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Newborn baby feeding milk


Breastfeeding: the first few days

In the first few days, you and your baby will be getting to know each other. It may take time for both of you to get the hang of breastfeeding.

This happens faster for some women than others. But nearly all women produce enough milk for their baby.

Preparing to breastfeed before the birth

It's good to find out as much as you can about breastfeeding before you have your baby. It may help you feel more confident when you start breastfeeding your baby.

Antenatal classes usually cover the most important aspects of breastfeeding, such as positioning and attachment, expressing, and how to tackle common breastfeeding problems.

Find antenatal classes near you.

You can find out about breastfeeding from your midwife, family and friends, and useful helplines and websites.

Find breastfeeding help and support.

There are lots of groups and drop-ins, some specially designed for pregnant women who want to know more about breastfeeding. You can find out more by asking your midwife, health visitor, local peer supporter or GP. Or visit your local Children's Centre.

Find a Sure Start Children's Centre on GOV.UK.

Skin-to-skin contact

Having skin-to-skin contact with your baby straight after giving birth will help to keep them warm and calm and steady their breathing. 

Skin-to-skin means holding your baby naked or dressed only in a nappy against your skin, usually under your top or under a blanket.

Skin-to-skin time can be a bonding experience for you and your baby. It's also a great time to have your first breastfeed. If you need any help, your midwife will support you with positioning and attachment.

Skin-to-skin contact is good at any time. It will help to comfort you and your baby over the first few days and weeks as you get to know each other. It also helps your baby attach to your breast using their natural crawling and latching-on reflexes.

You'll still be able to bond with and breastfeed your baby if skin-to-skin contact is delayed for some reason, for example if your baby needs to spend some time in special care.

If necessary, your midwife will show you how to express your breast milk until your baby is ready to breastfeed. They can also help you have skin-to-skin contact with your baby as soon as it's possible.

Skin-to-skin after a caesarean

If your baby is delivered by caesarean, you should still be able to have skin-to-skin contact with your baby straight after delivery.

Colostrum: your first milk

The fluid your breasts produce in the first few days after birth is called colostrum. It's thick and usually a golden yellow colour. It's a very concentrated food, so your baby will only need a small amount, about a teaspoonful, at each feed.

Your baby may want to feed quite often, perhaps every hour to begin with. They'll begin to have fewer, but longer feeds once your breasts start to produce more "mature" milk after a few days.

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

Your let-down reflex

Your baby's sucking causes muscles in your breasts to squeeze milk towards your nipples. This is called the let-down reflex.

Some women get a tingling feeling, which can be quite strong. Others feel nothing at all.

You'll see your baby respond when your milk lets down. Their quick sucks will change to deep rhythmic swallows as the milk begins to flow. Babies often pause after the initial quick sucks while they wait for more milk to be delivered.

Occasionally this let-down reflex can be so strong that your baby coughs and splutters. Your midwife, health visitor or breastfeeding supporter can help with this.

If your baby seems to be falling asleep before the deep swallowing stage of feeds, they may not be properly attached to the breast. Ask your midwife, health visitor or breastfeeding supporter to check your baby's positioning and attachment.

Sometimes you'll notice your milk letting down in response to your baby crying or when you have a warm bath or shower. This is normal.

How often should I feed my baby?

In the first week, your baby may want to feed very often. It could be every hour in the first few days.

Feed your baby as often as they want and for as long as they want. They'll begin to have fewer, but longer feeds after a few days.

As a very rough guide, your baby should feed at least 8 to 12 times, or more, every 24 hours during the first few weeks.

It's fine to feed your baby whenever they are hungry, when your breasts feel full or if you just want to have a cuddle.

It's not possible to overfeed a breastfed baby.

When your baby is hungry they may:

  • get restless
  • suck their fist or fingers
  • make murmuring sounds
  • turn their head and open their mouth (rooting)

It's best to try and feed your baby during these early feeding cues as a crying baby is difficult to feed.

Building up your milk supply

Around 2 to 4 days after birth you may notice that your breasts become fuller. This is often referred to as your milk "coming in".

Your milk will vary according to your baby's needs. Each time your baby feeds, your body knows to make more milk for the next feed. The amount of milk you make will increase or decrease depending on how often your baby feeds.

Feed your baby as often as they want and for as long as they want. This is called responsive feeding. In other words, responding to your baby's needs. It's also known as on-demand or baby-led feeding.

In the beginning, it can feel like you're doing nothing but feeding. But gradually you and your baby will get into a pattern and the amount of milk you produce will settle down.

It's important to breastfeed at night because this is when you produce more hormones (prolactin) to build up your milk supply.

In the early weeks, before you and your baby have become comfortable with breastfeeding, "topping up" with formula milk or giving your baby a dummy can lower your milk supply.

Speak to a midwife or health visitor if you are worried about breastfeeding or you think your baby is not getting enough milk.

They might suggest giving your baby some expressed breast milk along with breastfeeding.

Find out more about how to tell if your baby is getting enough breast milk.

Dealing with leaking breasts

Sometimes, breast milk may leak unexpectedly from your nipples.

Wearing breast pads will stop your clothes becoming wet with breast milk. Remember to change them frequently to prevent an infection.

Expressing some milk may also help. Only express enough to feel comfortable as you do not want to overstimulate your supply.

Find out about expressing and storing breast milk.

If your baby has not fed recently, you could offer them a feed as breastfeeding is also about you being comfortable.

Help and support for breastfeeding

  • Find out more about positioning and attachment, including how to get comfortable and make sure your baby is properly attached.
  • If you are having difficulties with breastfeeding, take a look at common breastfeeding problems.
  • Ask a midwife or health visitor for help. They can also tell you about other breastfeeding support available near you.
  • Search online for breastfeeding support in your area.
  • Call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm daily).

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Feeding Your Newborn (for Parents)

How you feed your newborn is the first nutrition decision you make for your child. These guidelines on breastfeeding and bottle feeding can help you know what's right for you and your baby.

Breast or Bottle?

The American Academy of Pediatrics (AAP) recommends that babies be breastfed exclusively for about the first 6 months. After they start on solid foods, babies should breastfeed through the first year of life and even beyond, if desired.

But breastfeeding isn't possible or preferable for all new moms. Deciding to breastfeed or bottle feed a baby is usually based on the mother's comfort level with breastfeeding and her lifestyle. In some cases, breastfeeding may not be recommended for a mom and her baby. If you have any questions about whether to breastfeed or formula feed, talk to your pediatrician.

Remember, your baby's nutritional and emotional needs will be met whether you choose to breastfeed or formula feed.

Benefits of Breastfeeding

Breastfeeding your newborn has many benefits. Perhaps most important, breast milk is the perfect food for a baby's digestive system. It has the nutrients that a newborn needs, and it’s easily digested. Commercial formulas try to imitate breast milk, and come close, but can't match it exactly.

Breast milk has

antibodiesthat help protect babies from many infections, including diarrhea and ear and lung infections. Breastfed babies are less likely to develop medical problems such as diabetes, high cholesterol, asthma, and allergies. Breastfeeding also might make a child less likely to become overweight.

Breastfeeding is great for moms too. It burns calories, so can help nursing moms lose the weight gained during pregnancy. Breastfeeding also may offer protection from breast cancer and ovarian cancer.

Some moms find breastfeeding easier and quicker than formula feeding — it needs no preparation, and you don't run out of breast milk in the middle of the night. Also, breastfeeding costs little. Nursing mothers do need to eat more and may want to buy nursing bras and pads, a breast pump, or other equipment. But these expenses are generally less than the cost of formula.

Breastfeeding meets a variety of emotional needs for both moms and babies. The skin-to-skin contact can enhance the emotional connection, and providing complete nourishment can help new moms feel confident in their ability to care for their newborn.

Limitations of Breastfeeding

With all the good things known about breastfeeding, why doesn't every mother choose to breastfeed?

Breastfeeding requires a big commitment from a mother. Some new moms feel tied down by the demands of a nursing newborn. Because breast milk is easily digested, breastfed babies tend to eat more often than babies who are fed formula. This means moms can be in demand as often as every 2 or 3 hours in the first few weeks. This can be tiring, but it's not long before babies feed less often and sleep longer at night.

Some new mothers need to get back to work outside the home or separate from their babies from time to time for other reasons. Some opt for formula feeding so other caregivers can give the baby a bottle. Mothers who want to continue breastfeeding can use a breast pump to collect breast milk to be given in a bottle, so their babies still get its benefits even when mom isn't there to breastfeed.

Fathers and other family members may want to share in feeding the baby. When mom is breastfeeding, dad or siblings may want to stay close by. Helping mom get comfortable, or providing a burp cloth when needed, will let them be part of the experience.

When breastfeeding is going well, other family members can help by giving the baby pumped breast milk in a bottle when mom needs a break.

Some moms may feel embarrassed or worried about breastfeeding. These feelings usually end after a successful breastfeeding process is set. It can help to get advice from those who've gone through the experience. Most hospitals and birthing centers offer in-depth instruction on breastfeeding to new moms. Your pediatrician, nurse practitioner, or nurse can answer questions or put you in touch with a lactation consultant or a breastfeeding support group.

In some cases, a mother's health may affect her ability to breastfeed. Moms getting chemotherapy for cancer and those who have HIV should not breastfeed, for example.

If you have a medical condition or take any medicines regularly, talk with your doctor about whether it's OK to breastfeed. If you have to stop nursing temporarily, continue to pump breast milk to maintain milk production. If you or your baby are sick, continue to breastfeed if you can. Talk to the doctor if you have any concerns.

In some situations, it may not possible to breastfeed, such as when a baby is very sick or born early. Mothers should talk with their baby's doctor about expressing and storing milk. Often, a baby who can't breastfeed can get breast milk through a feeding tube or bottle.

Some moms who have inverted nipples may have trouble breastfeeding, but a lactation consultant usually can help them overcome this. Likewise, women who have had plastic surgery on their breasts should be able to successfully breastfeed. Talk with your doctor if you have any concerns.

Hold off on pacifiers or bottles until your baby has gotten used to and is good at breastfeeding. Lactation professionals recommend waiting until a baby is about 3–4 weeks old before offering artificial nipples of any kind (including pacifiers).

Benefits of Formula Feeding

Commercially prepared infant formula is a nutritious alternative to breast milk. Bottle feeding can offer more freedom and flexibility for moms, and make it easier to know how much the baby is getting.

Because babies digest formula more slowly than breast milk, a baby who is getting formula may need fewer feedings than one who breastfeeds. Formula feeding also can make it easier to feed the baby in public, and lets the father and other family members help feed the baby, which can enhance bonding.

Limitations of Formula Feeding

Just as breastfeeding has its unique demands, so does bottle feeding. Bottle feeding takes organization and preparation, especially if you want to take your baby out. Store-bought formula can be pretty expensive, but do not try to make your own formula at home.

It's important to make sure that you have enough formula on hand, and bottles that are clean and ready to be used.

Here are a few guidelines for formula feeding:

  • Carefully follow directions on the label when preparing formula. Do not add more water than directed.
  • Bottles left out of the refrigerator longer than 1 hour and any formula left in the bottle that a baby doesn't finish should be discarded.
  • Prepared bottles of formula can be stored in the refrigerator up to 24 hours and carefully warmed just before feeding. You don't have to warm formula, but most babies prefer it.
  • A bottle of formula can be warmed by holding it in running warm water or setting it in a pan of warm water. A bottle of formula (or breast milk) should never be warmed in a microwave. The bottle can heat unevenly and leave "hot spots" that can burn a baby's mouth.

How Often Do Newborns Eat?

Your newborn will nurse about 8 to 12 times per day during the first weeks of life. In the beginning, mothers may want to try nursing 10–15 minutes on each breast, then adjust the time as needed.

Breastfeeding should be on demand (when your baby is hungry), which is generally every 1–3 hours. As newborns get older, they'll nurse less often and have longer stretches between feedings. Newborn babies who are getting formula will likely take about 2–3 ounces every 2–4 hours. Newborns should not go more than about 4–5 hours without feeding.

Signs that babies are hungry include:

  • moving their heads from side to side
  • opening their mouths
  • sticking out their tongues
  • placing their hands and fists to their mouths
  • puckering their lips as if to suck
  • nuzzling against their mothers' breasts
  • crying

A feeding schedule is not necessary — you and your baby will get into a routine. Babies know (and will let their parents know) when they're hungry and when they've had enough. Watch for signs that your baby is full (slowing down, spitting out the bottle or unlatching from breast, closing the mouth, turning away from the breast or bottle) and stop the feeding when these signs appear.

As babies grow, they begin to eat more at each feeding and can go longer between feedings. There may be other times when your infant seems hungrier than usual. Continue to nurse or feed on demand. Nursing mothers need not worry — breastfeeding stimulates milk production, and your supply of breast milk will adjust to your baby's demand for it.

Is My Newborn Getting Enough to Eat?

New parents often worry about whether their babies are getting enough to eat.

Babies are getting enough to eat if they:

  • seem satisfied
  • have about 6–8 wet diapers a day
  • have regular bowel movements (poops)
  • sleep well
  • are alert when awake
  • are gaining weight

A baby who is fussing, crying, seems hungry, does not appear satisfied after feeding, and has fewer wet diapers may not be getting enough to eat. If you're concerned that your baby isn't getting enough to eat, call your doctor.

Most infants "spit up" a small amount after eating or during burping, but a baby should not vomit after feeding. Vomiting after every feeding might be a sign of an allergy, digestive problem, or other problem that needs medical care. If you have concerns that your baby is spitting up too much, call your doctor.

Should Newborns Get Nutritional Supplements?

Breast milk has the right combination of vitamins and easily absorbed iron for newborns. A healthy infant being nursed by a healthy mother doesn't need extra vitamins or nutritional supplements, with the exception of vitamin D. Breastfed babies should begin vitamin D supplements within the first few days of life, continuing until they get enough vitamin D-fortified formula or milk (after 1 year of age).

Breastfeeding mothers who follow vegetarian diets that do not include animal products need vitamin B12 supplements.

Iron-fortified formula has the right blend of vitamins and minerals for a baby, so supplements usually aren't needed. Infants drinking less than 1 liter, or about a quart, of formula a day may need a vitamin D supplement.

Water, juice, and other foods usually aren't necessary during a baby's first 6 months. Breast milk and formula provide everything babies need nutritionally until they start eating solid foods. Talk to your doctor if you have any questions about feeding your newborn.

Reviewed by: Mary L. Gavin, MD

Date reviewed: February 2021

Breastfeeding a newborn | What to Expect in the First Week

The first week of a baby's life is a wonderful but hectic time, especially if you haven't breastfed before. Our breastfeeding tips will help you settle in as quickly as possible

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The first time after childbirth, mothers are often confused. The body is still recovering, and you are already starting to get to know your newborn baby. The emotional state during this period can be unstable, especially between the second and fifth day, when many women have milk 1 and at the same time postpartum depression begins 2 . In addition, people around often expect (and demand) that a woman come to her senses as soon as possible and become a “super mom”. But the best thing to do this first week is just to be with your baby and get breastfeeding going.

When should I start breastfeeding my newborn?

Try to breastfeed your baby within the first hour after birth. When the baby latch onto the breast and begins sucking rhythmically, it stimulates the mammary gland cells and starts milk production. 1 It is not for nothing that this time is called the “magic hour”!

“Ideally, the baby should be placed on the mother's stomach immediately after birth so that it can immediately attach to the breast. He won't necessarily eat, but he should be able to,” explains Cathy Garbin, an internationally recognized expert on breastfeeding.

“Hold your baby and let him find the breast on his own and put the nipple in his mouth. This is called the breast-seeking reflex. On the Internet you can watch videos that show what this process looks like. If the baby does not latch onto the nipple on its own, the midwife will help to properly attach it to the breast. But for starters, it’s good to give the baby the opportunity to do it on their own. In this case, the optimal position for the mother is reclining. ”

Don't spend that special first hour of your baby's life weighing and swaddling—or at least wait until he's suckling for the first time. Enjoy hugs and close skin-to-skin contact. This promotes the production of oxytocin, the hormone of love, in you and your baby, and oxytocin plays a key role in the supply of the first breast milk - colostrum. 3

“As soon as the obstetricians were convinced that our son was healthy, the three of us — me, my husband and our baby — were left to give us the opportunity to get to know each other. It was a very special hour - an hour of awkwardness, turbulent emotions and bliss. During this time, I breastfed my son twice, ”recalls Ellie, a mother of two from the UK.

Did you know that breastfeeding helps to recover after childbirth? This is because oxytocin stimulates uterine contractions. In the first hours after childbirth, this contributes to the natural release of the placenta and reduces blood loss. 4

What if the birth did not go according to plan?

If you had a cesarean section or other complications during childbirth,
You can still make skin-to-skin contact with your baby and breastfeed him in the first hours after birth.

“If you can't hold your baby, have your partner do it for you and make skin-to-skin contact with the baby. This will give the baby a sense of security, care and warmth so that he can hold on until you recover, ”Katie advises.

If the baby is unable to breastfeed, it is advisable to start expressing milk as early as possible and do so as often as possible until the baby is able to feed on its own. “While breastfeeding in the first hours after birth lays an excellent foundation for the future, it is not so important,” Cathy reassures. “It is much more important to start lactation so that in the future, if necessary, you can start breastfeeding. ”

To start milk production, you can express milk manually or use a breast pump that can be given to you at the hospital. 5 And with expressed precious colostrum, it will be possible to feed the child. This is especially important if the baby was born premature or weak, since breast milk is extremely healthy.

If a baby was born prematurely or has a medical condition and cannot be breastfed immediately, this is no reason not to continue breastfeeding. “I have worked with many new mothers who were unable to breastfeed their baby for the first six weeks due to preterm labor or other reasons. However, all of them later successfully switched to breastfeeding,” says Kathy.

Does the baby latch on correctly?

Correct breastfeeding is essential for successful breastfeeding 6 , as it determines how effectively the baby will suckle milk and hence grow and develop. Latching on the breast incorrectly can cause sore or damaged nipples, so don't hesitate to ask your doctor to check that your baby is properly attached to the breast, even if you are told that everything is fine and you do not see obvious problems - especially while you are in the hospital.

“While I was in the hospital, I called the doctor at every feed and asked me to check if I was breastfeeding correctly,” says Emma, ​​mother of two from Australia. - There were several cases when it seemed to me that everything seemed to be right, but it was painful to feed, and the doctor helped me take the baby off the breast and attach it correctly. By the time I was discharged, I had already learned to do it confidently.”

When applying to the breast, point the nipple towards the palate. This will allow the baby to take the nipple and part of the areola under it into their mouth. It will be easier for him to suck if he has both the nipple and part of the areola around in his mouth. 6

“When a baby latch on properly, it doesn't cause discomfort and it causes a pulling sensation, not pain,” Cathy explains. - The baby's mouth is wide open, the lower lip may be slightly turned outward, and the upper one lies comfortably on the chest. The body language of the child indicates that he is comfortable. There isn't much milk at this early stage, so you probably won't notice your baby swallowing, but he will suckle a lot and nurse frequently."

How often should a newborn be fed?

The frequency and duration of breastfeeding in the first week can vary greatly. “The first 24 hours of life are completely different for different children. Someone sleeps a lot (after all, childbirth is tiring!), And someone often eats, says Katie. - Such a variety greatly confuses young mothers. Everyone gives different advice, so it's important to remember that every mother and child is different."

“Colostrum is thicker than mature breast milk and is produced in smaller amounts, but has many benefits. When the baby eats colostrum, he learns to suck, swallow and breathe until milk begins to flow in more volume, ”explains Cathy.

Milk usually arrives on the second or fourth day after birth. Until this time, the baby is applied to the breast 8-12 times a day (and sometimes more often!), including at night. 7 Feeding may last 10-15 minutes at this stage, or 45 minutes or even an hour, as the baby is just beginning to develop the muscles and coordination needed to suckle effectively.

“At first, the intensity of feeding is very high, often higher than many people realize, and this is shocking to most new mothers,” says Cathy. - Sometimes mom has no time to go to the toilet, take a shower and have a snack. It usually comes as a surprise."

Camille, a mother from Australia, experienced this. “The first week, Frankie ate every two hours, day and night, and each time it took half an hour to an hour to feed,” she recalls. “My husband and I were completely exhausted!”

Do I need to feed my newborn on a schedule?

The good news is that frequent feeding promotes lactation and stimulates milk production. 7 The more your baby eats, the more milk you will have. Therefore, forget about feeding your newborn on a schedule - this way he will have less chance of feeding. Try to feed your baby when he signals that he is hungry 8 :

  • tossing and turning in her sleep;
  • opens eyes;
  • turns his head if he feels a touch on his cheek;
  • sticks out tongue;
  • groans;
  • licks lips;
  • sucks fingers;
  • is naughty;
  • whimpers;
  • is crying.

Crying is the last sign of hunger, so when in doubt, just offer your baby the breast. If he bursts into tears, it will be more difficult to feed him, especially at first, when both of you are just learning how to do it. As your baby grows, he will likely eat less frequently and take less time to feed, so breastfeeding will seem more predictable.

Does breastfeeding hurt?

You may have heard that breastfeeding is not painful at all, but in fact, in the first days, many new mothers experience discomfort. And this is not at all surprising, given that the nipples are not used to such frequent and strong sucking.

“Breastfeeding can be uncomfortable for the first couple of days – your body and your baby are just getting used to it. If a baby eats for too long and does not latch well, the sensations are almost the same as from unworn new shoes, Cathy compares. Just as tight shoes can rub your feet, improper suckling can damage your nipples. Prevention is always better than cure, so if the pain persists after a few days of feeding, contact a lactation consultant or healthcare professional.”

Maria, a mother from Canada, agrees: “Although my son seemed to latch onto the breast well, he damaged his nipples while feeding, and I was in pain. As it turned out, the reason was a shortened frenulum of the tongue. The breastfeeding specialists at our city clinic have been of great help in diagnosis and treatment.”

In addition, you may experience period cramps during the first few days after breastfeeding, especially if this is not your first baby. This is the so-called postpartum pain. The fact is that oxytocin, which is released during breastfeeding, contributes to further contraction of the uterus to restore its normal size. 4

When milk arrives, the breasts usually become fuller, firmer and larger than before delivery. In some women, the breasts swell, harden and become very sensitive - swelling of the mammary glands occurs. 10 Frequent breastfeeding relieves these symptoms. For more breast care tips, read our article What is Breast Swelling?

How often does the newborn urinate and defecate?

What goes into the body must go back out. Colostrum
has a laxative effect, helping to eliminate meconium - the original feces. It looks a little scary - black and sticky, like tar. 11 But don't worry, it won't always be like this. Breastfed babies usually have a slightly sweet smell of stool.

How many times a day you will need to change diapers and how the contents should look like, see below.

Day one

  • Frequency: once or more.
  • Colour: greenish black.
  • Texture: sticky like tar.

Day two

  • Frequency: twice or more.
  • Colour: dark greenish brown.
  • Texture: less sticky.

Day three

  • Frequency: twice or more.
  • Colour: greenish brown to brownish yellow.
  • Texture: non-sticky.

Fourth day and then the entire first month

  • Frequency: twice or more.
  • Color: yellow (feces should turn yellow no later than by the end of the fourth day).
  • Texture: grainy (like mustard with grains interspersed). Leaky and watery.

The baby's urine should be light yellow. On average, babies urinate once a day for the first two days. Starting around the third day, the number of wet diapers increases to three, and from the fifth day onwards, diapers have to be changed five times a day or more often. In addition, during the first few days, the weight of wet diapers increases. 11

Is the baby getting enough breast milk?

Since very little milk is produced at first,
You may feel that this is not enough for your baby. But if you feed your baby on demand, you will produce exactly as much milk as he needs. If you want to keep the process under control, be guided by the frequency of diaper changes above. If your baby soils less diapers, check with your doctor.

“For the first three or four weeks, most babies just eat and sleep. If the child is worried and constantly asks for a breast, you should consult with your doctor, ”Katie recommends.

Sometimes the baby may vomit after feeding. If the vomit is the color of milk, this is not a cause for concern. But if there are orange, red, green, brown or black blotches in it, or the child vomits with a "fountain", consult a doctor. You should also consult a doctor if the baby has a high temperature, the fontanel (soft spot on the head) has sunk, blood is found in the stool, and also if the weight recorded at birth has not recovered within two weeks. 11

But if there are no frightening symptoms and the baby is growing at a normal pace, it means that he has enough milk. Soon you will both get used to breastfeeding and establish a more stable routine.

For the next step in breastfeeding, see Breastfeeding in the First Month: What to Expect.

Literature

1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation." G Mammary Gland Biol Neoplasia. 2007;12(4):211-221.

2 Shashi R et al. Postpartum psychiatric disorders: Early diagnosis and management. Indian J Psychiatry . 2015; 57( Suppl 2): S 216– S 221. - Shashi R. et al., Postnatal mental disorders: early diagnosis and treatment. Indian J Saikiatri. 2015; 57(App 2):S216-S221.

3 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206. - Moberg K, Prime DK, "The effects of oxytocin on mother and child during breastfeeding." Infant. 2013;9(6):201-206.

4 Sobhy SI, Mohame NA. The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. J Egypt Public Health Assoc . 2004;79(1-2):1-12. - Sobhi SI, Moham NA, "Early initiation of breastfeeding and its effect on vaginal bleeding in the fourth stage of labor." G Egypt Public Health Assoc. 2004;79(1-2):1-2.

5 Meier PP et al. Which breast pump for which mother: an evidence-based approach to individualizing breast pump technology. J Perinatol . 2016;36(7):493. - Meyer P.P. et al., Breastpump Selection: A Scientific Approach to Customizing Pumping Technology. J Perinatol (Journal of Perinatology). 2016;36(7):493-499.

6 Cadwell K. Latching - On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women ’ s 2007;52(6):638-642. — Cadwell, K., "Latching and sucking in healthy newborns: evaluation of breastfeeding." W Midwifery Women Health. 2007;52(6):638-642.

7 Kent JC et al. Principles for maintaining or increasing breast milk production. 2012;41(1):114-121. - Kent J.S. et al. , "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.

8 Australian Breastfeeding Association [ Internet ]. Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]

9 Jacobs A et al. S3-guidelines for the treatment of inflammatory breast disease during the lactation period. Geburtshilfe Frauenheilkd . 2013;73(12):1202-1208. - Jacobs A. et al., "Guidelines S -3 for the management of inflammatory breast disease during breastfeeding." Geburtskhilfe und Frauenheilkünde. 2013;73(12):1202-1208.

10 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.

Feeding expressed milk | breastfeeding

When can I start breastfeeding my baby with expressed breast milk? How to do it right? Is it worth worrying that the child will confuse the pacifier with the breast? In this article we will answer your questions.

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When can I start breastfeeding my baby?

If your baby is healthy and breastfeeding well, there is no need to give him expressed milk. For the first four weeks, you work together to start and increase milk production, and your baby also learns to suckle properly at the breast. There is not enough scientific evidence on this yet, 1 but there is an opinion that bottle feeding in the first month may adversely affect the process of establishing breastfeeding.

However, if the newborn is unable to latch on or suckle for some reason, start expressing milk as soon as possible after birth. Read more about this in our articles on coping with problems in the first week, breastfeeding premature babies and babies with special needs, and seeking help from your healthcare provider.

How do I feed my baby with expressed breast milk?

There are many expert feeding solutions that allow you to give your baby expressed milk in a variety of ways, depending on your and your baby's needs.

For example, the innovative Calma smart pacifier only lets milk through when the baby creates a vacuum by suckling. This means that when feeding from a bottle, he will make the same movements with his tongue and jaws as when sucking at the breast. 2. 3 The Calma Smart Soother was developed with input from breastfeeding experts at the University of Western Australia. When using this pacifier, the baby can suck, swallow, pause and breathe in the same way as when breastfeeding. 4 Preservation of natural sucking skills allows the baby to easily transition from breast to bottle and back.

In addition, Medela also offers regular bottle teats* in two versions that produce milk at different rates. All Medela* nipples can be placed directly on bottles used for expressing milk, minimizing the risk of spillage.

If you need to feed your baby with expressed milk, but you do not want to bottle feed him until he is learning to breastfeed, you can use a sippy cup* for temporary feeding. The baby will be able to drink milk from such a mug, but you should be careful not to spill the milk. For the first time, it is advisable to feed the child from a drinking cup under the supervision of the attending physician in order to learn how to do it correctly.

If your baby needs to be supplemented with expressed milk in addition to regular breastfeeding, the Supplementary Feeding System (SNS)* can be used. It is equipped with a thin, flexible capillary that can be clipped close to the nipple to give your baby expressed milk while breastfeeding. Thanks to this, the baby suckles the breast for longer, thereby developing sucking skills and stimulating the production of milk from the mother. This can be helpful when there is a shortage of breast milk, as well as when feeding adopted or surrogate children.

If the baby is unable to breastfeed because he is too weak or has a congenital disease, you can use the Special Needs Cup*, which releases milk with gentle pressure, making it suitable for feeding these babies.

How to teach a child to bottle feed?

If breastfeeding is going well and you decide to start bottle feeding your baby with expressed breast milk, follow these guidelines.

Start early and take your time

Don't wait until the first day of work or the first time you leave the house to start bottle feeding your baby. Start accustoming your baby to small portions of expressed milk a couple of weeks before the desired date, calmly and without haste. Gradually build up to one full serving of pumped milk from a bottle.

Choose a time

Ideally, at the first bottle feeding, the baby should be hungry, but not too hungry - in this state, he is as relaxed as possible.

Let others feed

Your baby is used to feeding from your breast, so when you offer him a bottle it can be confusing. The process can go faster if the first time the baby is bottle-fed by someone else while you are not in the room, so that your sight and smell do not embarrass the baby.

Maintain optimal temperature

Your baby will be more willing to eat expressed milk if the temperature is around 37°C, close to body temperature.

Dip the nipple in milk

Try dipping the nipple in expressed milk before offering it to your baby. This way it will taste and smell like your breast milk. Lightly touch the baby's upper lip with the nipple to open the mouth.

Choose the right position for bottle feeding

Feed your baby on demand and keep him reclining during feeding. Never bottle feed your baby when he is lying or sitting, otherwise he may choke. Listen to the wishes of the child - take as many pauses as he needs. You can even try to shift it from one hand to another during feeding.

Be patient

Don't worry if your baby doesn't take the bottle right away - it may take several tries. If he pushes the bottle away or starts crying, calm him down, wait a few minutes and try again. If he still doesn't want to bottle feed, wait a few more minutes and breastfeed him as usual. Repeat the bottle experiment at a different time of day.

How much pumped milk should I give my baby?

All children are different. Research shows that between the ages of one and six months, a baby can consume between 50 and 230 ml of milk per feeding. To start, prepare about 60 ml and observe how much your baby needs - more or less. You will soon realize how much milk he usually eats. Just never force him to finish the cooked portion.

How can I keep my baby safe when bottle feeding?

Always clean and sterilize your pump and bottles according to the manufacturer's instructions. Wash your hands before expressing, pouring milk, and feeding your baby. Follow our instructions for safely storing and thawing your expressed milk.

If breastmilk needs to be warmed, place the bottle or bag in a bowl of warm water or a heater or under running water at a maximum of 37°C. Never heat breast milk in the microwave or on the stove.

Will the baby be able to transition from breast to bottle?

Some mothers worry that if they start bottle feeding too early, they will get used to the artificial nipple and not want to breastfeed. Others, on the contrary, are worried that if the child is not immediately accustomed to the bottle, then he will no longer eat from it. In general, in these cases, they say that the child confuses the nipple with the breast.

Experts disagree on whether such confusion is a problem. 1 Without a doubt, it is easier for a baby to suckle milk from a regular bottle with a teat that does not require a vacuum than from the breast, because the milk flows faster, also under the influence of gravity. And some babies really have clear preferences: only the breast or only the nipple. However, many babies are comfortable suckling both the breast and the pacifier.

If you are unable to feed your baby with expressed breast milk, seek help from a lactation consultant or specialist.

Literature

1 Zimmerman E, Thompson K. Clarifying nipple confusion. J. Perinatol. 2015;35(11):895-899. - Zimmerman I., Thompson K., "On the issue of breastfeeding." J Perinatol (Journal of Perinatology). 2015;35(11):895-899.

2 Geddes DT et al. Tongue movement and intra-oral vacuum of term infants during breastfeeding and feeding from an experimental teat that released milk under vacuum only.

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