term, breastfeeding helps the uterus to contract down to its pre-pregnancy size and helps to slow down blood loss after the birth,’ explains Gilchrist. ‘While in the long term, it reduces the mother’s risk of breast and ovarian cancer.’
Preparing to breastfeed
It’s a good idea to learn as much as you can about breastfeeding while you are still pregnant. Antenatal classes are a brilliant source of information, not just for the impending birth, but also for breastfeeding advice. Your local NHS hospital will offer free antenatal classes, including breastfeeding classes, or if you decide to join the NCT, your classes will include breastfeeding information and support. It’s best to attend antenatal classes when you are 30-32 weeks pregnant.
‘Read and research about breastfeeding while you are pregnant,’ agrees Gilchrist. ‘Also, ask any friends and family who have breastfed their babies to share their stories with you and ask if they will help you, if you need it, once your baby is born.’
One of the best things you can do for both you and your baby after birth is have some skin-to-skin contact. This involves holding your baby while naked (or wearing just a nappy) against your bare skin. This type of contact helps with bonding, as well as keeping them warm and regulating their breathing. Skin-to-skin contact is also the best way to help introduce breastfeeding.
‘After your baby is born, allow plenty of time for skin-to-skin contact, to allow baby unrestricted access at the breast,’ says Gilchrist. ‘This will help both you and your baby learn how to latch and attach at the breast.’
When helping your baby latch onto your nipple to feed, Gilchrist has the following tips:
✔️ Your baby should have a wide-open mouth.
✔️ Much of the areola (the flat part of the nipple) should be in their mouth too.
✔️ There should not be any noises or pain once your baby is feeding.
✔️ If you are experiencing pain, or can hear them sucking, take baby off the breast by gently inserting a finger into their mouth, and re-attach them.
✔️ It’s very important to get the latch right from the start, to help prevent soreness.
What is colostrum?
Colostrum is the first milk your baby will have when you start breastfeeding. ‘It is yellow and watery looking, but is high in fats and proteins, and contains everything your baby needs, including lots of antibodies, which protect your baby against infections and diseases,’ explains Gilchrist.
‘During the first few days, your baby only needs a small amount of this rich and concentrated colostrum, until your milk production and your baby’s stomach size increases,’ she adds.
When will your milk come-in?
Your milk production will start to increase dramatically at approximately day three after your baby has been born, but it can vary from person to person.
‘When your baby feeds, you will feel the “let down reflex”, which can be a tingling feeling in all or part of the breast,’ says Gilchrist. ‘You may also have feelings that your breasts are quite full, as well as having some leaking from the other breast while your baby is feeding.’
‘This is caused by the hormone oxytocin and is triggered by your baby being close to you. Your baby can trigger this even when they aren’t suckling. You may also find that other people’s babies or crying babies do this, too! If you are prone to leaking from the other breast, you can collect this milk in a sterilised container or bottle to refrigerate or freeze and use at a later date.’
Signs your baby is hungry
There are a number of signs that it is time to feed your newborn. ‘Hungry babies will wake and root for food,’ says Dr Tamara Bugembe. ‘They may start chewing on their fists or clothing, or they may stir and cry.’
‘However, many newborns do not wake with hunger, because while in the womb they are fed continuously through their umbilical cord, and so may not quite realise that they are now feeding at intervals and need to wake for their feeds,’ she adds.
‘Do not let your baby go more than three hours between feeds. Wake them, change their nappy, stimulate them a bit and then feed them.’
How often should you feed your baby?
You know your baby best, so look for your baby’s cues and trust your own instincts. But, as a guide, Dr Bugembe advises:
‘It is best to start off by feeding your baby on demand, while they master the technique of breastfeeding and your milk starts to come in. By two weeks of age, most newborns will feed at three-hourly intervals. Smaller babies can sometimes be hungrier and need feeding every two-and-a-half hours. After four months, they may be able to stretch to four-hourly intervals.’
How to prevent nipple soreness
It is normal for your nipples to become sore during breastfeeding. ‘Don’t worry if your nipples do become sore – you can still feed your baby through this, even though it is uncomfortable,’ says Gilchrist.
‘However, making sure your baby has the correct latch and attachment is key to preventing sore nipples. Access any help you need from your midwife or midwifery support assistant after the birth, as they can provide you with tips for achieving the best positions to breastfeed and help you to correct any latch and attachment issues.’
Pharmacist Daniel Brash, co-director of Pharmacare Ltd and managing director of Healthcare4all, has these additional tips to help prevent sore nipples while breastfeeding:
• Nipple pain
Nipple plan is most often triggered by baby not latching on correctly, so it’s worth trying different positions to feed baby in.
Tongue tie is an oral anomaly that can make it difficult for a baby to breastfeed. Ask your midwife or health visitor to check for tongue-tie. Many cases are picked up while still in hospital, but some are more difficult to detect (especially posterior tongue tie).
• Nipple shields
Even if it’s painful when breastfeeding, try to avoid using nipple shields if possible. They can restrict the amount of milk the baby is able to get, which can lead to the breasts becoming more engorged and sore.
Mastitis can occur in the breasts – it’s an inflammation, and there can also be some infection present, usually caused by a blockage of milk flow. It’s essential to keep on breastfeeding throughout, and seek advice from your health professional.
• Nipple cracks
For nipple cracks and soreness, it may help to use a lanolin ointment or Rite Aid Hydrogel Breast Disc, which is a breast pad that allows very rapid healing to take place underneath it.
Many new mothers worry that their baby is not getting enough milk from breastfeeding alone, or that their baby is feeding too regularly/not often enough. Worries surrounding breastfeeding are completely normal. After all, this is new to you, so you do not yet know what is ‘normal’ for you and your baby.
While it is impossible to know exactly how much milk your baby is getting from breastfeeding (after all, you can’t see your breast emptying, as you can with a bottle), rest assured, there are lots of ways you can tell your baby is receiving enough milk.
‘It is difficult to know when breastfeeding exactly how much milk your baby is taking and if it is enough,’ agrees Dr Bugembe. ‘However, in the first 48 hours, your baby should be having approximately three wet nappies a day if they are taking in enough milk. By day five, they should have six wet nappies in every 24-hour period.’
Worries surrounding breastfeeding are completely normal.
Worries surrounding breastfeeding are completely normal so don’t panic if you are concerned. ‘Your baby should also start coming off the breast on their own after feeds,’ adds Dr Bugembe.
‘This is another indicator that they have had enough milk. If, however, they are becoming increasingly jaundiced or the soft spot in their head seems sunken, these are signs that they may be underfed and need more milk. Your baby should be reviewed by a healthcare professional if there are any of these signs, as they may have an infection that is making it difficult for them to feed.’
What you need for breastfeeding
Breastfeeding is by far the easiest and most convenient way to feed your new baby, once you have got the hang of it, as there is no need for any expensive equipment or sterilising. However, to make your breastfeeding experience more comfortable, you may wish to invest in the following:
✔️ A well-fitting and supportive nursing bra.
✔️ Breast pads, to help absorb leakages – both disposable and reusable options are available.
How to express breastmilk
Recommendations now say you can hand express breastmilk from 36 weeks’ pregnant. ‘Any milk that you collect can be frozen and then used, if needed, once your baby is born,’ says Gilchrist. ‘Hand expressing can also be done in the early days after your baby is born, if baby is not able to effectively latch and attach at the breast straightaway. Any milk collected can then be given to your baby.
‘Expressing milk via a hand or electric pump is only advised once breastfeeding is established, as the breasts can become overstimulated and engorged, which can be quite uncomfortable. If your baby needs to be in the special care baby unit for any reason, you can start using an electric pump straightaway, which the hospital will provide for you.’
Breastfeeding help and support
If you experience breastfeeding problems it can be quite an emotional time. ‘Please don’t worry, as there’s plenty of help available,’ says Gilchrist. ‘Your midwife and midwifery support assistant will be able to signpost you to the relevant resources available in the early days and weeks after birth.
‘There are baby-cafés in many areas of the UK, which are run by midwives and women experienced in breastfeeding. They can help, and will provide excellent advice and support. There are also organisations, such as La Leche League, who offer online, face-to-face and telephone support for families.’