Feeding your baby

25 April 2019

Choosing whether to breastfeed or bottle feed your baby can be a difficult decision, and sometimes one that's out of your hands. It's important to remember that whichever method you choose should feel comfortable for you and enable your baby to thrive.

Here our Ask the Expert team share their insight on breast and bottle feeding your baby, based on the most frequently asked questions they receive.

Breastfeeding your baby

Why people say ‘breast is best’

Breast milk is regarded as ‘best’ by some because it’s the food that’s naturally designed to meet your baby’s needs and it’s full of essential nutrients. According to Unicef, research has shown that breastfeeding also provides babies with various health benefits, including protection from infections and a long list of illnesses, from vomiting and diarrhoea to asthma, diabetes, childhood leukaemia and sudden infant death syndrome (SIDS).

Breastfeeding also has benefits for the mother, lowering the risk of developing breast and ovarian cancer and conditions such as osteoporosis and heart disease.

Finally, breastfeeding can be a good way of bonding with your baby. Skin-to-skin contact helps comfort your baby, and regulate their breathing and temperature. And both mother and baby are said to derive mental health benefits from the closeness and soothing feelings that the breastfeeding process promotes.

Breastmilk

Just after your baby is born, the first milk you produce is called colostrum and is thicker and more yellow in colour than milk. This concentrated substance is packed full of antibodies for your baby and they only need about a teaspoon each feed, but they may feed for a long time initially, to help stimulate your body to make milk for the coming days.

Around day 3, your milk will 'come in' and your breasts will probably feel full, heavy and firm. The milk then produced will be whiter and thinner in consistency. As your milk is 'let down' in response to your baby crying or starting to feed, you may feel a tingling sensation in your breasts. When your baby feeds you will now probably start to hear them swallowing the milk down as it comes in greater quantities. It's important to wind your baby after feeds to help them feel more comfortable.

Breastfeeding for beginners

Since 2003, the Department of Health has recommended that women should ideally exclusively feed their baby with breast milk for the first six months of life, before introducing any other food or drink.

But like any skill, learning to breastfeed can be difficult to start with, and it's important to seek support from your midwife, health visitor or local breastfeeding support services if you're finding it difficult or painful.

How do I know when to feed my baby - and when to stop?

Breast feeding works on a supply and demand system, so the more your baby feeds, the more milk you will produce.

It's important to try and learn your baby’s hunger cues. Examples of this can be sucking their hands, making sucking noises or looking around with their mouth open. It is best to try to feed them when they are showing these signs rather than waiting for them to cry.

Allow your baby to feed until they're satisfied. If they're still looking for more milk once you feel they have fully fed from one breast, you can offer the second breast. Make sure you alternate breasts for each feed.

Tips to make breastfeeding more comfortable

  1. Make sure you're sitting comfortably before you start feeding and that you have a glass of water nearby. Relax your arms and shoulders.

  2. Make sure your baby’s head and body are in a straight line. This will help them swallow more easily. You can use pillows to help you with this.

  3. Position your baby’s nose level with your nipple. They will naturally tilt their head back and open their mouth and then you can bring them swiftly onto the breast chin first, allowing them to take a large mouthful of breast.

  4. They should do a couple of strong sucks initially to attach properly and then start a pattern of rhythmic sucks with pauses.

  5. Ensure your baby’s neck, shoulders and back are well supported.

  6. If your baby needs encouragement to feed, try stroking their top lip to encourage them to open their mouth wide, or have them skin-to-skin with you.

It's important to remember that the baby needs to suck the nipple right into their throat (or 'latch on') to feed effectively from the breast. It's when the baby has only the nipple in their mouth and it's rubbing on the baby’s hard palate that soreness occurs. This can feel like a pinching sensation and it's vital that if you're not happy with the latch, you take the baby off and reposition them to prevent sore nipples.

If your nipples are sore, squeezing a little milk out and coating the nipple between feeds can promote healing.

Common Breastfeeding Issues

Sometimes health conditions can occur during breastfeeding, creating difficulties for mum and baby. These include issues such as blocked milk ducts, mastitis, abscesses and thrush.

Blocked milk duct

“Occasionally a blocked milk duct can occur, causing a swollen, red area on the breast,” explains Registered Midwife, Rosie Henley. "To help unblock the duct, it's important to keep breastfeeding your baby. Other ways to help unblock the duct are to gently massage the area downwards to encourage the flow of milk. Using warm flannels or a warm shower on the area can also help alleviate the discomfort and blockage.

"You can help prevent blocked ducts from occurring by ensuring your baby is in a good position when feeding to help them fully drain the breast, and refraining from wearing tight clothing or ill fitting bras."

Mastitis

Mastitis occurs when a blocked milk duct doesn’t settle after one to two days, causing it to become infected. “It will become red, hard, painful and swollen, and you may develop a fever and feel very unwell. You need antibiotics to clear this up, along with continuing to feed from that breast to clear the blockage,” advises Rosie.

Breast abscess

“A breast abscess is another rarer complication causing a red, painful, hard lump. You may also feel unwell and experience flu-like symptoms." The abscess is a collection of pus and needs draining quickly by a doctor, followed by a course of antibiotics. If you're worried that you may have a breast abscess, seek advice from your doctor as soon as possible.

Thrush

Breast thrush causes severe nipple or breast pain and can be spread from mum to infant. The nipple usually appears red and shiny and a white coating can be seen on the baby’s tongue and gums. “Thrush is treated with prescribed anti-fungal medications, usually cream for the mother and drops or gel for the baby’s mouth,” explains Rosie. Painkillers may be required too to help ease pain.

Feeding with formula

If breastfeeding doesn’t work for you and your baby, or you decide not to breastfeed, you can feed your baby infant formula milk.

If you choose to bottle feed your baby, you can still experience closeness and bonding with your baby. Ensuring lots of eye contact and feeding your baby skin-to-skin can help this.

It's important to note that babies can often take in more air when feeding from a bottle, so make sure you wind them mid-way and after a feed to help prevent vomiting and make them more comfortable.

Tips for making up formula milk

If you're bottle feeding there's no need to feed your baby any milk other than first infant formula in their first year, unless recommended by your doctor.

Formula milk comes in two forms: powdered infant formula, which isn't sterile and ready-to-feed liquid infant formula, sold in cartons, which is sterile.

Tips for making up powdered infant formula

  • Follow the instructions carefully
  • To reduce the risk of infection, make up each feed as your baby needs it, using boiled water at a temperature of 70oC or above
  • Let the milk cool before feeding it to your baby
  • Bottled water is not recommended for making up feeds with powdered milk
  • Do not change the powder to water ratio as it's not safe to do so
  • Discard any bottles of milk that have been made up and kept at room temperature but not used within 2hours.

Tips for using ready-to-feed liquid infant formula

  • Follow the instructions carefully
  • If you're using ready-made cartons of milk, you can store any unused milk in the carton at the back of the fridge on the top shelf for 24 hours, after that it needs to be discarded.

Washing and sterilising bottles

  • Always carefully wash and sterilise bottles to avoid dangerous vomiting or diarrhoea bugs
  • You can use cold water sterilising solution, boiling or steam sterilising methods to sterilise the bottles and teats. 

How do I know my baby is getting enough milk?

Whether they're breast or bottle fed, you should expect 6 wet and 2 dirty nappies from your baby in a 24 hour period. This is likely to be less in the first 24 hours and the first poo they pass will be sticky and black (called meconium). This gradually changes to green and then yellow, loose poo over the first week. When you change wet nappies, the urine should be pale yellow or colourless with little or no smell.

Your baby will be weighed regularly in the first few weeks of life and their weight gain is a positive sign that they're having enough milk. If you are at all worried your baby isn't getting enough milk, speak to your midwife or health visitor.

Next steps

If you have any concerns or worries about feeding your baby or anything else that comes with being a new parent, please do speak to your GP, midwife or health visitor. You can also get information and support at any time of the day or night through our Early Years Support Service.

Early Years Support from AXA PPP healthcare

At AXA PPP healthcare, we understand that becoming a parent – and a family – is a life-changing event, which at times we may not feel fully prepared for.

That's why we've developed our Early Years Support Service for anyone embarking on becoming a parent, by birth or through a fostering or adoption process, however many times you may have ‘been there’ before!

Available through our Health at Hand team, the Early Years Support Service has registered midwives and nurses at the end of the phone for you or your family to talk to  day or night, 365 days a year*.

We're here to provide medical information and support, whenever you need us. So if you’re looking for some reassurance or just a friendly chat, or if you have questions about anything from pregnancy, delivery, the postnatal period and adapting to parenthood, to negotiating the early developmental stages, planning for the future, returning to work or even extending your family further, call us on 0800 003 004. Or if you prefer you can contact us by email via our Ask the Expert service and one of the team will get back to you. 

*Availability of specialist support:
Nurses and counsellors are available 24 hours a day, every day.
Midwife and pharmacists services available 8am to 8pm Monday to Friday, 8am to 4pm    Saturdays and 8am to 12pm Sundays. Call backs can be arranged.
We will transfer members to our Counselling service as appropriate.

Further reading

How to bond with your baby - AXA PPP healthcare
Pregnancy and Children's health centres - AXA PPP healthcare