Infant feeding and relationship building

Skin to skin
 

Hand expressing
 

How do I know feeding is going well
 

Dad’s and partners
 

Positioning breastfeeding
 

Your newborn baby

The relationship between you and your baby, starts during pregnancy.

It continues and develops after birth and this close and loving relationship helps you to be responsive to your baby’s needs, in turn nurturing their brain development and growth. 

Babies begin to get familiar with their parents voices and will be aware of emotions felt by the mum during pregnancy. 

Responding to your baby during pregnancy will help to develop this relationship, produce feel good hormones and ultimately help baby’s brain growth.  Developing this relationship begins with responding to you baby, for example, when they move – you can do this by rubbing your tummy, talking and singing to baby, playing music and its great for partners, siblings and family members to join in as well.  Every day take time out to think about your baby, imagine what he or she looks like and consider what they can do at this stage in their development and how they are growing, some people like to name their baby to help with this bond.

Importance of relationship building

Useful links:

• Building a Happy Baby

After your baby is born and you are having a cuddle, for most babies this will lead to the first feed, usually soon after the birth. This is facilitated by having skin to skin as soon as possible, uninterrupted and unhurried until at least after the first feed, but as long as you wish. 

Meeting baby for the first time video

Breastfeeding is the biological normal way to feed your baby, is specific and unique to you and your baby and brings with it many health benefits for Babies and Mothers, for instance reducing the risk of some cancers, diabetes and obesity. 

CHILD Cohort Study: New scientific insights into breastfeeding © AllerGen Inc. 2020

Breastfeeding provides all the nutrients, protection, growth factors and antibodies which your growing baby requires and changes as your baby grows. 

Human Milk, Tailor-made for Tiny Humans video

Initially colostrum is produced and this starts from around 16 weeks in pregnancy. After 37 weeks gestation you may want to start harvesting your colostrum, this aids with getting breastfeeding off to a good start and will help you to be effective at hand expressing and have some colostrum ready if you need it. Your midwife will support you with this and provide a harvesting pack.

Hand expression video

The babies’ stomach is the size of a cherry on the first day and therefore takes small amounts of colostrum and then over the next 3-4 days the quantity of milk increases as your babies’ stomach grows. 

No equipment or special diet is needed – ensuring that breastfeeding has no cost and it is recommended that baby continues to breastfeed for 2 years or longer if mum and baby wishes. The benefits to mum and baby are dose related, which means that the more breastmilk and the longer the feeding goes on for the longer and better the benefits will be.

Useful links:

• How lactation works
• Getting breastfeeding off to a start – what it all means
• Positioning and attachment video - Baby Friendly Initiative
• Harvesting colostrum for your baby

After the birth, baby is in your arms having skin to skin, with lots of eye contact and soothing talking - baby will feel familiar, snuggled, calm and relaxed, these behaviours boost your supply of the hormones oxytocin and prolactin which will assist with developing your milk supply and close and loving relationships. 

Warmth from the mum is shared with the baby and is the perfect place for baby to be to help it recover from the birth, warm up and regulate its breathing after the birth.  If this is not possible straight after birth then it should be carried out as soon as possible after the birth.

During skin to skin the baby will also lick and nuzzle at the breast and pick up some of the microbiome - healthy bacteria, aiding gut health and shaping longer term health.

Skin-to-skin contact

The baby will then be ready for its first feed and by keeping baby in skin to skin, uninterrupted and unhurried the baby can use its reflexes and feeding will get off to a good start.  It is important to keep the baby in skin to skin for the first feed, however you choose to feed your baby.  Weighing etc can wait till after the first feed.

Skin to skin can be undertaken at any point and will help with bond between parents and baby and assist with feeding. It's great for dad’s and Partners to undertake this as well. Don’t worry if you don’t get a chance for skin to skin straight after the birth – just do it as soon as you are and your baby are able to.

Enjoy discovering your baby, what does he or she looks like, that baby smell and little noises they make – you are already starting to get to know your baby and understand their needs.

Breastfeeding in the First Hours

Newborn babies breastfeed on average between 8 and 12 times in a 24 hour period, sometimes they will have shorter feeds and sometimes longer, between 5 and 40 minutes on average. The more your baby feeds the more your milk supply will increase to meet the needs of your growing baby. Babies will often cluster feed and this encourages the supply to increase. It is important to note that you cannot over feed a breastfed baby.

Feeding when your baby shows feeding cues for instance – stirring, mouth opening, turning head to one side etc is recommended as all babies are different.

Remember you and baby are still learning this together and be patient. It isn’t always easy but it is worth it. This Breastfeeding leaflet may help you.

Making sure that position and attachment is effective will help you to get breastfeeding off to the best start, support supply and prevent nipple damage. The acronym CHIN is used to help remember this:

• Close: babies body close and touching mums body
• Head free: hand on back of shoulders, so to not restrict the head tilt to latch effectively
• In line: babies head, shoulders and hips in a line, to aid swallowing and comfort
• Nose to nipple: nipple pointing up the nose and chin on the skin under the nipple, to encourage wide mouth

Useful resources:

• Positioning and attachment video
• Deep latch breastfeeding
• Attaching Your Baby at the Breast

Breastfeeding should be comfortable and the baby should be settled at the breast. Your baby will start to swallow more milk once your milk comes in about 3 to 4 days after birth. You are reassured that breastfeeding is going well when the babies output is as expected and that baby spontaneously comes off the breast themselves when they are ready. Please see the checklist and video below for further info.

• mothers breastfeeding checklist (UNICEF)
• How to recognise when a baby is drinking well

During a breastfeed, this is what you should see:

• babies mouth wide open 
• rhythmic suck/swallow (nipple remains rounded at end of feed)
• More Areola (area of dark-colored skin on the breast that surrounds the nipple) visible above babies top lip
• The nipple goes as far back as the junction of the hard and soft palate. The junction of the hard and soft palate is where the bony part of the roof of your mouth meets the soft, fleshy part at the back of your throat.
• Cheeks are full and rounded
• Chin Indenting the breast

Ensure you have the support of your ‘village’ of people around you encouraging and helping. Support is available throughout the area via, peer supporters, Infant feeding team, 24 hour telephone line.

Information for breastfeeding twins

• Breastfeeding Twins - with Kathryn Stagg IBCLC
• Twins Trust | Breastfeeding

Expecting a baby with Down’s Syndrome

Positive about Down syndrome provides information and support to new and expectant parents of a little one with Down syndrome. 

They have two digital booklets available which bust that myth that babies born with Down's Syndrome cannot breastfeed breastfeeding-flipbook (positiveaboutdownsyndrome.co.uk) and The Lived Experience - Breastfeeding a baby with Down syndrome (positiveaboutdownsyndrome.co.uk)

Alternative languages

• Foreign language resources
• videos showing various different aspects of breastfeeding in various languages

A healthy diet is recommended for all mums and breastfeeding mums

Vitamin D is required to help keep bones, muscles and teeth healthy. The main source of vitamin D is sunlight it is therefore advised in the UK that the whole population take a vitamin d supplement of 10mcg daily. 

All pregnant mothers and breastfeeding mothers are advised to take a supplement of 10mcg vitamin D. 

Babies who are breastfeeding or having less than 500mls of artificial milk daily, are advised, as a precaution, to be given a supplement of 8.5-10mcg of vitamin D daily from birth to 1 years. All children 1 aged over 1 year old are advised to take 10mcg daily.

Useful resources:

• Eating well for new mums, including information for breastfeeding mothers
• Vitamin D

Important information should you choose to use artificial milk for your baby:

• You should give your baby First Milk for the first year
• After the first year your baby can then go onto cows milk
• Second stage, comfort, hungry baby, colic milks, etc are not advised as there is no evidence to support their use and they are more expensive.
• By law, all formulae have be made to the same specification, therefore it doesn't matter which brand you choose. If you require for research and evidenced based info please have a look at First Steps nutrition.

Infant milks: information for parents and carers

Sterilising and making up the feeds using the guidance below and making them up as you need them, will ensure that they are made up appropriately, this is important to keep your baby safe.

Bottle feeding leaflet

Responsive bottle feeding is advised – this will help with relationship building and brain development along with assisting to prevent over feeding.

1. Limit people who feed your baby, to help with bonding, ideally you and your partner.
2. Watch for feeding cues that the baby is hungry – like stirring, opening mouth and head turning/rooting
3. Allow the baby to take the teat and introduce slowly.
4. Pace the feeds by allowing regular winding breaks and ensure the angle of the bottle is not upright so the milk flows more slowly
5. Observe for finishing cues – these include the baby dribbling milk, pushing teat out with their tongue, or splaying their hands, signalling they are stressed.        
6. Move from cradling baby on one side to the next at different feeds.

Useful resources:

• Infant formula and responsive bottle feeding
• Tips for bottle feeding your baby
• Guide to bottle feeding