Frequently asked questions?
Answers to the breastfeeding questions you need to know.
What different breastfeeding positions can I use?
Cradle hold
-
The cradle position is commonly used after the early weeks.
This is the classic position most of us picture when we think of breastfeeding. It involves you sitting upright, with your baby positioned on their side, their head and neck laying along your forearm and their body against your stomach, in a tummy-to-mummy position. Although it’s a very popular position, it’s not always easy with a newborn because it doesn’t give your baby as much support as some other holds. A pillow or cushion behind you and a breastfeeding pillow across your lap propping up your baby or your arms may give you more support, and avoid strain on your back or shoulders. If you use a breastfeeding pillow, make sure it doesn’t lift your baby too high – your breasts should remain at their natural resting height to avoid sore nipples and a strained latch.
If feeding on the left breast your baby’s head would be resting on your left forearm or wrist and your left hand supporting their back or between their shoulders, you can use your right hand to tip the nipple if you need to “offer” the breast by stroking the nipple on baby’s nose and lips to encourage gaping to latch.
Cross-cradle or Transitional hold
-
Cross-cradle is usually used in the early weeks to provide more control.
This looks similar to the cradle hold but your arms switch roles so your baby’s body lies along your opposite forearm. The aim is to support your baby around the neck and shoulders to allow them to tilt their head prior to latch. This is a great newborn breastfeeding position and is also good for small babies and those with latching difficulties. Because your baby is fully supported on your opposite arm, you have more control over their positioning, and you can use your free hand to shape your breast if needed.
If you are breastfeeding on the left breast you would use your right hand to support around baby’s the bony part of your baby’s lower shoulder, and you can support the breast with the right hand, or overlap the right hand over the left for more support.
Laid-back breastfeeding or Biological nursing
-
The laid-back breastfeeding position, also known as biological nurturing, is often the first mums try. If your baby is placed on your chest or tummy as soon as they are born, all being well they’ll instinctively work their way towards one of your breasts and attempt to latch on – this is known as the ‘breast crawl’. Skin-to-skin contact helps stimulate feeding instincts, while gravity helps your baby to latch on well and keeps them in place.
However, laid-back breastfeeding isn’t just for newborns – it can work well with babies of any age. It may be especially useful if your baby struggles to latch in other holds, or if they don’t like their head being touched as they feed, if you have a forceful let down, or if your breasts are large.
Lay back in a comfortable, reclined position with baby laid upon you, facing you. Ensure you have adequate support from cushions or pillows. If feeding on the left breast you can support the left breast during latching with your right hand, and the left arm will wrap around baby with your left hand supporting baby’s bottom.
Side-lying
-
Ideal for relaxed night feeds and breastfeeding in bed or on the sofa, side-lying can also be more comfortable than sitting if you’ve had a caesarean or perineal stitches. You and your baby need to lie on your sides facing one another, belly-to-belly. Make sure you have good head and neck support for yourself. If feeding on your left breast, you would lie on your left side. Your baby can be supported by your right hand with their back along your forearm.
Rugby or Football hold
-
This position is useful if you have had a caesarean section, twins, or a premature baby, along with those who have larger breasts.
In this position (also known as the underarm or clutch), you sit with your baby resting along your forearm. Their body tucks alongside your side, with their feet towards the back of the chair, or whatever you’re sitting on. As baby grows longer, you may need to stack vertical pillows behind your back to create more space for baby’s legs. This is another helpful early nursing position because it supports your baby well, while giving you plenty of control and a good view of their face. Being tucked in closely alongside your body will help your baby feel safe too. If feeding on your left breast, baby lies along your left side, you support their lower shoulder with your left hand, and their back along your left arm.
Upright or Koala hold
-
In the upright or koala hold, your baby sits straddling your thigh, or on your hip, with their spine and head upright as they feed. You can do this hold with a newborn if you give your baby plenty of support, and it’s also a convenient way to feed an older baby who can sit unaided. The upright or koala hold is often the most comfortable breastfeeding position for babies who suffer from reflux or ear infections (who often prefer to be upright), and it can also work well with babies who have a tongue-tie or low muscle tone.
-
You might have been told breastfeeding shouldn’t hurt, but many mums find the first few days uncomfortable. It’s not surprising when you consider your nipples aren’t used to all that strong, frequent sucking your baby is doing.
Preventing damage is better than having to treat it, so see a lactation consultant or breastfeeding specialist if pain continues after the first few days.
You may also feel period-like cramps (known as afterpains) following feeding sessions in the first few days, especially if this isn’t your first baby. This is because the oxytocin released by breastfeeding will help your womb contract further, as it starts to return to its usual size.
When your milk comes in over the first 3-5 days, it’s usual for breasts to feel full, firm, and certainly bigger than they used to be. Some women find their breasts get very swollen, hard and tender – a condition called engorgement. Feeding your baby frequently should help relieve the pressure.
-
Regardless of what position you choose to feed in, the technique to position and latch your baby is the same.
Remember to start by getting yourself comfy where you mean to feed, making sure you are stable and your back is well supported. Bring baby to the breast (not the breast to baby), and line baby up nose to nipple while the breast is at rest. Let the nipple stroke on baby's nose to encourage a wide gape. When baby gapes widely, use the hand behind their shoulders to pull them into the breast firmly. Support baby in firmly throughout the feed, holding them in behind their shoulders and bottom for cheek and chin contact with the breast, tummy touching your body, and a straight spine. This stability and security from firm support helps baby to relax and focus at the breast, so it can help to reduce wriggling and pulling away. If baby’s nose is squished into the breast, then the baby needs to be moved along your body away from the breast to allow their head to tip back so baby can breathe and swallow comfortably.
-
Allergy
Breastfeeding women do not need to avoid foods, unless they have an allergy to the food themselves. Avoiding foods while pregnant or breastfeeding does not help prevent allergies in the baby.
If cow’s milk or any other food is removed from your diet, seek advice from a dietitian to ensure that you and your baby are not missing out on important nutrients.
If you think that a certain food that you are eating is affecting your baby, discuss this with your LMC. Well Child nurse or GP.
Dietitian
Some women may need special advice from a dietitian about eating. Ask your LMC or GP to arrange for you to see a dietitian if you:
-find that certain foods that you eat are affecting your baby
-have a medical condition that affects your eating, such as diabetes
-eat very little or have a history of eating problems
-are vegetarian or vegan
-are 18 years old or younger.
Caffeine is a stimulant, so it can make your baby restless. Aim to have no more than 300mg of caffeine per day. If you are struggling with a wakeful or restless baby, then you could experiment with cutting out all caffeine, such as coffee, tea, chocolate, energy drinks and other soft drinks.
Alcohol passes through your breast milk to your baby, so it is ideal to avoid it while you are breastfeeding. Drinking alcohol can also lower your milk supply and it might make your baby irritable, unsettled or sleepy and not able to feed well. If you do have a few drinks, make sure that you avoid breastfeeding for at least a couple of hours afterwards. You could use previously expressed breastmilk instead if your baby needs to feed in those couple of hours. You do not need to pump and dump if you’ve had a single unit of alcohol because the alcohol will pass out of your breastmilk and back into your bloodstream within a couple of hours to be excreted by you. If you have had a number of alcohol units then the length of time until the alcohol passes out of your milk multiplies. This means you may need to pump and dump breastmilk over this increased number of hours in order to reduce your risk of blocked ducts and mastitis, and to help maintain your supply. If you choose to drink alcohol, make sure that your baby has someone looking after them who is alert to their needs and free from alcohol or drugs. Check out the Feed Safe app to help you calculate how long to avoid breastfeeding after having a drink.
Smoking
Be smokefree and keep your baby smokefree.
Smoking can reduce the amount of milk you make.
If you do choose to smoke:
-Never smoke during breastfeeding
-Never smoke in the same room as your baby – smoke outside if possible.
-Use a smoking coat- a coat you wear when you are outside to smoke. Take it off outside and wash your face and hands, and brush your teeth before having contact with your baby or child.
-Some people think smoking is an easy way to lose weight. This is not true.
Medication
Seek advice about taking medication.
Use medication only as advised by your LMC or GP.
Taking any other sort of drugs, for example, illicit drugs or party pills, is not recommended for mothers who are breastfeeding.
-
The let-down reflex (or milk ejection reflex) is an automatic natural reaction that happens in your body when your baby starts to breastfeed.
There are nerves in your nipples that are triggered by your baby’s sucking. These nerves cause two hormones to be released into your bloodstream.
Prolactin is responsible for making more breastmilk.
Oxytocin causes the let-down reflex so your milk flows.
The milk-making cells in your breast contract and squeeze out the milk, pushing it down the ducts towards the nipple. Oxytocin also makes the milk ducts widen, making it easier for the milk to flow down.
This pushing out of milk is known as the let-down reflex or the milk ejection reflex. It happens at the beginning of feeds but there will also be several more throughout the feed, though you may not notice these.
You might notice some of these signs:
*a tingling feeling
*a feeling of sudden fullness which can be quite strong, even painful sometimes.
*milk leaking from the other breast (let-down happens on both sides at the same time).
*feeling thirsty
Some mums don’t notice any physical signs but...
Everyone should notice this sign:
*Your baby starts to suck deeply and rhythmically.
A sure sign that you’ve had a let-down is a change in your baby’s sucking pattern. The quick, shallow suck-suck changes to a rhythmic suck-swallow pattern as the milk begins to flow and your baby starts to drink deeply.
You may also find that you get a let-down if you see or hear your baby, or even just think about them. The let-down becomes a conditioned reflex, so your breasts will respond to certain ‘cues’ like a baby crying (even if it’s not your baby!).
-
We can't measure how much your baby takes when they breastfeed but there are some reliable signs that your milk supply is going well.
Your baby's nappies
Provided your baby is only having breastmilk:
After 5 days of age baby will have at least 5 heavily wet disposable, or 6-8 very wet cloth nappies, in 24 hours.
Urine (wee) will be pale. If baby's urine is dark and smelly, this is a sign that they aren't taking in enough milk.
Plenty of soft poos of a yellow-mustard colour. Under the age of 6 to 8 weeks, babies usually have three or more runny poos a day, about the size of the palm of baby's hand.
As baby gets older, they may poo less often, even once every 7 to 10 days. As long as when your baby does a poo, there is a large amount of soft or runny poo coming out!
Your baby's signs of growth
In addition to the 'what goes in must come out' signs:
Baby has some weight gain after the initial weight loss in the first week after birth.
Baby has growth in length and head circumference. (Are your baby's clothes getting snugger?)
Baby looks like they fit their skin, with good skin colour and muscle tone.
Baby is meeting developmental milestones.
Your baby's behaviour
You can also observe your baby
Baby will be alert, particularly after 2 weeks old.
Baby will have some contented times between feeds
They may still be fussy at times and some babies may cry a lot but still be getting enough milk.
The number of feeds your baby is having.
It's normal for young babies to feed 8-18 times in 24 hours and most babies will need this many. The more frequently your baby feeds, and therefore the more drained your breasts, the more milk you will make.
Normal baby behaviours that you may confuse with hunger.
Young babies feed frequently, especially in the late afternoon and early evening.
Most babies wake for night feeds. Some babies sleep through the night at an early age while others wake during the night for some time.
Babies have fussy periods and have times when they feed more frequently.
Some babies may cry a lot but this doesn't mean they are hungry.
If your baby is doing any of these, it isn't necessarily a sign they are hungry. Be guided by their feeding cues, nappy output and growth.
-
Feel like you're feeding all day?
Many mums wonder how long a feed should be, how often baby should feed, one breast or two and should I stretch feeds out?
Frequent feeding is common and normal.
How often do babies feed?
Your supply will meet your baby’s needs if you breastfeed them whenever they seem hungry or fussy. Young babies will commonly feed 8 to 14 times or more in 24 hours.
Your baby may be happy with only one breast per feed occasionally, but always offer both breasts. However, feeds can vary in length. Sometimes your baby might want a very quick feed, and at other times they may like to spend a long time at the breast. This is a little like you eating a larger meal, a snack or even just a drink at different times during the day.
Your baby doesn’t have to take a ‘full’ feed every time.
Many babies have periods of cluster feeding particularly in the late afternoon and evening. Babies who have a long stretch of sleep overnight may need to feed more frequently the rest of the day to catch up.
No matter how many feeds your baby has in a 24-hour period, what is important to know is if they are getting enough milk.
How long do feeds take?
Many parents are surprised at how long their babies spend feeding, especially in the early days. Your baby is learning how to breastfeed and only removes a small amount of breastmilk with each suck. As your baby grows, they will become more efficient at milking the breast and feeds will gradually get shorter.
If you know that feeding frequently is normal, you can plan your day around this. Some mums like to set up a feeding space with everything they need – water, pillows, footstool etc.
I've been told to space out the feeds
Sometimes mums are advised to stretch out the time between feeds. Frequent feeding is sometimes seen as the reason why a baby might be upset or windy.
The fact is that young babies have tiny tummies and breastmilk is digested quickly. Very soon, they are ready for another feed. Responding to your baby's needs and offering a breastfeed, even if it feels like you've just fed them, will keep them happy and keep up your milk supply.
Most babies who are made to wait for a certain time to feed will become very unhappy. Soothing them can be exhausting for parents whereas a quick top-up feed usually settles everyone.
Trying to stretch out a baby’s feeds will also restrict their access to food, which may affect their weight gains.
Why has my baby's feeding pattern changed?
Babies’ feeding frequencies can change for other reasons:
There may be times of the day when your baby wants to feed more often, and there may be days/weeks where they seem to need less.
The amount of milk that breasts can hold is also individual and may affect how often your baby needs to feed.
Your baby may prefer fewer, larger feeds, or more frequent, smaller feeds.
As your baby gets older, they may tend to feed less frequently overall.
In hot weather a thirsty baby may want to breastfeed more frequently but for shorter periods. This means they are getting more fluids.
If your baby is unwell, in discomfort or upset, then they may want to feed more frequently.
What about routines?
It’s common for new parents to be told that their baby should be in a routine as soon as possible. In fact, many mums like the idea of having a routine because their life before baby was probably quite well organised.
However, the difficulty with routines is that very few babies are happy with them. Routines tend to suggest less frequent feeding which doesn’t meet your baby’s need to take in breastmilk often especially later in the day.
Routines often advise how long baby should be sleeping and when but most babies won't follow this advice. As a result, new parents become stressed because they have an unhappy baby and feel they are doing things the wrong way.
Babies are all different so strict routines written down as ‘one-size-fits-all’ methods mostly don’t work.
Breastfeeding is never just food to your baby. Babies need comfort, reassurance and ‘connection’ with their mum, as well as breastmilk.
Cuddling your crying baby, breastfeeding them when they want and breastfeeding to sleep are more likely to result in a happy baby and happy mum.