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Your breastfeeding questions answered....

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Antenatal period

What are the benefits to my baby if I breastfeed?

Are there any benefits to me if I choose to breastfeed?

What can I do during my pregnancy to prepare myself for successful breastfeeding?

Why is the support of my partner and family so important to the success of breastfeeding?

What should I look for in a breastfeeding bra?

Are there any books on the subject of breastfeeding that you would recommend?

Do I need any special equipment for breastfeeding?

Are inverted or flat nipples necessarily a problem?

In what circumstances may breastfeeding not be suitable for the mother?

In what circumstances may breastfeeding not be suitable for the baby?



Breastfeeding in the early days


I was told that it is important to feed my baby within the first hour of life. Why is this and what other factors will help us to succeed?

What happens during a breastfeed?

Why is it so important to not offer any formula feeds in the first few days of breastfeeding?

My baby is jaundiced and seems to be too sleepy to feed. Why is this and how can breastfeeding help?

During labour I was given an injection to help the pain. The midwife said that this could make my baby sleepy for a few hours. Will this upset my chances of breastfeeding?

How can I tell if my baby is getting enough milk?

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Breastfeeding as part of your life


In the early days and weeks of breastfeeding I felt exhausted. Is this normal and what can I do to make life easier?

My baby seems to want to feed all the time. Does this mean I don't have enough milk?

When I go out with my baby, I feel embarrassed to feed in public places. What is your advice?

How long does a breastfeed last?

How long will I be giving night feeds for?

Is it true that breastfeeding helps you to get your figure back?

How do I express breastmilk? What are the best ways to store and prepare it?

I am going back to work. Does this mean that I will have to stop breastfeeding?

Do I need to give my baby extra feeds of water or fruit juices as well as breastfeeds?

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Problems and their treatments


My baby suffers from colic. Is this common with breastfeeders and what can I do to help?

What can I do to avoid getting sore nipples? If they are sore, what are the recommended treatments?

What is meant by 'engorgement' of the breasts?

What is meant by the terms blocked duck and mastitis and what treatments would you recommend?

My baby has thrush in his mouth. Can I catch it whilst breastfeeding?

My baby is full of the cold and is finding it hard to feed. What can I do to help?

My baby was premature and I was worried that I may be unable to breastfeed. Is this the case?

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Special circumstances


Is it possible to breastfeed after breast surgery?

Can I still take the 'contraceptive pill' whilst breastfeeding?

Is it possible to breastfeed my baby who suffers from 'Downs Syndrome'?

What happens if I am ill, do I still continue to breastfeed?

What is meant by the term 'breast refusal'?

Is it safe to take prescribed drugs whilst breastfeeding?

I have heard that it is even possible to breastfeed my adoptive baby. Is this true?

Everyone tells me it is too difficult to breastfeed twins. Are they right?

Could you tell me about milk banks and how they work?

What is meant by relactation?

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Weaning


Why can’t I wean my baby before 6 months?

But my baby is four months, and seems hungrier?

How do I go about introducing solid foods to my baby?

Do I reduce the milk feeds once I start weaning?

What foods should I avoid?

Where can I find out more about weaning?

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Q. What are the benefits to my baby if I breastfeed?

Everyone knows that breastfeeding is good for your baby, but why? I want to explain these benefits and the relevance behind each one.

Breastmilk is tailor-made with your very own baby in mind. It provides exactly the correct nutrients in an easy to digest package at exactly the right temperature, whenever your baby wants it!

Colostrum or first milk is produced during pregnancy and in the first two to four days of life prior to the milk 'coming in'. This is rich in antibodies to help protect your new baby from infections and build resistance. Colostrum is also high in protein, so a little goes a long way. Even if you do not want to breastfeed your baby on a regular basis, it is very important to give your baby the benefit of this excellent first food. It is also known to aid the smooth passage of meconium through the bowels. This is the sticky dark stool that has been in the bowels of your baby during pregnancy.

Breastfed babies suffer less infections in their first year. This is not only better for the baby, but also for the NHS, as the breastfed baby is less likely to need expensive treatment in hospital. Their need for antibiotics is also reduced, which avoids any side-effects to their immature immmune system. Infections include those to the eyes, ears, chest, urinary system, skin and gastrointestinal system [tummy bugs]

Sticky eyes are very common in the newborn and cause much worry and struggling with fiddly eyedrops. I did not realise, until I was informed by a friend, that expressing a few drops of breastmilk straight into the affected eye would treat it. I tried it and miraculously my son's sticky eye cleared up within hours! This treatment is used by mothers in the developing World all the time.

Obesity is uncommon with breastfed babies as they seem to only take what their body needs to grow. This will lessen risks of developing complications in later life. These include heart disease , strokes, high blood pressure, diabetes and many more.

Necrotizing enterocolitis is a bowel infection seen mostly in premature infants. This is known to be up to ten times more common in formula fed babies than breastfed babies.

Immunisation. With all the recent talk about the dangers of immunisation, especially the MMR (measles, mumps and rubella) you will be encouraged to hear that breastfed babies appear to have a better tolerance to immunisations than formula fed babies. Breastmilk contains high levels of antibodies that pass from mother to infant. This natural immunity continues until you wean. In addition, his immune system appears to mature at a faster rate, so he is better equipped to fight infections.

Allergies were an important issue to me, as I suffer from hayfever and am allergic to penicilin, cats and dogs. I was keen to try and avoid my children suffering, as I had. Also, in a world where there are so many new chemicals and man-made products, which are known to harm young immune systems, it is vital to give them the best protection possible. Breastfeeding has been seen to reduce the incidence of allergic reactions, which go on to cause: asthma, eczema, hayfever and, more commonly now, nut allergies. It is important to remember that you should try to avoid allergy-triggers, which may go on to sensitize an infant's immune system (Northstone 2002). Current advice recommends giving gluten-free products for the first six months and to avoid cows-milk as a drink until a year. Nuts and eggs are also thought to trigger allergies, if introduced too early. Recent research also suggests, that it is important to avoid baby bath products, baby wipes and antiseptic powders in the first few weeks of life. The skin needs time to mature and could become sensitized to these products, if used too early.

Less dental problems and better jaw development

Better brain and nerve development leading to higher IQ levels!

Sudden Infant Death Syndrome (SIDS) is a complex subject and there are many causes. Breastfeeding alone will not give your baby total protection from this tragedy, but it will lessen the risks. Our first son died at three weeks of age due to cotdeath. I mention this because he was breastfed, so why did this not protect him? He had been born with hydrocephalus (fluid on the brain), he had undergone surgery at a few days old, been given lots of drugs, all of which would have been risk factors. He also slept on his tummy (which is not recommended today). I may never know the real reason why he died but I do know, that by breastfeeding him, I gave him the best chance I could. The best advice for any new mother is still to breastfeed, if possible and NOT TO smoke near your baby. Always lay your baby on their back, towards the bottom of the cot, so they cannot wriggle down under the covers. The use of duvets and cot bumpers are not recommended until a year old as they could cause overheating, which is, in itself, another risk factor.

©Sharon Trotter@ www.tipslimited.com
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Q. Are there any benefits to the mother if she chooses to breastfeed?

A lot is said about the benefits to the baby , but what about the mother? You may be surprised to hear that there are just as many advantages for her including:

Reduced susceptability to breast cancer

Reduced susceptability to ovarian cancer

Reduced susceptability to uterine cancer

Less chance of developing postnatal depression. This is due to hormone levels staying much more stable during breastfeeding. Added to this, during each feed, the brain releases endorphins into the bloodstream. This creates a feeling of wellbeing and relaxation - well it worked for me!

Protection against osteoporosis. This is due to the delay in the return of your periods - when they do return they usually continue until later in life. This means that the high levels of progesterone and oestrogen also continue, delaying the menopause and its associated risks to your bone density, which can lead to osteoporosis.

Closer relationship with your baby leading to contentment for mother and child.

Added contraceptive protection. Although this cannot be guaranteed, breastfeeding delays the return of menstruation and hence fertility. This provides a natural gap between babies, which is safer for mother and child. My periods did not return for nine to 13 months following the birth of my children.

You will get your figure back! Now this really is one to shout about!

It is cheaper! There is no need to buy expensive sterilising equipment and bottles, and with the cost of formula milk on the increase, breastfeeding saves.

It is environmentally friendly - if it benefits the world we live in, then it will benefit the mother and her baby in the long term.

A guaranteed natural high! Every time you feed your baby you get a rush of endorphins ( feel good hormones) that will relax and de-stress you within five minutes. Definitely not to be missed.

Sex. Breastfeeding is an extremely sensual experience. In the early months, when you are overwhelmed by hormones and tiredness, sex is probably the last thing on your mind! However, once you become established with feeding, you will realise how relaxing it can be. The endorphin boost you get during a feed could put you in the mood! So, once your baby is safely tucked-up in his cot, you can turn your attentions to your partner! A definite benefit - I think you will agree!
These are all great reasons to breastfeed, but for me it is the overwhelming pleasure and satisfaction I feel that is beneficial in itself. To see your thriving baby and know that you have played a part in this, not only gives you a great feeling of achievement, but also gives your baby a first-class start in life, which is priceless! It is hard work and exhausting at times, but so is bottlefeeding! Breastfeeding is much more a two-way street, where you both get to benefit from the whole process together.
©Sharon Trotter @ www.tipslimited.com

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Q. What can I do during my pregnancy to prepare myself for successful breastfeeding?

Start to think about how you want to feed your baby as soon as possible

Get information from your midwife at the antenatal clinic

Read as much as you can on the subject, while you still have the time!

Ask friends and family for advice if they breastfed

If you have inverted or flat nipples, it may be worth having a chat with your midwife or lactation consultant. It is perfectly possible to breastfeed with little or no help, but sometimes treatment is required. (see FAQ about this subject)

There are many old wives tales on how to toughen up your nipples, all of which are pointless. The best way to prepare is by gentle nipple stimulation with your partner on a regular basis, which is much more fun!

You will produce colostrum while you are pregnant and this will naturally moisturise and protect your nipples. So as not to wash this away do not use soaps, creams or lotions. Use only plain water.

Talk it over with your partner and get his support and understanding. Explain to him the reasons why you want to breastfeed and the advantages to you and your baby. Studies show that a partners support is one of the most important factors to eventual success. Include him every step of the way and reassure him that he will not have to do any night feeds - this usually works a treat! In return, he can agree to help out more in the daytime.

Stock up on basics in your storecupboard and fill the freezer with ready-made meals. This will avoid any unnecessary shopping trips in the early days. Have a kitty put aside for takeaways when you cannot be bothered to cook! Shop online if you have a computer - this is such a great idea!

Go to a breastfeeding workshop . This is a great way of learning about breastfeeding from midwives, counsellors and feeding mothers. Your local antenatal clinic should offer you a place on one. If not, ask the National Childbirth Trust (NCT) or your local breastfeeding counsellor/lactation consultant.

Before your baby is due, organise an evening out with your partner and enjoy your last night of freedom for a while!

Get to know your midwife and explain your wishes for birth and breastfeeding. Do not be embarrassed to ask any questions. You can be sure she will have heard them all before , however strange!

Take some disposable breastpads with you into the hospital, as you may need them in the first few days. 100% cotton are the best.
©Sharon Trotter@ www.tipslimited.com
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Q. Why is the support of my partner and family so important to the success of breastfeeding?

Breastfeeding is a learned skill and the best way to achieve success is by watching others. If you have been lucky enough to have grown-up in a family where breastfeeding was the norm, it will seem quite natural to you to continue this tradition. However, if you have never seen anyone breastfeeding, this does not mean you will not succeed. What is important, though, is the support you receive from your partner, along with your family, midwife and other health professionals. Peer support is also important and many peer support groups are cropping up all over the country with excellent support and advice from fellow breastfeeders. Your partner can help in many practical ways, like doing chores,cooking meals,keeping visitors to a minimum( in the early days) and letting you rest. Even more importantly, By learning about the benefits to both mother and baby, they can also feel happy in the knowledge that you, as a couple, are giving your baby the best possible start in life. As far as other siblings are concerned, this is the best way to educate a child in the natural art of breastfeeding. They will grow up with the understanding that breastfeeding is the norm. When they become parents, they too will be much more likely to give it a go and in this way, attitudes will gradually change in favour of breastfeeding. Once you become more confident as a breastfeeder, you will feel happy to feed while out and about with your baby. This, in itself, will promote breastfeeding to the wider community and so continue the 'drip-drip' effect of education by example. It may take another generation for this message to get through, but hopefully the results will be longterm
©Sharon Trotter@ www.tipslimited.com
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Q. What should I look for in a breastfeeding bra?

There are many things to look for when buying a breastfeeding bra. Certain features will be more important to some mothers than to others. In my opinion these are the main features to look for in a good feeding bra:

Attractive to look at: although this is a consideration, looks alone are no guarantee of a functional breastfeeding bra.

Supportive: needs will vary but there is little point in a bra looking lovely if it doesn’t give you the desired support or ease of use.

Size: does it come in a wide enough range of sizes to fulfil your needs? During pregnancy and breastfeeding it is advisable not to wear under wired bras as these could restrict the breast tissue, leading to blocked ducts. A good supporting bra in the correct size is vital. If possible get measured properly for your feeding bra a few weeks before your baby is due. At this stage, your breasts have grown to their full size. Following delivery and the first few days, your breasts will settle back to this size and your new bras will still be the perfect fit. I cannot emphasise enough the importance of trying a variety of sizes until you are comfortable. NB. Don’t forget to leave room for breast pads.

Availability: Is it easy to get hold of? Is it sold in a high street store, mail order catalogue or over the Internet?

Comfort: this is a must. It is important to try on the bra because you can’t tell how it’s going to fit from a picture. This is where high street brands are helpful because you can try before you buy. If you do buy mail order or online, make sure the company has a good returns policy.

Design: in the early days of breastfeeding, your breasts can be swollen and tender (engorgement). It is very important not to wear a restrictive bra at these times. Straps that are too tight or that cut in at awkward places could lead to a blocked duct.

Lining: Bras with an inner lining have the potential to cause restriction so unlined/open designs are especially useful. This allows the breasts to be free from obstruction during feeding (following testing and because of the incredibly stretchy and breathable fabric used in the Anna Cecilia easy-zip bra, I believe this is still an excellent choice, even though this design does have an inner lining). Play around with the different features so that you are familiar with how they will perform when you are feeding. This may sound odd but will pay dividends when you find the right bra for you!

Ease of use: it doesn’t matter if it feels and looks great, if you can’t manage to open the bra easily for feeding. Once again, it’s important to try it before you buy it. A one handed opening device (as with the new Anna Cecilia range) is the easiest, allowing you to be discreet if required.

Fabric: is the fabric too thick or too thin? Will it be hot or will the straps dig in? Sports type nursing bras may have an elastic under-bust band. This should not be too tight and should be tried on and tested for comfort? The new breathable microfibre fabrics are excellent at keeping skin cool and dry, drawing moisture away from the body.

Putting it on: this may seem obvious but needs a mention. If you have tender breasts, putting on a bra over your head can be a struggle. It’s much easier to have a front or back opening bra. This said, someone recently informed me that they ‘stepped into’ their pull-on designed bras, which is a good tip.
* Washing instructions: you will need to wash and dry your breastfeeding bras on an almost daily basis, so it’s better if they are machine washable and even better if they go in the tumble dryer. Check the labels. Some manufacturers recommend hand washing, even though the bras seem to tolerate machine washing and tumble drying well. It is up to you whether you want to take the risk.

Information: you don’t need a book, but some accurate information on the bra and about breastfeeding would be helpful. Check to see if there are leaflets in store to go with the bras. These can be very informative and are usually free!

Matching underwear: just because you are breastfeeding doesn’t mean that you need to feel frumpy. There are lots of maternity bras that have lovely pants or thongs to match and come in a variety of colours.

Price: you will need at least four or more bras if you are going to breastfeed. With this in mind you must choose the bra that best suits your budget.

Remember: that you will need to fit breast pads inside the bra, so allow for this when trying them on. It is also helpful to check how visible breast pads are under the bra. The best breast pads are those that do not have any plastic backing as they become hot and sticky. 100% cotton is the best and most absorbent material. You can choose from reusable washable ones or disposables.

And you thought it was just a matter of buying the first maternity bra that you came across!
©Sharon Trotter@ www.tipslimited.com
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Q. Are there any books on the subject of breastfeeding that you would recommend?

My top books for breastfeeding are:

1. Breastfeeding: the essential guide.
By Sharon Trotter, Midwife and Mother. Published by TIPS Limited. 100 pages. Price £5.99.
This book has been written by one of our midwife contributors and remains in the top 5 best selling breastfeeding books on amazon.co.uk Sharon is passionate about breastfeeding and her book is aimed at parents and professionals alike. It comes with a foreword by Anne Diamond and gives you all the advice you need for success. It also contains personal photos of Sharon breastfeeding her babies. This book has received rave reviews and has recently been featured in the internationally respected Journal of Human Lactation.
ISBN: 0954838106


2. Breast is Best.
Revised and updated in 2005 by Dr Penny Stanway. Published by Pan Books. 356 pages. Price: £8.99. I came upon the early edition (by Drs Penny & Andrew Stanway) back in 1983 and it was my bible throughout my breastfeeding life and beyond. It is written in a no-nonsense language and covers everything clearly. An absolute must for every new mother.
ISBN: 0330436309


3. The Breastfeeding Answer Book.
By Nancy Mohrbacher IBCLA & Julie Stock BA IBCLA. Published by The La Leche League International 1997. A third revised edition was introduced in January 2003 with a foreword by Edward Newton. The cost is approx £32. This is a spiral bound question and answer book, which covers everything you are likely to need to know about the subject and more! Slightly on the expensive side but very readable and great for a really in-depth account.
ISBN: 0912500921


4. The Politics of Breastfeeding.
1993 edition by Gabrielle Palmer. Published by Pandora (an imprint of Harper Collins). Series Editor is Sheila Kitzinger. 361 pages. Price: approx.£10. This is a provocative book about the wider issues involved within the subject of breastfeeding. It is well written and will certainly make you sit up and think! This is one for the enthusiast!
ISBN: 0863582206


5. Successful Breastfeeding.
Third Edition by the Royal College of Midwives. Published by Churchill Livingstone 2001. 176 pages. Price: approx. £10. As a midwife I was sent the second edition and was impressed at the sound advice that this book contains. It is not the most exciting but it does cover the important topics, without going into too much detail. It may also be interesting to see what a midwife is taught about the subject.
ISBN: 0443059675


6. Best Feeding - How to breastfeed your baby.
Mary Renfrew Chloe Fisher and Suzanne Arms. August 2004. 274 pages. Price: approx £10. Published by Celestial Arts. This is a delightful commonsense book with some wonderful pictures too. It contains all you need to know to become successful at the art of breastfeeding.
ISBN: 1587611953
Sharon Trotter @ www.tipslimited.com August 2005
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Q. Do I need any special equipment for breastfeeding?

Breastfeeding is convenient because you can feed anytime, anyplace, anywhere and the only equipment you need is yourself and your baby! This said you might find the following suggestions helpful:
Bra: This must be comfortable, supportive, breathable and above all easy to use whilst breastfeeding. There are many on the market, available through high street stores, mail order catalogues and on the Internet. They range in price but it’s worth shopping around to get the right one for you. You can find out more about the top nursing bras we have tested on this website...
Breast pads: These can be reusable or disposable. Available in all baby shops and specialist mail order catalogues. The reusable ones are made of 100% cotton, hemp, merino wool or velour and can be machine-washed. The disposable ones come in lots of shapes and materials but the best, by far are the 100% cotton. They are soft, comfortable, breathable and very absorbent. Try to avoid ones that have a plastic backing as they may cause you to become hot and sticky. They may cost a little more but you will need less of them because of the superior quality. Recently, there has been a new introduction to the breast pad market in the form of silicone breast pads. These are not designed to collect leaks but to stop them happening. By exerting gentle pressure on the nipple they inhibit a mother’s ‘let-down’ and can be worn discreetly under lacy bras, during showers and while swimming. They are washed in soapy water and are breathable. I would not recommend using them for a couple of months when the delicate balance of supply and demand has been established but they are a great innovation which I am sure will become a must-have for nursing mothers. Look out for the reviews on www.tipslimited.com when parent testers put breast pads/treatments to the test.
Bibs and burp-pads: In the early days you will need a drawer full of terry or muslin squares. These are great for mopping up little accidents after feeding. When you start mixed feeding terry towelling bibs are ideal. Many have a Velcro strap for ease of removal. Avoid plastic backed bibs as they will become hard and cracked after a few washes. Stick to white or light colours as they can be washed at a high temperature to remove stains. There are many fashionable designs on the market but in my experience the motifs merely reduce the absorbency of the bib, so it just runs off onto the clothes it is trying to protect!
V-shaped pillow: This is widely available in the household section or bedding stores. You can also buy spare pillowcase covers. This is invaluable, especially in the early days when you need to protect yourself from back strain whilst feeding. I would not go anywhere without this comfort and it is all machine washable, in case of accidents! Remember to get your baby in the good position and attached well for feeding, before using pillows to maintain this. They should not be used as a platform to lay the baby as the baby should be in close contact with the mother’s body for optimising the feeding position.
Breast pump: Once you have become established with breastfeeding, you may want to express some breast milk, so that you can leave your baby in the care of a babysitter for social events. You may need to go back to work and do not want to give up breastfeeding. Whatever the reason, a good breast pump is worth its weight in gold. You could hand express if you wish, which is easy to do and does not require a breast pump. However, this does not always suit, so a breast pump that is easy to use, efficient at milking the breasts and easy to sterilise is vital. I have tried many and in my opinion the hand held models are the best. They are easy to use and new designs simulate the action of your baby sucking. This in turn leads to faster ‘let-down’ of milk. They are hand operated and above all quiet, so you can use them anywhere. These pumps are widely available in baby stores and by mail order.
©Sharon Trotter@ www.tipslimited.com
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Q. Are inverted or flat nipples necessarily a problem?

Many women manage without any help, but some may experience problems. Treatment is available in the form of a new product called the Niplette. This is a relatively cheap device invented by a plastic surgeon. It looks like a transparent nipple-shaped cup with a syringe attached. By following the instructions and using the device for two to three months, preferably before or in the first six months of pregnancy, your nipples are prepared for feeding. Clinical trials sponsored by the manufacturer have been carried out and results look promising. This said, the best advice is still to consult your midwife or lactation consultant.
©Sharon Trotter@ www.tipslimited.com
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Q. In what circumtances may breastfeeding not be suitable for the mother?

There are some occasions where breastfeeding may not be advisable - these include:

Breast reduction surgery - many women have managed to breastfeed following surgery, although success is not guaranteed. It is important to speak to your surgeon to find out how destructive the surgery will be around the nipple area. This will determine the possibility of future breastfeeding. Breast reduction surgery almost always involves moving the nipple to a new position and if great care is taken, most of the milk producing ducts can be saved. Whatever happens, you will need support and information and should be prepared for some problems along the way. There is an excellent website which gives detailed advice on all aspects of breastfeeding after surgery. Go to: www.bfar.org


HIV positive status - although research is ongoing. Some studies have shown that a baby, born to an HIV positive mother, who is exclusively breastfed (no introduction of formula feeds for the first six months of life), has a better chance of becoming HIV negative as his immune system matures.


Certain drug therapies - drugs are known to cross over into the breastmilk. Most drug companies have little data concerning breastfeeding, which is why they cannot recommend the use of their products for breastfeeding mothers. However benefits must be weighed against the potential risks before deciding whether or not to prescribe a drug. This is certainly the case with ex-drug users who are now taking methadone. Breastfeeding is positively encouraged for these mothers because the benefits for the baby far outweigh the risks. Dr. Mary Hepburn is famous for her work with drug dependent mothers at the special reproductive health unit at the Princess Royal Maternity Hospital in Glasgow. Detailed information about drugs and breastfeeding is also available in the annual publication by Dr Thomas Hale and via the Breastfeeding Network (www.ibreastfeeding.com ).
©Sharon Trotter@ www.tipslimited.com
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Q. In what circumtances may breastfeeding not be suitable for the baby?

Serious metabolic disorders ie galactosaemia.

Cleft lip or palate malformations. This does not mean that you cannot breastfeed, but it will be more challenging and expert advice should be sought. Cup feeding or using specially adapted spoons and teats have been found to be helpful in order to feed the baby expressed breast millk (EBM). Once surgery has been carried out to repair the problem, then breastfeeding can start properly and will actually aid the development of the mouth and jaw. To contact the Cleft Lip and Palate Association go to their website at: www.clapa.com or phone 020 7431 0033.
©Sharon Trotter@ www.tipslimited.com
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Q. I was told that it is important to feed my baby within the first hour of life. Why is this and what other factors will help us to succeed?

Whatever type of birth you experience, you will hopefully be encouraged to have immediate skin-to-skin contact with your baby. The benefits of early skin-to-skin contact cannot be underestimated and research shows that it greatly increases the success of breastfeeding. You should try to feed your baby, with help if needed, as soon as he looks interested. This is usually within an hour of birth, when the baby is wide awake and you will still be awake with excitement! If your baby is traumatised, as a result of the birth, breastfeeding, and skin-to-skin contact, will actually provide pain relief and stabilise his heartrate and temperature.


Getting comfortable before feeding is THE most important piece of advice I can give you! This is no easy task in the early days, but well worth spending time getting right. If you have had a caesarean section or are feeling too sore to sit, then lie down on your side. If sitting, I found the V-shaped pillows a great help, especially as a support for your back. For perineal pain, there are now cooling gel pads (feme pads) that alleviate discomfort. Pain killers should also be offered in the maternity unit. If not, ask!


There is much written about how to position your baby but I have found that the best way is also the most natural way. By cuddling your baby close and turning his whole body towards you, this brings his nose in line with your nipple. This allows the baby's mouth/cheek to be in contact with the breast and increases the chances of successful breastfeeding. This is also known as biological nurturing, which describes the instinctive ways in which women and babies respond to each other whilst breastfeeding. A baby will naturally tilt his head while feeding and this is why you do not need to hold onto his head (except gentle support). His bottom lip and chin will touch your breast first and this stimulates him to open his mouth and get a good mouthful. More areola (darkened area around the nipple) will be seen above the top lip than below the chin.


NEVER let the baby suckle on the nipple alone as this will become very painful - the baby gets milk by squeezing the ducts around the nipple and not from the nipple itself.


You may want to bring the nipple out slightly by using your thumb and forefinger to roll it. This may express a little colostrum (first milk), which will tempt the baby to fix onto the breast.


Alternatively, stroke the baby's lips/cheek with your nipple and this will stimulate him to open his mouth wide enough to take a good mouthful. This is called attachment (sometimes referred to fixing or latching) and once achieved you can relax and enjoy!


Although breastfeeding should be painfree, some women find it to be a toe-tingling experience during the first few seconds. This is perfectly normal and should subside as your nipples become used to the new sensation. A good way to check correct attachment is to look at the shape of the nipple after a feed. There should not be any sign of distortion, squashing or blistering.


I cannot emphasise enough how important these first feeds are in establishing good positioning and attachment techniques. It will take a little while to get it right but once you have , it is like riding a bike - the rest will follow.


Following a breastfeed, you may find you bleed more. This is because, during the feed, the uterus contracts (similar to when you were in labour - often called 'after pains'). This is due to the release of hormones while feeding and helps your uterus go back to its pre-pregnant size quickly. It is nothing to worry about as long as it is not associated with large clots or very heavy bleeding. Should this happen, contact your midwife. The bleeding will gradually lessen and change colour from pink to brown. It should have stopped by six weeks postnatally.
©Sharon Trotter@ www.tipslimited.com
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Q. What happens during a breastfeed?

Once your baby has attached to the breast correctly, and you are comfortable, he will begin to suck. This sensation may seem strange at first, but should be completely painfree.


You will notice his jaw moving in time with his sucking.


This sends a message to the brain and back to the breast for the 'let-down' of milk to occur.


This takes about one to two minutes and may be associated with a tingling sensation as your breasts fill with milk.


As your baby sucks, you will hear the milk being swallowed and sometimes even gulping noises.


Your baby's sucking now becomes deeper and slower as he takes his milk feed.


By the end of the feed your baby will hardly suck at all, except for slight fluttery movements. These are important and will be still be stimulating your breasts. Let your baby continue until he lets go of the breast or falls asleep.


The first part of the feed is watery and quenches your baby's thirst. This is sometimes referred to as 'foremilk'.


The second part of the feed is more creamy and higher in calories. This satisfies your baby's need for calories and is sometimes referred to as 'hind milk'.


Try not to get confused with colostrum, foremilk and hind milk. They all combine to form the perfect combination of breast milk which adapts to the changing needs of your baby.


What is important though, is to complete the whole feed from each breast. If your baby gets only foremilk, it could cause him to become unsatisfied and may lead to colic.


You will know when your breasts are empty, because they will become much softer to touch and the feeling of fullness will lessen as the feed progresses. The best way to judge is to look at your baby, who is usually flat-out when they have emptied a breast.


Once the feed nears an end, the sucking pattern will become shallow and intermittent. When ready, your baby will let go of the breast and may fall asleep. If your baby does not let go by himself, you can put a clean finger into the side of his mouth to break the suction and release the nipple. Try not to just pull your baby from the nipple as you may become sore, especially when the teeth start to appear. I know this to be true from bitter experience!


As a rule, there is no need to 'wind' a breastfed baby as he will usually bring up any wind naturally. However, if you think your baby is uncomfortable, you could sit him up and support his chin under your hand, keeping his back straight. This will allow any wind to be passed easily. Alternatively, you could put your baby over your shoulder, which will have the same effect - do not forget to protect your shoulder first.


Breastfed babies are not often sick, but they may bring up a mouthful of milk at the end of a feed.


If your baby is still hungry, then change over to the other breast and let him feed until he has had enough.
©Sharon Trotter@ www.tipslimited.com
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Q. Why is it so important to not offer any formula feeds in the first few days of breastfeeding?

It is vital to allow completely unrestricted feeding as this will stimulate your breasts to produce milk. This takes between 2-4 days depending on how frequently you put the baby to the breast. This is called: 'the milk coming in'.

Do not worry that your baby will starve before the milk comes in. He will be getting colostrum (first milk), which is full of antibodies and high in protein. It is also important because it helps the passage of the meconium (first stool) through the gut of your baby. This will change colour from dark brown to green to yellow and have 'mustard seed'appearance by the third to fourth day. Breastfed babies' stools will remain like this until mixed feeding begins and must not be confused with diarrhoea.


Do NOT be tempted to supplement with a bottle of formula milk. Your baby does not need this and it may well confuse him. If he sees how easy it is to get milk from a teat , he may be reluctant to feed from the breast in future. Some people may try to tell you that large babies will be harder to feed and that they need extra formula. This is not the case and your breasts will provide exactly the right amount of milk, whatever the size of your baby. My children ranged in weight from 8lbs 3ozs to 12lbs 2ozs at birth and were all exclusively breastfed until four months and thereafter for one to three years.


If you do introduce formula feeds early on, you run the risk of sensitising your baby's system, which could lead to the early onset of allergic reactions. These include asthma, eczema, hayfever and many more. This can occur after only one bottle of formula milk.


The use of dummies or pacifiers is not encouraged as this tends to just confuse or frustrate breastfed babies. A clean finger can always be used in an emergency.


Keep your baby close to you and sleep when he sleeps, to try and conserve your energy. Let your partner help if you need a break. He can let the baby suck on his clean finger or pace the floors for a time, while you have a bath or go to the toilet in peace.


Your breasts will get noticeably larger and tense when your milk 'comes in' (this is known as engorgement) and will probably leak on one side as you feed from the other - this is when the breastpads come in useful.


Let your baby complete a feed from one breast until he has had enough and lets go. If you take him off half way through a feed, he will not empty the breast properly, which could cause problems later.


Move over to the second breast, if your baby is still looking for more. If he is sound asleep, leave him to wake up naturally and give him the second breast next time.


If your baby is very sleepy or affected by drugs from the labour, you should initially feed him three hourly until the effects wear off. You could try changing his nappy to wake him up. If you think he has still not taken a good feed, you could try changing him after each side. Alternatively you could give him some expressed milk from a spoon or cup. This phase should be short-lived.


Your baby will naturally lose about 10% of his birthweight in the first two to three days. This is perfectly normal - he has enough fat stores to deal with this loss. Once the milk 'comes in', he should start to regain this and by ten to 14 days will probably be back to his birthweight.


A lot of babies become jaundiced (yellow tinged skin colour) in the first week of life. This is called physiological jaundice and should have disappeared by 14 days. This is caused by the breakdown of the red blood cells that were at a high level prior to birth (allowing for maximum oxygen levels during labour). Breastfeeding will help to flush out the by-products of this breakdown, so the condition will correct itself. Extra supplements of water or formula milk are NOT necessary. Sometimes the baby will be more sleepy as a result of jaundice. In this instance, it is advisable to wake the baby up for frequent feeds until the jaundice has passed.


Never time your feeds - it is not necessary.


You may find it useful to write down which side you have fed on as it is easy to forget. Alternatively you could leave a breastpad in the side you are due to feed from next.


This can be an exhausting time, but will also be very rewarding. Try to make the most of these precious few days by getting to know your new baby.


Get as much help as possible and get your partner to do any household chores. This is when the ready meals and takeaways come into their own. Older children can also help out and toddlers will enjoy being spoiled by grandparents or friends. Prioritise and remember that most things can wait, whereas your new baby cannot!


When it comes to friends and family visiting, it is up to you to set the ground rules. Especially in the first few days, when you are trying to establish feeding, keep visitors to the absolute minimum. People will understand and can see you all at a later date. If you are embarassed about feeding in public, give yourself time and your confidence will grow daily. Once you have settled into breastfeeding, you will be surprised at how easy it is to feed anywhere, without having to expose yourself to anyone. This is where your partner can help, by giving you the time and space required to establish a feeding pattern.


Gradually, by feeding on demand you will fall into some sort of routine (although it will be like no other you have experienced before). This is when you stand at your bedroom window at 3am in the morning and wonder if you are the only person awake - you are not! News24 (we didn't have cable TV then!) and the Open University programmes will become intimate friends. It is amazing what interesting subjects you will learn about!
©Sharon Trotter@ www.tipslimited.com
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Q. My baby is jaundiced and seems to be too sleepy to feed. Why is this and how can breastfeeding help?

In order to understand why your baby is sleepy, you need to know the causes and treatment of jaundice itself.
To provide extra oxygen during the stressful period of labour and birth, a baby's blood contains many more red blood cells than usual. In the first few days after birth, these red blood cells are broken down in the reticuloendothelial system (liver, spleen and bone marrow). The resultant waste product called bilirubin rises and is the cause of the yellow skin your baby displays. This is called jaundice and can even the white (sclera) of the eye can become discoloured. Following various chemical processes the baby combines the bilirubin with proteins so that it can be safely excreted via the liver and kidneys.
Physiological jaundice, as it is known, is very common and affects about 30% of all babies. It occurs around the third day and is usually clear by the 10th-14th day, without any long-term consequences. Jaundice is observed using simple colour charts (icterometer) and if the colour deepens a heel prick blood test will be carried out. This is called a serum bilirubin (SBR). Serum bilirubin levels are checked once or twice daily and as long as they do not rise above 250-300 mmol/litre no treatment is required. Each hospital will have in place a set of guidelines that are followed in order to highlight any potential problems.
If levels rise above this, there can be a risk of brain damage, which is why it is so important to monitor bilirubin levels regularly. Phototherapy helps to speed the process of bilirubin breakdown, thus bringing it back to normal.
Phototherapy consists of a set of fluorescent strip lights that provide blue light. This is either placed over the cot/incubator or as a mattress (called a bilibed) that the baby lies on top of. The baby is nursed naked and fed frequently to provide the necessary energy and protein. Extra care is needed to reassure the mother that this is a short-term process that will hopefully resolve the problem.
If levels rise further and are not helped by phototherapy, there may be a need to investigate the cause. An exchange transfusion of blood may be required in this instance. However these complications are very rare and the most important point to remember is the commencement of early feeding.
Breastfeeding not only provides the baby with the energy and proteins that are needed for the breakdown processes, but also aids the efficient removal of the first stools through the gut, thus allowing for the excretion of the by products of the bilirubin breakdown.
As a consequence of all these chemical processes, it is not surprising that a jaundiced baby is sleepy, making feeding difficult. This is why it is important to feed a little and often. If the baby is reluctant to breastfeed, milk can be expressed and given to the baby using a spoon or cup. This avoids the baby using up too much of his energy on actually feeding. The breast can be offered for short periods, whilst the mother is encouraged to express in between times, until the baby is strong enough to take all the feeds himself. It is not necessary to give formula feeds, as long as enough expressed breast milk is collected.
Extra clear fluids used to be given to 'flush' the kidneys. However this is now known to be unnecessary. The priority is to provide the baby with sugars for energy and proteins to bind with bilirubin. These are both available in the perfect proportions in the mother's own breastmilk.
In this way, the levels of bilirubin can be reduced quickly and turned into safe waste products that can then be excreted in the baby's urine and stools. This, alongside phototherapy should be enough to treat most infants.
If you have any worries, your midwife will be happy to advise you.
©Sharon Trotter@ www.tipslimited.com
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Q. During labour I was given an injection to help the pain. The midwife said that this could make my baby sleepy for a few hours. Will this upset my chances of breastfeeding?

The simple answer is yes. However there are steps you can take to minimise any problems.
The most common painkiller given by injection today is called Diamorphine. Some units still use Pethidine, which is also given by injection. These are strong drugs that cross the placenta and, as such, can also affect the baby. If they are given early in labour, this will not cause a problem because the effects will have worn off by the time the baby is delivered. However, if they are given towards the end of labour, the baby may indeed be quite sleepy. An antidote can be given, if necessary, but is not common practice in most cases.
Immediately after delivery, even if affected by these drugs, you will find that most babies are wide-awake for the first hour or so. This is why it is so important to introduce the first breastfeed at this time. It will give your baby a well-earned feed after the exertion of labour and delivery, as well as reassuring you that you are capable of latching on and feeding your baby.
Over the next few hours and days your baby may continue to be sleepy at times. This does not necessarily have to be a problem. The only difference is that demand feeding may need to be prompted slightly, should the baby remain sleepy for long periods. As the drugs wear off, you will find that your baby is more alert and looking for feeds. Once this happens you can become more baby-led.
It is important to express some breast milk after feeds, whilst the baby is affected, so that your milk supply is not interrupted. This milk can be given to your baby on a spoon or from a small cup. This will avoid any confusion over teats, which may hinder the establishment of breastfeeding.
The most important advice is to be patient and by following these simple guidelines, your baby will soon be waking and taking his feeds on demand.
©Sharon Trotter@ www.tipslimited.com
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Q. How can I tell if my baby is getting enough milk?

This is one of the most commonly asked questions about breastfeeding and the answer is surprisingly straightforward.
As long as your baby is waking and alert before a feed, takes the feed well, settles between feeds and has lots of wet and dirty nappies, he will probably be getting enough. This is a simplification and all babies stray from the rules because they don't know what the rules are!
Your baby may feed more frequently during the evenings, but this can also be said of formula fed babies. Weight gain will vary but, on average, it will be less than a formua fed baby. Some weeks your baby may gain a whole pound, whilst others, it could be as little as a few ounces.
Your breast should feel soft and relaxed after a feed is complete. I say breast because you will probably only need to feed from one side at a time. It is very important to finish one breast before changing over to the second. This is because, the feed is made up of two types of milk. The first is sometimes reffered to as foremilk and is watery to quench your babies thirst. The second is sometimes referred to as hindmilk and contains the bulk of the calories to satisfy your baby. If you were to switch over to the second breast too early, your baby could drink too much foremilk ,get overful, but still seem unsatisfied. This is a common problem, which can easily be helped by following these simple guidelines.
Let your baby feed on demand, for unrestricted periods and he will eventually settle into a pattern. Every few weeks, you may find that your baby needs more feeds than usual. This does not mean that your milk supply has run out, but your baby is probably going through a growth spurt. Feed more often, as and when the baby demands and within 24-48 hours things will have settled down and you will be producing enough milk to cope with your babies growing needs.
It is all about supply and demand and this is how your breasts make sure that your baby is getting enough.
©Sharon Trotter@ www.tipslimited.com
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Q. In the early days and weeks of breastfeeding I felt exhausted. Is this normal and what can I do to make life easier?

It is important to remember that even if you are bottle-feeding, motherhood is an exhausting time.
Your body is still trying to get over the experience of childbirth and this will take time. This is perfectly normal and you should not be worried. Mother nature is very clever and by breastfeeding, she makes sure that, you are sitting down and resting, instead of rushing around doing unnecessary chores.
My tips include:

Get as much rest as possible. If this means going sleeping in the middle of the day when your baby is asleep, then so be it.


Enjoy this precious time with your new baby. It will go all too quickly and this is a great excuse to savour every minute.


Eat takeaway food if you can't be bothered to cook.


Get your partner and family or friends to help out with shopping, cooking or household chores etc. This will give you the time you need to establish breastfeeding and recover from the lack of sleep. This period will only last for a few weeks and most things can be put on hold.


Don't try to be superwoman! If you overstretch yourself, you will end up feeling run-down and this could go on to affect your milk supply.


Keep visitors to a minimum in the early weeks - your partner can help with this by deflecting any unwanted guests!


Listen to your body and be guided by it. By doing this you will soon be back to your energetic self - I promise!


Gradually you will get into a routine (although it will be like no other you have experienced before!) and begin to feel less tired.
©Sharon Trotter@ www.tipslimited.com
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Q. My baby seems to want to feed all the time. Does this mean I don't have enough milk?

Every few days or even weeks, you will notice that you seem to be feeding more often. This is perfectly normal and usually coincides with a growth spurt of your baby. In order for the breasts to increase their supply, to keep up with your babys growing demands, they need more stimulation. This is what your babys extra feeds are telling your breasts. It does not mean that your milk supply is running out or that you should supplement with formula. Listen to your babys wishes and within 24-48 hours things will have settled down again and you will be producing the required amount of milk for your baby.
©Sharon Trotter@ www.tipslimited.com
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Q. When I go out with my baby, I feel embarrassed to feed in public places. What is your advice?

Once you have more confidence with your feeding, you will be free to go out and about without having to carry lots of bottles etc. with you. (you will still need nappies,clothes, prams car seats and all manner of other bits and pieces!). All you have to do is find a quiet place and , wearing discreet clothing you can feed just about anywhere! I have frequently fed in carparks, restaurants, cinemas, childrens play areas, planes, trains and even side streets on the way home from the shops! Some shops or department stores provide mother and baby rooms, but most fall short in terms of facilities for breastfeeding mothers. A lot will provide bottle warmers and nappy changing areas, but fail to provide a comfortable chair to feed in. Others have a chair but no toilet for the mother to use! (we need to go as well !) However, they are getting better and the beauty of breastfeeding is that you don't really need any facilities, its easy to feed anywhere.
Be proud and try not to be put-off by inquisitive stares. They are probably just curious and may have never seen anyone breastfeeding in public before. They may actually be embarrassed themselves. This will hopefully change as more people breastfeed in public and it becomes the acceptable way to feed your baby. I recently went to Florida on holiday and was surprised and reassured at the number of women openly walking around the theme parks whilst feeding. They wore shawl-like slings which allowed the baby free access to the breast but were completely discreet.
You will be surprised at how quickly you become confident about breastfeeding and before you know it, you will not give it a second thought.
©Sharon Trotter@ www.tipslimited.com
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Q. How long does a breastfeed last?

I have not mentioned how long a feed should take because there is no real answer. However, once your feeding is established, it can be a lot quicker to breastfeed than bottlefeed. This will vary everyday so I don't want you to worry about times or clock-watching. The simple answer is to feed your baby whenever he demands it and let him take as long as he needs. This will settle into a pattern that changes with the growing needs of your baby. Be led by him and you cant go far wrong.
©Sharon Trotter@ www.tipslimited.com
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Q. How long will I be giving night feeds for?

Night feeds also vary and may disappear within 6-8 weeks but more often will continue for 6-8months! Hormone levels are higher at night, so it is important to give night feeds. In this way you will make sure that the supply and demand of your milk stays balanced, allowing you to produce enough milk for your growing baby. A few minutes to feed and put down your baby is no great hardship and it's a good excuse to have a cuddle! Once you get proficient, it really can only take 10 minutes from lifting your baby and putting him back,all fed! I know because I have timed it! (purely for research purposes!). I stay pretty much asleep and don't even put the light on,although a dim nightlight can be helpful. If you have to change a nappy,do it before the feed, so that you can put the baby down when he falls asleep on the breast. Once settled, don't forget to place your baby on his back and towards the bottom of the cot, so that he cannot wriggle down under the covers (which could cause overheating).
©Sharon Trotter@ www.tipslimited.com
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Q. Is it true that breastfeeding helps you to get your figure back?

While you were pregnant, your body laid down extra fat stores to prepare for feeding your baby. This will gradually be used up over the first six to eight months of breastfeeding. This means that, even though you can eat and drink pretty much what you want (within reason!) you should still have lost the weight you gained during pregnancy. This has got to be a bonus! I have a very good appetite and have never had a problem regaining my pre-pregnancy figure, with the help of breastfeeding. However, this does not mean that you will suddenly become a size 10, if you started out as a size 14 when you became pregnant!
©Sharon Trotter@ www.tipslimited.com
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Q. How do I express breastmilk? What are the best ways to store and prepare it?

It takes about six to eight weeks for breastfeeding to become established, so you will need to be with your baby most of the time. However,after this period, if you wish to go out and leave the baby for a while, you can express some milk and leave it for someone else to feed him. You will probably only be away for short periods, so if you feed your baby before you leave he may not even need it. There are many pumps on the market, but I have found that the best ones to use is the hand-operated ones. They are easy to use and produce milk quickly and efficiently. Freeze the milk in sterile containers and when needed defrost and reheat.
As well as using the breast-pump or electric humilactor, seen in hospitals, you can always hand-express yourself. This is very easy to do and avoids the need for expensive pumps. Start by stroking your breast. This encourages an increase in blood flow to the area. Continue by gently massaging either side of your areola ( the dark area around the nipple) with your thumb and forefinger. This may be associated with a tingling feeling as your breasts start to produce milk, which can then be dripped into a sterilised container. A small bowl is best as it is difficult to aim into a bottle! As with the breast-pumps,it is helpful to have a photo or even a tape recording of you baby, as this will stimulate you to produce milk quicker.
When using expressed breast milk (EBM), do NOT reheat in a microwave as it is known to damage the antibodies. The best way to reheat the EBM is to put the container of milk, into a jug or saucepan of hot water and heat gently. Always test the temperature of the milk on the back of your hand, so as not to scald your baby.
If your baby will not feed from a teat (and this is very common with breastfed babies), you can feed him EBM from a sterilized spoon or cup. This usually works well.
©Sharon Trotter@ www.tipslimited.com
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Q. I am going back to work. Does this mean that I will have to stop breastfeeding?

The short answer is no. There is no reason why you cannot combine working with breastfeeding. It really is not as difficult as you think and after you have established a routine it need not be any more difficult than bottlefeeding. It is up to you how long you breastfeed for. This depends on many factors and is a personal choice. I fed my first two children for a year each, then went on to feed my third child for 2¼ years! My youngest child stopped breastfeeding just before his third birthday!
If you have to return to work early, then you can leave a feed of EBM (expressed breast milk). Express the feed you would have missed at work, store the milk in a refrigerator and when you return home, transfer it to the freezer. EBM can be stored in the freezer for up to three months. This way you will always have a fresh feed ready for your next shift. You will soon get into the way of expressing quickly and easily. A photo of your baby next to you and a quiet room will help.
Employers MUST allow new mothers the opportunity to express milk or even have their baby brought to them for a feed. You can find out more about your rights at work on the Maternity Action website (www.maternityaction.org.uk).


It is totally up to you and your baby, but it is advisable not to stop feeding suddenly. This will not only be bad for you, as you will become sore and engorged, but it would also be traumatic for your baby.
If you know that you will be returning to work, then try to wean your baby over a few weeks. If you wish to stop breastfeeding, then give your baby a formula feed once a day to start with and gradually introduce more. If he will not take it from you, which is very common with breastfed babies, then give him to your partner to feed. Alternatively you can use a sterilised spoon or cup instead. If you want to continue to breastfeed, then start to get used to using the breast pump and leave some feeds in the freezer. Express after your baby has fed, so that you are not depriving him of milk. While you are at work, the baby can have EBM and you can express the feed you would have given him. This way your milk supply will not be affected and your baby has a fresh feed for the next day already prepared!
©Sharon Trotter@ www.tipslimited.com
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Q. Do I need to give my baby extra feeds of water or fruit juices as well as breastfeeds?

Your baby does not need any other food or drink for the first six months of life. If the weather is hot, just dress the baby in a vest and feed more often, as the baby demands. Breast milk is mostly made up of water so the baby will not become dehydrated.
Introducing juices is not necessary and the use of teats could confuse the breastfed baby. You should still offer the breast after each mixed feed and you will find that this is all that your baby will need. If you do give EBM or water, because you have to leave the baby, then you can use a cup from six months, thus avoiding bottles altogether.
©Sharon Trotter@ www.tipslimited.com
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Q. My baby suffers from colic. Is this common with breastfeeders and what can I do to help?

Unfortunately colic can affect breastfed babies as well as bottle fed babies. This usually occurs at about three weeks of age and can continue until about four months. It is characterised by a crying baby with no obvious way of settling them. They go red in the face and often draw their legs up, as though they are in pain - muscular spasms are thought to be the cause and could be linked to an intolerance of cow's milk or even stress related. Personally I think the cause could be that the baby's intestines are starting to grow and unwind. All my babies have been exclusively breastfed and although colic is less common in breastfed infants, mine have all suffered! It usually only lasts for a few weeks and I have never changed my diet, before or after the colic, so I do not believe that to be the cause (although some may disagree). When the milk supply is becoming established, the baby could be taking too much milk and just becoming full of wind. Whatever the cause, it can be the most distressing condition to deal with.
I have a few answers you can try. Firstly, make sure that the baby does not feed too fast. Give him small breaks and wind him if necessary. Putting the baby over your shoulder and pacing the floor works well, but as soon as you stop, the crying starts. A wonderful homeopathic remedy called Colcynth 30c granules is worth a go. Put a few granules on your finger and put it onto your baby’s tongue before each feed and the colic would be eased within 24-48 hours. You can buy these online here.

If you think it may be food intolerance, try to avoid that particular food and see if this helps. Sometimes strawberries, chocolate or wheat products have been known to aggravate colic. White noise can be helpful (vacuum cleaners, hair dryers etc) to calm a fractious baby. Sitting my babies in front of the tumble-dryer seemed to be the best treatment, but our electricity bills went through the roof! Cranial osteopathy can also be a great help so try to find a practitioner in your local area (preferably one who comes highly recommended by other parents).  

With the help of all these treatments you should be able to keep yourself sane for long enough to let the colic run its course! Rarely, colic could be a sign that there is a medical or surgical problem. If there is any diarrhoea, sickness, constipation or fever, then do not hesitate to call your General Practitioner.
©Sharon Trotter@ www.tipslimited.com
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Q. What can I do to avoid getting sore nipples? If they are sore, what are the recommended treatments?

This is one of the most common but treatable problems. If left, it will almost certainly lead to the failure of breastfeeding, due to the pain and subsequent fear of feeding. This is almost always caused by poor positioning and fixing-on of the baby.
Once again, I cannot emphasise enough how important it is to get comfortable. Position the baby and spend some time allowing him to attach to the breast before you let him start the feed. If you feel any pain, then stop and reposition until you are more comfortable.
While your nipples are healing, it is advisable to experiment with different feeding positions at each feed until you are back to normal. Some women have very sensitive nipples and may have to persevere for a while until they get used to the feeling of the baby sucking. However they should not be in pain after the initial attachment. Rarely, a condition known as 'Vasospasm', which is known to affect the circulation of blood to the breast, is the cause of sore nipples. Get advice from your midwife, health visitor or lactation consultant and maybe ask them to watch your feeding technique. They will be able to tell you if you need to change any part of this technique.
Nipples that are tender, but not cracked, are best treated with a pure nipple cream that can be left on whilst feeding. Many find this comforting, while they get used to the sensation of feeding. I explain this to women as similar to dry lips in need of moisturizing. Research suggests that wounds heal quicker after a period of moist healing. With this in mind, Specially impregnated dressings and creams are now available to buy or receive on prescription. Get advice from your midwife, health visitor or lactation consultant. Continue to feed throughout the treatment, unless it is really painful. If this is the case, then you can express milk from the affected side, until it is more comfortable. Gradually re-introduce feeds and although It may be sore initially to attach, once the baby is feeding well in the correct position, the nipples will soon heal! PROMISE!
©Sharon Trotter@ www.tipslimited.com
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Q. What is meant by 'engorgement' of the breasts?

This is when the breasts become overful and very tender. It is common in the first few days after delivery, when the milk is 'coming-in'. This coincides with an increased blood supply as the milk production changes from colostrum to mature milk. It will settle down in a couple of days, but in the meantime, it is advisable to feed frequently. Support your breasts, to avoid blocked ducts. If it is difficult for the baby to attach onto the breast, try expressing a little milk first to soften them. This will allow for easier attachment. There are many products now available to relieve sore breasts including gel pads that can be cooled or warmed, but the best answer I know of is a cabbage leaf straight from the fridge. It fits neatly inside your bra and gives instant relief!
©Sharon Trotter@ www.tipslimited.com
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Q. What is meant by the terms blocked duct and mastitis and what treatments would you recommend?

A blocked duct will make part of the breast appear red, lumpy and painful to touch. It is caused by poor emptying or a badly fitting bra, which in turn blocks the duct. The breast is made up of 15 to 20 ducts, which lead to the nipple. This is where the milk is stored until the baby is ready to feed. If the baby is in a poor position or something is pressing on the breast, it is likely to get blocked. The milk cannot get past and builds up behind the blockage. You may also suffer from flu-like symptoms. If this happens, the most important thing to remember is: do not stop feeding.
You will need to rest, so get help from your partner or family member. Remove any tight bras or straps and just wear a close-fitting top, which will hold your breast pads in place. You may need to get bigger bras for later. While feeding, try to support the affected breast with your hand. Check that your positioning is allowing good milk emptying by the baby. Start with the affected breast and feed often, until it is clear. A warm bath lying on your tummy may bring some relief. Using your fingers, massage the reddened area towards the nipple in gentle strokes. This may help to loosen the blockage. You may wish to use the 'rugby ball' position as an alternative - this is when the baby is held under your arm, with his body behind your back and only his head around the front. This takes the pressure off a blocked duct. Continue to feed and take care with positioning and within 24 to 48 hours it should correct itself. You do not need antibiotics at this stage, but Ibuprofen can help the pain and inflammation. If possible stay in bed for 24 hours while you are feeling poorly. Once again the trusty cabbage leaf will come in handy. Keep some handy in your fridge. Mastitis just means inflammation of the breast and may be caused by a blocked duct or over-full breasts. It may or may not be infected. If antibiotics are prescribed, take the whole course but continue to feed and follow the treatments for a blocked duct. Taking antibiotics can affect your milk supply so should be avoided if possible. I have suffered from blocked ducts/mastitis on numerous occasions, including high temperatures and flu-like symptoms and have recovered without the need for antibiotics. As long as you start to feel better within 24-48 hours of onset, the likelihood is that you have been successful in treating yourself. However, if you are worried, get advice from your midwife, lactation consultant or general practitioner.
©Sharon Trotter@ www.tipslimited.com
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Q. My baby has thrush in his mouth. Can I catch it whilst breastfeeding?

Antibiotics used to treat mastitis, wound infections or pelvic infections are the commonest cause of thrush. If you have thrush you will notice pink or red spots around the nipple - these may be sore. There will also be spots inside the baby's mouth or lips and he may be fretful. Once again I must emphasise that you should continue to breastfeed. You will both need to be treated at the same time with cream or tablets from your GP. Treatment may take up to two weeks to avoid reinfecting each other.
©Sharon Trotter@ www.tipslimited.com
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Q. My baby is full of the cold and is finding it hard to feed. What can I do to help?

When a baby has a cold, he finds it very hard to suck and swallow at the same time. He becomes frustrated and upset and may be sick or choke. In this situation, breastfed babies appear to feed easier than formula-fed babies. Breastfeeding seems to allow mucus to drain down the back of their throat. Try to feed the baby more often, as this will help to clear his nose and settle him to sleep.
©Sharon Trotter@ www.tipslimited.com
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Q. My baby was premature and I was worried that I may be unable to breastfeed. Is this the case?

Even if your baby is born too early and is being cared for in the special care baby unit (SCBU), there is no reason why you cannot breastfeed. In fact studies have shown that premature babies who are fed on EBM do better than those who are fed with formula milk and suffer less complications.
With the help of the staff in the SCBU, you will be advised how to express milk using the hospital electric pumps. As the baby is usually small, their milk needs are not great, so you will only need to produce a few millilitres each feed. Some hospitals even have a milk bank (see the section on milk banks at the beginning of the book), so that you can donate milk for other sick babies rather than waste your leftover supply.
Once your baby gets bigger and stronger, you can try a cup or spoon instead of tube feeding, then eventually introduce the breast during the daily routine. Gradually you will be able to drop more tube or cup feeds, until you are breastfeeding all the time. This will take a lot of determination at a very worrying time, but will be well worth it.
©Sharon Trotter@ www.tipslimited.com
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Q. Is it possible to breastfeed after breast surgery?

In the case of breast implants, there is no reason why you should not be able to breastfeed your baby. You will still have all the breast tissue and as long as there has not been any surgery on the nipple area, you should be OK. There may be some problems with engorgement due to the presence of the implant but this should settle down within a few days.
With breast reduction surgery the chances of success are much lower. However, depending on the extent of the surgery, it can be possible to breastfeed. It is important to speak to your surgeon at the time to find out how destructive the surgery will be around the nipple area as this is what determines the possibility of future breastfeeding. If you would like to attempt to breastfeed following your surgery, you need to speak about this with your surgeon. Breast reduction surgery almost always involves moving the nipple to a new position and if great care is taken, most of the milk producing ducts can be saved. However, this is not always the case and consequently, your chances could be greatly reduced. Whatever happens, you will need a lot of support and information and you should be prepared for some problems along the way. There are some excellent websites on the Internet, which give detailed advice on all aspects of breastfeeding after surgery. One such site is called: www.bfar.org there is also a book on the subject. It is called: Defining your own Success: Breastfeeding after Breast Reduction Surgery by Diana West.
©Sharon Trotter@ www.tipslimited.com
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Q. Can I still take the 'contraceptive pill' whilst breastfeeding?

It is not recommended that you use the combined contraceptive pill as this has been found to affect the production and the duration of the milk supply, due to the increased levels of oestrogen. However, it is quite safe to use the progesterone only pill (often called the mini-pill). It is advisable to wait until 6 weeks, until your milk supply has established and you are breastfeeding well. You must remember that you need to take this pill at the same time every day as the blood levels need to stay constant in order to fully protect you from pregnancy. If you are exclusively breastfeeding your baby (this means not giving any other supplements of formula milk and feeding on demand throughout the day and night) it is unlikely that you will ovulate in the first six months following delivery. Some women do not get their periods back until a year later. However, this should not be relied upon as a form of contraception as it is possible to get pregnant whilst you are breastfeeding. The best place to receive information and treatment, which is also free, is at your local family planning clinic. A list is available in your local phone book.
©Sharon Trotter@ www.tipslimited.com
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Q. Is it possible to breastfeed my baby who suffers from 'Downs Syndrome'?

Downs Syndrome is a genetic disorder where the child has an extra chromosome on the 21st pair of chromosomes. This results in a variety of problems, ranging from fairly mild to life threatening. A common problem is a weak sucking reflex and poor muscle tone. They are prone to respiratory infections, so the additional protection from infections that breastfeeding brings is even more vital. The development of the mouth, tongue and facial muscles can also be helped by breastfeeding and this in turn can aid the development of speech for these children. It may take more time to establish breastfeeding and extra help and support is vital but the long-term benefits cannot be underestimated. There are wonderful support websites which include: www.dsa-uk.com and www.breastfeeding.asn.au The former is the Downs Syndrome Association in the UK and the latter is the Australian Breastfeeding Association, where there is an excellent article about breastfeeding a baby with downs syndrome if you click on 'breastfeeding information'. If you do not have access to the Internet then your Midwife or Health Visitor will be happy to find you a support group in your area.
Although I have only mentioned Downs Syndrome, there are many other special needs babies that would benefit from the protection of breastfeeding. With help and understanding there is no reason why you should not attempt to breastfeed your baby. Even if you find it too difficult to breastfeed in the early days, you can express your breast milk and give it to your baby by cup, spoon or tube, until such time that your baby is strong enough to try breastfeeding from you. This will almost certainly help you to bond better with your baby, during the difficult time, whilst you are coming to terms with the reality of your baby's condition. Be guided by your paediatrician and midwife and don't be afraid to ask for help.
©Sharon Trotter@ www.tipslimited.com
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Q. What happens if I am ill, do I still continue to breastfeed?

If you are full of the cold or in bed with the flu or even a blocked duct, it is important to continue to breastfeed. You do not need to worry about passing on the germs to your baby, as your own antibodies that are produced in the breast milk will protect them. All the time that you are breastfeeding, your baby will be given the added protection of your natural immunity to all sorts of infections.
The most important thing is to get as much rest as possible until you are feeling better. Try to get some help so that you only have to breastfeed your baby, whilst someone else looks after the baby. You will usually feel better within 24-48 hours, when you can gradually take over.
If the condition is serious and you need to go into hospital, then you will need more support. However, it is still possible to be given the baby just for feeds and you may even be able to keep the baby next to you, as long as someone else is at hand to support you in between feeds. You could also express feeds to be used overnight if your baby is not permitted to remain in the ward.
These situations will all be special cases, so it is important to be guided by your doctor. Most hospitals will be willing to accommodate you if you are breastfeeding a young baby.
©Sharon Trotter@ www.tipslimited.com
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Q. What is meant by the term 'breast refusal'?

Occasionally and sometimes for no apparent reason, your baby may actually refuse to feed from the breast. This can be extremely distressing for all involved. In this instance, patience and expert support is vital. During this period, maintain lactation by expressing frequently, whilst feeding your baby with EBM by spoon or cup. Periods of skin-to-skin contact should be enjoyed, until the baby is ready to return to the breast. Advice from your midwife, breastfeeding counsellor or lactation consultant is essential, but be assured that by expressing, you are still giving your baby the best nutrition. Hopefully these difficulties will be short lived.
©Sharon Trotter@ www.tipslimited.com
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Q. Is it safe to take prescribed drugs whilst breastfeeding?

Certain prescribed drugs are known to cross over into the breastmilk. Most drug companies have little data concerning breastfeeding, which is why they cannot recommend the use of their products for breastfeeding mothers. However benefits must be weighed against the potential risks before deciding whether or not to prescribe a drug. This is certainly the case with ex-drug users who are now taking methadone. Breastfeeding is positively encouraged for these mothers because the benefits for the baby far outweigh the risks. Dr. Mary Hepburn is famous for her work with drug dependent mothers at the special reproductive health unit at the Princess Royal Maternity Hospital in Glasgow. Detailed information about drugs and breastfeeding is also available in the annual publication by Dr Thomas Hale and via the Breastfeeding Network.
©Sharon Trotter@ www.tipslimited.com
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Q. I have heard that it is even possible to breastfeed my adoptive baby. Is this true?

It is possible to stimulate the breasts to produce milk for an adopted bab.! This will take a lot of planning and expert advice from your breastfeeding counsellor. However, it can be achieved and is a wonderful way to stregthen the bond between mother and new baby. There is a great website that is written by a women who has breastfed her two adopted babies, which gives lots of sound advice and support. Go to: www.fourfriends.com/abrw
©Sharon Trotter@ www.tipslimited.com
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Q. Everyone tells me it is too difficult to breastfeed twins. Are they right?

There is no reason why you should not breastfeed twins or even triplets. However, this will take a lot of organisation and extra help is vital, especially in the early weeks. The Twins and Multiple Birth Association (TAMBA) will have lots of excellent advice for you. Their address can be found at the end of the book. Their web address is: www.tamba.org.uk They have just celebrated 25 years and can be contacted by phone on: 0870 770 3305.
©Sharon Trotter@ www.tipslimited.com
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Q. Could you tell me about milk banks and how they work?

Milk banks are alive and well. Many people think that there are no longer any milk banks because of the incidence of HIV infection. This is not the case and there are now seventeen in the UK alone. Queen Charlottes Maternity Hospital Milk Bank opened in 1939 and is still going strong! They have saved the lives of countless babies and will go on doing so in the future. Guidelines, introduced by the UK Association of milk banks (UKAMB) in 1994, were revised for the second time in 2003. These are endorsed by the Royal College of Paediatrics and Child Health. The milk is collected from women in the hospital or in the community. Donors are all tested for HIV and other infections and the milk is pasteurised to make it safe for use in the special care units around the country. A website, run by the UKAMB covers all aspects of the subject. The address is www.ukamb.org
©Sharon Trotter@ www.tipslimited.com
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Q. What is meant by relactation?

This simply means re-establishing breastfeeding after a period of artificial feeding. Whilst researching mys book, many women have come to me with heartbreaking stories of disappointment and guilt after bad experiences with breastfeeding. They may have suffered from sore nipples, mastitis, lack of support, ill health, sick baby or just felt too tired to get feeding established. Whatever the reason, their babies are now doing well but they still feel upset because their expectations of breastfeeding have been shattered. This is all too common, causing much anguish and though rarely mentioned, I feel it is important to introduce the possiblility of giving breastfeeding another try. This may shock many women but it is perfectly reasonable to re-lactate, even after a period of many weeks or even months. Once your breasts have produced milk, with enough stimulation, they can produce milk again. You will need determination and preferably expert advice, but if you really want to do this and your baby is willing, there is nothing to stop you. Start with periods of skin-to-skin contact and let your baby feed, for comfort at first. Continue to feed with formula milk whilst building up the number of breastfeeds offered. Meanwhile express regularly, using a breast pump or by hand until your milk supply increases. As the number of breastfeeds increase, you can drop the number of formula feeds. It may take a few weeks to re-establish but it is possible and should not be ruled out in certain circumstances. In this instance, I strongly advice contacting your midwife or breastfeeding counsellor for advice and support.
This will obviously not be suitable for everyone, but for some women it will be very rewarding. It will take time and a high level of commitment, which could still lead to dissappointment, should it not succeed. However, just because it is unusual does not mean it is unworthy of a mention. The important point to remember is to do what you feel is right for you and your baby. For more information there is an extensive document relating to this subject, which is available from the World Health Organization (WHO 1998).
©Sharon Trotter@ www.tipslimited.com
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Q. Why can’t I wean my baby before 6 months?

Weaning should not be attempted before six months of age, as recommended by the UK Dept of Health and the World Health Organisation.
©Sharon Trotter@ www.tipslimited.com
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Q. But my baby is four months, and seems hungrier?

Before this time all a baby needs is breast milk or formula feeds. This is because a baby’s digestive system is too immature. Exclusive breastfeeding (or bottle feeding) during the first six months of life provides for all the nutritional needs of a baby. Half of these needs can still be met by breastfeeding in the period from six to 12 months. From 12 to 24 months a baby will still receive a third of its nutritional requirements from breast milk alone. From six months of age, once solid foods have been introduced, cup feeding, using an open cup, can complement breastfeeding or give an alternative to the bottle. This will help to maintain breastfeeding and fulfil the UK Committee on Medical Aspects recommendation that bottles should be discontinued by the age of one year.
©Sharon Trotter@ www.tipslimited.com
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Q. How do I go about introducing solid foods to my baby?

Baby-led weaning is a common-sense approach to eating for babies which follows on nicely from baby-led feeding. At six months, when your baby starts to show an interest in chewing things, you can start to introduce new tastes.

Baby-led weaning is simply that: letting your baby decide what he wants to eat by letting him join the family at mealtimes. The theory is that if you offer your baby the same food as his siblings, but cut in shapes he can pick up, hold and put to his mouth, he will soon eat the same foods as them.  No need to start with purees or cereals just normal food in bite-size pieces. Keep the food bland and do not add any salt or overprocessed ingredients. These are hard for the baby’s immature liver and kidneys to process and can be harmful. Food is only one aspect of the feeding process. Comfort, security, closeness, bonding, sociability and self-confidence all develop through appropriate feeding practices. After all, eating is a highly social experience that should always be shared. It is possible to prevent children becoming ‘faddy eaters’ by encouraging good eating habits from the start and involving the whole family. Mealtimes don’t need to turn into a battleground.
©Sharon Trotter@ www.tipslimited.com
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Q. Do I reduce the milk feeds once I start weaning?

Babies still rely heavily on milk feeds for their nutritional needs so these will continue to form a major part of their diet. Continue to breastfeed (or bottle feed) after mixed feeds and the baby will gradually demand less. Morning and evening feeds will still be the most important. However, you will still have days when the breast (or formula milk) is the only food your baby will want. Be guided by his demands and you cannot go far wrong.  If you have any questions, your Midwife, Health Visitor or Dietician will be happy to help.
©Sharon Trotter@ www.tipslimited.com
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Q. What foods should I avoid?

If you wait until your baby is ready to move onto solid foods you can gradually introduce most foods. Full fat cow’s milk can be used in cooking from six months old but should not be given as a drink until a year old. For full details about baby-led weaning and more advice on foods to offer your baby check out the following website: www.baby-led.com
©Sharon Trotter@ www.tipslimited.com
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Q. Where can I find out more about weaning?

  • Baby led weaning by Gill Rapley and Tracey Murket
    Published by Vermillion (6 Nov 2008) ISBN: 0091923808 RRP: £10.99
  • Starting Solids DVD (includes booklet Starting solid food)
    Distributed by la Leche League GB RRP: £18.99   

    eNews12_DVD book cover eNews12_DVDbooklet

The book and DVD were reviewed in TIPS e-newsletter no. 12
©Sharon Trotter@ www.tipslimited.com
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