infant feeding

Skin to skin contact helps your baby feel safe and secure.

When your baby is born we will encourage you to hold your baby in skin contact for an unrestricted length of time. Babies need lots of skin contact with their mothers in the early days to get feeding off to a good start.

We encourage dads to have some skin contact with baby too. We encourage you to give your baby their first feed in skin contact (breast and bottle feeds). Keep your baby in skin contact as much as possible in the first few days. Vest tops and low and loose-fitting T-shirts are useful clothes to wear in hospital to make skin to skin contact easier.

Why is skin contact so important?

• It makes your baby feel safe and secure
• It keeps baby’s heart rate and breathing stable
• It maintains baby’s blood glucose levels
• It releases the hormone oxytocin which helps your baby’s brain to grow and develop.
• It increases your milk production
• It keeps your baby warm
• It helps you and your baby to recover from the birth.
• It helps protect your baby from infection
• It encourages your baby to look for the breast and want to breastfeed.

While having skin to skin with your baby, it is important to follow the principle of the TICKS guidance sheet to make sure you keep baby safe

Your newborn baby needs to know you are close all the time. They will be used to hearing your voice and hearing your heart beat and so skin contact helps your baby to feel safe.

There is lots of evidence of the benefits of skin to skin for mothers and babies

Babies who are well when born should be laid skin to skin with the mother, have close observation in the first minutes after birth.

The checks conducted by your midwife to assess newborn health can be carried out during skin to skin but it may sometimes need to be briefly interrupted.

Adopting a half lying, semi recumbent position is key to ensure the mother can always see the baby’s face.

Your midwife will help you to position baby so their airway is clear and have a conversation with you about recognizing changes in your baby’s condition.

University Hospitals Coventry and Warwickshire NHS Trust promotes breastfeeding as the healthiest choice of feeding for both mothers and babies.

We will provide support and information for all mothers, whichever method of infant feeding they choose.

If you wish to express breast milk and feed this to your baby by bottle, we will support you in this choice.

If you make an informed decision not to breastfeed, please note we do not provide formula milk or refrigeration storage to new mothers wishing to formula feed. We encourage the use of first milk starter packs to reduce waste.

The UNICEF UK Baby Friendly Initiative and department of health publication guide to bottle feeding contains information on preparation and sterilization of feeding equipment to minimize risks to your baby.

The First Steps Nutrition Trust have produced a simple guide which provides a summary of which infant milks are suitable to use.

We may think that a baby lets us know they are hungry by crying. In reality, they let us know long before crying in many other little ways – called early feeding cues.

Examples of these are when babies move their eyes rapidly, lick their lips, bring out their tongue, put their fingers into their mouth, begin ‘rooting’ or become restless.

Feeding a baby before they cry, when they are showing early feeding cues is much easier than waiting until they are upset.

This video looks at the importance of developing close and loving relationships with babies in their early days and weeks. For further information click here.

Rooming In

Spotting these early feeding cues is much easier when baby is with you. Keep your baby close to help you to recognise their needs and feeding patterns. Initially feeding patterns seem to have no pattern but this is normal because it builds your milk supply.

You can experience short gaps between feeds especially in the evenings because this is when milk production is at the highest. It is normal for a baby to feed 8-12 times in 24 hours. Each breastfeed length varies just the way our appetite varies throughout the day.

The Lullaby Trust recommends placing your baby to sleep in a separate space in the same room as you for the first six months as well as breastfeeding your baby to reduce the risk of SUDI sudden unexpected death in infancy. Click here to download a copy of the Baby Friendly Initiative’s caring for your baby at night leaflet.

If your baby is premature, has a low birth weight, sleepy or on medication

In these cases you may not be able to spot early feeding cues, newborn babies need to feed 8-12 times in 24 hours so rather than waiting it is important to stimulate baby to feed by having lots of skin to skin contact and hand expressing and feeding it to your baby regularly.

If you are unsure about if your baby is having enough milk, please click here.

Did you know that most women in Coventry breastfeed their babies? There are countless reasons they choose breastfeeding, to benefit their baby and themselves.

You may find it useful to watch this video, explaining why it is so important to breastfeed your baby.

What are the advantages for you?

There’s a lot of evidence that breastfeeding limits your chances of breast and ovarian cancer later in life, as well as lowering your risk of weak bones.

• It can help you lose your baby weight by burning up to 500 calories a day. While you’re pregnant, your body stores fat for feeding. Using this up will also protect against longer term risks of being overweight, diabetes and heart disease.
• Mums say that breastfeeding helps them feel really close to their baby and is a once in a lifetime experience between you and your baby.
• Your breast milk is safely available at the right temperature whenever and wherever your baby is ready for a feed, making it convenient.
• Breast milk is, of course, free and will save you a fortune because it never runs out. As your baby feeds, your body is busy making more milk.
• It is more environmentally friendly

Breast milk and formula - what’s the difference?

To help you make informed choices about how to feed your baby, it is vital you have the facts about these differences between both milks.

Breast milk is tailor made natural milk made just for tiny humans, it contains everything they need including water, fat, protein, carbohydrates, minerals and vitamins. Breast milk also contains other parts which cannot be replicated and is unique to you and your baby such as essential fatty acids, immunological and protective factors, hormones, enzymes and growth factors. Breast milk is changing all the time to meet the needs of your baby, it varies from feed to feed so provides just the right amount of what your baby needs with each breastfeed. It is a complete milk.

Infant formula is made from processed cow’s milk, this processing makes it suitable for babies and it contains ingredients such as antioxidants, fish oils, vegetable oils and soya protein. There are different brands of infant formula but they all contain similar ingredients.

There is so much that partners, grandparents and the extended family can do to support breastfeeding. Babies love to be rocked, read to, played with, bathed and changed by other family members helping to build close loving relations and giving the parents some time for rest.

Family can support new parents by performing household chores or cooking meals so parents can choose to spend more time with their baby for bonding. They can give positive praise, encouragement or offer to look after older siblings.

Effective positioning and attachment help the baby to get the milk they need and to make feeding more comfortable. Watch this video to learn more about why effective attachment is so important to breastfeeding.

The mothers and others guide provided to you in hospital and the UNICEF UK Baby Friendly Initiative and Department of Health publication Off to the Best Start includes lots of helpful images to assist with effective attachment at the breast.

Skin to skin

Skin to skin isn’t just for after birth, it can be used whenever you plan to feed your baby and helps you with getting to know your baby in the first few weeks and months.

Laid back breastfeeding

Laid back or biological nurturing positions are enjoyed by new mothers in the early days, it helps mothers to rest when breastfeeding and promotes baby’s instinctive feeding reflexes.

A newborn baby has a really small stomach (about the size of an almond) so it is normal for your baby to want to feed frequently.

However you choose to feed baby, hand expression is a useful skill to learn. It can help with relieving full breasts and is a great way to give your baby more breast milk in the early days if they are struggling to feed from the breast.

You can find information about expressing your breast milk before baby is born here. It is a useful skill to learn.

This video explains why breast milk expression may be useful and explains how to perform it. If you want more information about hand expression, please contact your midwife.

Keeping your baby close to you day and night helps you get to know your baby’s needs and learn their different ways of expressing their needs for feeds, changing, love and attention.

Responding to the baby’s needs will help you build strong, loving relationships with your baby, giving them the best start and helping them to grow up to be happy, confident young children and adults.

Click here for advice on getting to know your baby and building foundations for close, loving relationships for life.

Safe sleeping

Keep your baby in the same room as an adult day and night.

The Lullaby Trust recommend placing your baby to sleep in a separate space in the same room as you for the first six months as well as breastfeeding your baby to reduce the risk of Sudden Unexpected Death in Infancy (SUDI). Click here to download a copy of the Baby Friendly Initiative’s caring for your baby at night leaflet.

The Lullaby Trust also recommend that you:

• Don't smoke during pregnancy or breastfeeding, and don't let anyone smoke in the same room as your baby
• Don't share a bed with your baby if you have been drinking alcohol, if you take drugs, or you're a smoker
• Never sleep with your baby on a sofa or armchair
• Don't let your baby get too hot or cold. Use a room thermometer if you can and choose lighter bedding and clothing in warm or hot weather
• Keep your baby's head uncovered. Their blanket should be tucked in no higher than their shoulders
• Place your baby in the "feet to foot" position, with their feet at the end of their separate sleep space

Newborn Sleep

The baby sleep info source (BASIS) provide information about normal infant sleep based upon latest UK and worldwide research. This helps new parents to make informed choices about infant sleep and night-time care. If you have any queries, please speak with your midwife or health visitor.

I think I have a low milk supply what can I do?

Many mums think they have a low milk supply but this is rare, most do not. This video can provide more information.

If you want to increase your milk supply:

• Ensure your baby is feeding effectively, feeds are pain free, baby is transferring milk effectively and suckling and swallowing is audible.
• Breastfeed responsively, 8-12 times in 24 hours as a minimum. It is normal for baby to have gapes between feeds but they should not go longer than three hours between feeds.
• Take a ‘babymoon’, this could be a weekend or two to three days where you have no plans, no visitors and just respond to the needs of your baby and rest.
• Offer both breasts at each feed, let baby finish one side and then offer the other breast.
• Try switch feeding. Feed on one side and when the feeding slows down transfer them to the other breast, when they become sleepy again you can ‘switch’ them to the other side.
• Avoid teats and dummies, they reduce breastfeeding opportunities. If baby wants to suckle for comfort allow them to do this at your breast.
• Take care of you. Eat and drink well. Get plenty of rest.
• Consider expressing after feeds, this encourages your breasts to produce more milk

For more information go to www.kellymom.com

Painful feeding. Is this normal?

With the right support breastfeeding should be comfortable and enjoyable, get help as soon as you can if you are feeling pain. Contact your local infant feeding teams or your midwife via the numbers provided in your infant feeding pack. This film clip shows you how a baby should feed so that it is comfortable. Positioning and attachment is key to pain free feeding.

I think my baby has jaundice

Jaundice is mild and harmless for most babies and usually clears up by itself with regular feeds. It is important to let your midwife know if you suspect this, you may notice it on your baby’s skin, the whites of their eyes, inside their mouth or gums which could have a yellow colour. If this happens within the first 24 hours of birth it is important you contact a healthcare professional immediately via 111 or visiting Childrens A&E. This could be a sign of another medical concern.

If your baby is over 24 hours old contact 111 or Children’s A&E. You should tell your midwife if your baby passes pale, chalky stools or dark urine that stains the nappy. You can find more information about jaundice here.

My baby will not latch

After birth babies can take a little while to recover from the stresses and strains from labour and the birth before they are ready to breastfeed.

You midwife will support you with unrestricted skin to skin during this time, help keep baby warm and comfortable and encourage them to feed.

You will be shown how to hand express your milk and feed it to your baby to maintain your milk supply and give your baby all the protection that breastmilk provides.

You will be assisted to comfortable position and attach your baby especially in a laid back position to encourage baby’s instinctive reflexes and help them to breastfeed when they are ready.

Full breasts

If your breasts feel overly full, hard, tight and there is pain this is described as being ‘engorged’. Some women experiences this when their milk transitions from colostrum to the mature milk at around day 3-5.

Breasts may become engorged if baby is not feeding often as they need or if there are problems with attachment. It is important for a mother and baby to responsively breastfeed and to seek support and reassurance with learning how to attach baby to the breast effectively.

Overfull breasts can make it harder for a baby to attach effectively at the breast. To relieve them apply gentle massage from the chest wall toward the nipple area and perform hand expression until the breast feels softer and more comfortable. This can be helpful with preventing other issues from developing. An ice pack wrapped in a lightweight towel to protect your skin between feeds for 15 minutes at a time can reduce swelling.

Thrush and breastfeeding

Other causes of breast and nipple pain are often misdiagnosed as thrush for breastfeeding women. Thrush is not common but it can affect a mother’s breast at any time when she is breastfeeding. Most nipple pain is associated with an ineffective attachment to the breast so seeking support with positioning and attachment is key.

According to The Breastfeeding Network, symptoms of thrush are a sudden start of breast and/or nipple pain in BOTH breasts after some weeks of pain free breastfeeding – pain is severe and can last for an hour after EVERY breastfeed. Thrush can only be confirmed by a swab so see your GP.

Tongue tie

If you baby has been diagnosed with the appearance of a tongue tie it does not always mean they will have feeding difficulties. The majority of babies with a tongue tie go on to feed without difficulty but may need more intensive breastfeeding attachment and positioning support. Please seek help from your midwife or health visitor.

For babies whose frenulum (membrane under the tongue) is restricted and affecting feeding it is recommended you protect your milk supply and try positions which encourage your baby to achieve a deep attachment.

For most tongue tie cases the feeding difficulties resolve by themselves without the tongue tie needing to be divided after being given time to practice breastfeeding. If a tongue tie has been identified and after 1-2 weeks of support with feeding your midwife or health visitor will refer you to the tongue tie assessment team who will arrange a phone call with you and offer you an appointment at the tongue tie clinic.

If you would like to find out more about tongue tie, click here to download the tongue tie and feeding your baby leaflet. You may also find this website helpful.

If baby doesn’t want to feed

At some point in feeding journeys women find their baby can be unwilling to feed at times. This could be because baby is unwell, it is important to contact your GP or call 111 if you are ever worried. Babies can be fractious after being ‘helped’ to breastfeed or by someone being too hands on. They may arch their back or be unsettled due to their previous negative experiences with breastfeeding.

In this case skin to skin and laidback feeding positions will help to calm mother and baby and to help baby become more comfortable. Carrying, holding and singing to baby are strategies to use in between offering feeds to enforce positive feeding experiences and encourage baby back to the breast.

If you are breastfeeding or pregnant thinking about breastfeeding your baby, you may want to find out more about the safety of taking medication whilst breastfeeding.

For more information about the use of medication of drugs whilst breastfeeding visit the Breastfeeding Network drugs in breastmilk information sheets.

Vitamin D is essential for good bone health. The best source of vitamin D is sunlight and there are small amounts in some foods.

However, when babies are growing either in the womb or in the first few years of life, they need additional vitamin D in the form of a supplement. The recommended amount is 10 micrograms a day and should be taken by:

• Pregnant women
• Breastfeeding women
• Babies
• All children up to the age of five

If babies are receiving more than 500ml of formula milk per day then they do not require vitamin D until they are receiving less than that amount.

It is normal for babies to lose weight in the first few days after birth. Your baby will be weighed on day three or four and it is normal for babies to lose up to 10 per cent of their birth weight.

When your midwife weighs your baby, she will also complete a feeding assessment. If you or your midwife have any concerns about feeding, your midwife will help you with a plan to help your baby feed more effectively.

Your baby should be back to their birthweight by 14 days. If there are any concerns at this stage your midwife will help you with a feeding plan and may refer you for extra support.

If your baby has lost between 10 and 12 per cent of birthweight then your midwife will support you at home to help your baby regain weight.

If your baby loses more than 12 per cent of their birthweight your midwife may arrange for you and your baby to be readmitted to hospital. This is so that a paediatrician can examine your baby for signs of infection or other illness that may have contributed to the weight loss. The paediatrician will take some blood tests from your baby to help them find out if there are any problems causing the weight loss.

Usually there are no problems and the midwifery team will support you with breastfeeding your baby and helping you to make sure your baby gets lots of milk. Your baby will be weighed again the next day and you can go home again as soon as you and the team are happy that baby is gaining weight.

How can I help my baby gain weight?

A feeding plan will usually involve:

• Help to make sure your baby is attaching well to the breast
• Helping your baby to feed at least 8-12 times in 24 hours
• Possibly expressing milk to help increase your milk supply
• “Topping up”; giving your baby some extra feeds of expressed breastmilk after a breastfeed to help baby get more milk quickly.
• Sometimes it may be necessary to give some extra feeds of formula milk especially when babies have lost a lot of weight. This will be an interim measure and you can usually go back to exclusive breastfeeding after a few days.

The Community Coventry Infant Feeding Team are here to help families make an informed decision about how to feed their baby, to support families through their feeding journey and beyond.

We are a team of UNICEF BFI trained and accredited Infant Feeding Peer Support Workers who offer support to Coventry families throughout pregnancy and after baby has been born.

https://www.swft.nhs.uk/our-services/children-and-young-peoples-services/coventry-family-health-and-lifestyle-service-0-19-years

https://www.facebook.com/coventryinfantfeedingteam

https://www.instagram.com/coventryinfantfeeding/

Boobie buddies Facebook support group Coventry
UHCW Maternity Services Facebook page

You can call the national breastfeeding helpline on 0300 100 0212 to speak to a volunteer breastfeeding supporter in English, Welsh, Polish, Bengali or Sylheti.

http://www.unicef.org.uk/babyfriendly/
https://www.rcpch.ac.uk/resources/growth-charts
https://www.llli.org
https://www.laleche.org.uk
https://www.breastfeedingnetwork.org.uk
https://abm.me.uk
https://www.firststepsnutrition.org

Breastfeeding peer support volunteers or breast buddies are passionate about breastfeeding, have successfully breastfed at least one child and have a desire to help other mothers in their local community do the same.

This is achieved by facilitating a local mother to mother support group, by building confidence and developing connections.

Breastfeeding peer support is recognized as an effective way to increase the number of women who choose to breastfeed and to help them to continue to breastfeed for as long as they wish. Breastfeeding peer support is highly valued by breastfeeding mothers especially in the early day after the birth of their baby, many mums find it useful to discuss queries about breastfeeding with a peer supporter.

Why become a breastfeeding peer supporter at UHCW?

• Increase your knowledge about breastfeeding
• Gain work experience for a change of career
• Have fun
• Socialize
• Keep busy
• Make a positive difference to new families
• Use your experience to help others
• Give someone the same support you experienced
• Make new friends
• Have the opportunity to work alongside dedicated, passionate health professionals
• Volunteers are entitled to free car parking or can have their bus fare reimbursed for the days they are on duty only

What does this role involve?

• Meeting, greeting, and supporting parents on the postnatal ward
• Sign posting to relevant services and groups
• Promoting supervision topics and displaying relevant literature
  Normalising breast feeding in the community

Skills Required

• Experience of having breastfed a child (either currently or in the past). All ages are welcome.
• A non-judgemental, supportive and friendly approach
• Good communication skills and the ability to relate to both adults and children in a virtual and a face-to-face breastfeeding peer support group setting
• Reliable, with the ability to be flexible and adapt to different situations

Training

Prior to starting this role, you will be required to complete in house UNICEF training, in addition to the volunteer training processes required by the trust. Through training you’ll learn about how breastfeeding works, responsive feeding, & the UNICEF Baby Friendly Initiative. You’ll also pick up lots of information on positioning, attachment, longer term breastfeeding, problem solving and communication skills.

We value your support and time, for further information about offering your time to support mothers and babies of Coventry and Warwickshire please click here.

If you have any questions please email volunteers@uhcw.nhs.uk or call 02476 965146/02476 965147.