Breastfeeding support - Derby

Women’s bodies are designed to produce milk and babies are designed to receive it. Breast milk is perfectly made to give your baby everything they need. In the early days colostrum provides your baby with antibacterial fighting properties which help keep infections at bay. It is highly concentrated in a small volume as a baby’s tummy can only take about:

• 5-7 mls in the first couple of days  
• Up to 25mls on day three 
• 40-60mls on day 10 

As your baby grows, your breast milk changes to ensure your baby gets everything that is needed.

Breastfed babies are less likely to suffer:

• Insulin dependant diabetes
• Eczema and asthma
• Some childhood cancers
• Obesity
• Heart disease in later life
• Chest infections and wheezing
• Ear and urine infections
• Sudden Infant Death Syndrome (also referred to as SIDS or cot death) 

Breastfeeding also:

• Can help visual development
• Provides better mental (brain) development
• May reduce the development of Crohn’s disease
• Promotes better mouth formation and straighter teeth
• Reduces blood pressure.

For mums it helps to:

• Reduce the risk of breast cancer
• Reduce the risk of ovarian cancer
• Promote stronger bones in life
• Provide a faster return to pre-pregnancy figure.

If you breastfeed your babies for a joint total of two years or more, it can reduce your risk of developing breast cancer by 8%.
 
Breastfeeding is an instant soother if your baby is upset or needs comforting. It can also reduce the pain from immunisations.
 
We now know you can never overfeed a breastfed infant.

Breastfeeding Clubs offer support for like-minded breastfeeding women and those who are providing breast milk. The clubs also welcome mums to be who would like to gain more information about breastfeeding.

Face to Face Breastfeeding Clubs in Derby

All sessions will be facilitated by a member of the Infant Feeding Team. If you would like to attend, please book your place by TEXTING the team on 07507 327754.

• Mondays between 11am-12pm at Derwent Family Hub, DE21 6BD 
• Tuesdays between 11am-12pm at Rosehill Family Hub, DE23 6WY
• Tuesdays between 1pm-2pm at Sinfin Family Hub, DE24 9SF 
• Wednesdays between 1pm-2pm at Audrey Drive Childrens Centre, DE21 4NP 
• Thursdays between 11am-12pm at Boulton Childrens Centre, DE24 0DD 
• Fridays between 11am-12pm at Becket Family Hub, DE22 3WR

Home visits are available to those requiring face-to-face support. Please contact the team if you would like any support with feeding. 

Face to Face Antenatal Feeding my Baby Sessions.

Booking required. 

These sessions are delivered by the Infant Feeding Team and will help you recognise baby’s feeding cues, how to know baby is getting enough milk and how responsive feeding can help your baby’s brain to develop.  Text ChatHealth on 07507 327754 to book your place.

These sessions can be attended as a stand alone session or as day 3 of the Preparation for Parenthood Course. Please see Antenatal (before birth) for dates.

During pregnancy mums often start to develop a relationship or bond with their baby. Once your baby is born, this can continue in a number of ways.
 
You may have started this with skin-to-skin contact following your baby’s birth which will have enabled you to say hello to your baby. This normally stimulates milk producing and mothering hormones.
 
Skin-to-skin contact helps your baby feel calm and safe as they will be able to hear the familiar sound of your voice and heartbeat. This special time promotes the positive mother-baby relationship, regardless of how a mother feeds her baby. It promotes the release of oxytocin, a hormone which has a calming, soothing effect on both you and your baby. Skin-to-skin contact is valuable at any time to help settle and calm a baby and it is also something your partner can enjoy with your baby. It can help you to get to know your baby and fulfil their need for love, comfort and food. You can’t spoil a baby by picking them up.
 
When a baby is hungry they will start to show signs called feeding cues. These are:

• Eye movement when waking
• Rooting
• Hands to mouth or sucking on fingers
• Wriggling
• Being restless                                                                       

If the feeding cues are not responded to in a calming manner, babies will cry. It is not recommended  to leave babies to cry for a long periods as this will increase their stress levels. When babies are picked up, cuddled and comforted they release oxytocin which helps them to feel calm and safe. Oxytocin levels are high during breastfeeding, helping your baby’s brain to grow by making nerve pathway connections, which are an important part of brain development.
 
At times a baby will want a breastfeed for comfort; this is okay to do as a breastfed baby cannot be overfed.

Unicef - Useful guidance and information on positioning and attachment.

Responsive Feeding – Cluster Feeds

Young babies feed at least eight times in 24 hours and vary the amount of time they spend at the breast. Some feeds can be short, some can be long; mums are encouraged to look how their baby feeds over a 24-hour period. A lot of babies tend to feed frequently in the evenings; this is often referred to as cluster feeding and this is normal. Many mums may not know this and may think their milk supply has reduced but this is not usually the case. Mums are encouraged to be responsive to their baby’s cues for feeding and comfort.
 
Responsive Feeding – Growth Spurts

Sometimes, for a day or two, babies can seem to want more frequent feeds than at other times. Such times have been referred to as growth spurts. More frequent feeds at any time stimulate an increase in milk supply for future feeds to meet the needs of the baby. Mums are encouraged to respond to their baby’s feeding cues.

On the first day your baby can only take about 5 – 7 mls of milk per feed. This first milk is referred to as colostrum. The amount a baby takes increases gradually.

Here are a few tips to help you know your baby is getting enough milk during each feed:

Your baby needs to be attached well at the breast. Feeding should be comfortable and pain free. Your baby needs to be fed when they want for as long as they want. During breastfeeds there will be a rhythmic swallow pattern; this starts off as rapid sucks, progressing to deeper sucks and swallows with some pauses. Towards the end of the feed you will notice some flutter-type sucks with occasional deeper swallows where your baby is getting the last of the fattier milk, so it is important you let your baby finish the feed.

Useful Websites

• Best beginnings 
• Unicef baby friendly initiative

Signs that your baby is getting enough milk include:

• Frequent, responsive feeding
• Baby is pooing and seeing 
• Baby settles on the breast and after feeds
• Baby is growing and gaining weight – their clothes are getting shorter or smaller
• Baby is alert and responsive
• Baby looks well

The contents of your baby’s nappy are a good indicator that your baby is getting enough milk. See the section 'What baby poo looks like' on the NHS page 'How to change your baby's nappy' for more details. 

This is a new skill to learn and to start with you may find you do not obtain much milk. The amount of milk expressed can vary. Healthy term infants can usually obtain more milk when feeding at the breast than the amount of milk that can be expressed. It is normal for your very nutritious breast milk to look thin, watery or even a bluey colour.
There are a few key points to follow which you may find helpful:
 

• Firmly but gently massage your breast and roll your nipple. This helps stimulate the hormones to release the milk – known as let-down or oxytocin reflex
• Cup the breast in your hand
• Feel for a change in texture which is approximately 2.5 cm from the base of the nipple
• Put your thumb above and finger underneath making a ‘C’ shape on the change of texture.
• Press and release with finger and thumb using rhythmic movement
• It may take a little while for milk to appear- if it doesn’t, move your fingers back slightly. Milk will usually trickle and then spurt out and then reduce to a trickle again
• Move your fingers and thumb around the breast to express milk from the other milk ducts
• Repeat on the other breast

Unicef - Advice and guidance for hand expressing 
 

Storing your breast milk

It is important to wash your hands before you start and to use a sterilised container to collect your milk. Your milk should also be stored in a sterilised container with a lid. Label the container stating that it contains breast milk, your name, date and time.

It is recommended that you use a fridge thermometer so that your breast milk is kept at its best.

• Storage in the fridge: Store at 0° to 4° and use within eight days
• Storage in the freezer compartment of a fridge: Up to two weeks
• Storage in the freezer: Store at -18°C or lower and use within six months or three months if your baby was born prematurely

Once the baby has drunk from a bottle of expressed milk it should be used up within an hour or thrown away. To avoid wasting your expressed breastmilk it is best to offer the baby only a little at a time. You can do this by keeping most of it in one container, in the fridge, and using it to top up the baby’s bottle a little at a time.

Defrosting your breast milk

It is recommended to defrost breastmilk in the fridge and use within 12 hours of removing from the freezer. If your breastmilk is still frozen after this time, or you need to use it quickly, defrost under cool, then warm, running water and use immediately after drying the container. Shake gently to mix the creamy, separated particles together. If your milk is often frozen after 12 hours in the fridge, try to freeze in smaller quantities.

If you are thinking of giving formula milk there may be other options for you depending on your reasons. These may include expressing breast milk and giving this instead of formula, getting support with feeding if you are experiencing a difficulty or getting support to breastfeed discreetly when out and about.
 
Breastfeeding works on a supply and demand basis. If this is interrupted with formula milk the breast may not produce enough milk for future feeds.
 
When a breastfed baby is given formula it changes the protective coating that the breast milk creates in the baby’s gut. This can increase the risk of baby getting infections such as gastroenteritis.
 
Babies given formula milk may appear to be less satisfied with subsequent breastfeeds as formula milk is harder for the baby to digest and can stay in the baby’s tummy for longer.
 
Sucking from the teat of a bottle is different from breastfeeding and this may make it harder for your baby to attach correctly to the breast.
  
Giving formula milk may increase the risk of your baby developing allergies such as asthma and eczema.
 
Your breasts can become full and uncomfortable (engorged) if the baby does not go to the breast frequently enough. This can make it painful and difficult to attach the baby to the breast.

Breastfeeding can take practice to learn how to get it right.
Sometimes partners can feel left out so it is important to talk to each other about how you feel.
A mum is more likely to choose to and to continue to breastfeed if her partner is positive and supportive about it. There are lots of ways for partners to help with breastfeeding. Try the following:

• Reassure your partner and praise and encourage her; if she believes she can breastfeed, she most likely will
• Be involved with the baby in other ways so that the caring is shared such as winding the baby, changing nappies and bathing the baby
• Help to reduce the household chores your partner has to do so that she can feed the baby for as long and as often as the baby needs
• Encourage your partner to eat and drink regularly, so that she feels more able to cope
• Encourage your partner to get specialist help if she is having difficulties with breastfeeding. Seeing a member of the Infant Feeding Team, for instance, can really make a difference
• Help your partner get into a comfortable position to feed
• Have cuddles with the baby after feeds
• Lie the baby on your chest, and have skin-to-skin contact
• Bathe your baby
• Take your baby out for walks
• Play with your baby
• Talk to your baby. Babies are really interested in watching things, especially faces, and often will start imitating mouth movements; this is the formation of very basic speech development.

Other suggestions for supporting the breastfeeding mum:

• Talking and listening to each other
• Encouraging the mum to attend a breastfeeding club
• Having a positive attitude to breastfeeding
• Making a sandwich in advance for the mum’s lunch
• Doing household tasks such as shopping, cooking or washing
• Supporting the mum to enable her to have some ‘me time’, perhaps a long soak in the bath

After a few weeks, if feeding is going well and you want to feed your baby, you could give expressed breast milk. Giving a baby a bottle before feeding is going well may result in your baby preferring the bottle. 

It can be difficult to know whether to use a dummy for your new baby or not. The following information may help you to decide what is best for your baby and you:

• Introducing a dummy in the first few weeks when you are breastfeeding may discourage your baby from feeding from the breast
• Your breast milk is produced in response to your baby feeding so if your baby does not feed frequently you may not produce enough milk to continue to meet their needs in the future
• The sucking action at the breast is different from sucking a dummy. Using a dummy when your baby is still learning to breastfeed may mean your baby does not attach properly to the breast
• Using a dummy may mean that you miss your baby’s feeding cues. If your baby is unsettled, offer the breast before giving the dummy in case your baby is hungry. Remember it is OK to breastfeed your baby for comfort as well as food
• Remember to sterilise dummies before every use to prevent the risk of infections.

Some reports suggest that some parents use a dummy to settle their baby to help to reduce the risk of sudden infant death syndrome. The Foundation for the Study of Infant Deaths states that dummies should not be used for breastfed babies for the first four weeks in order to allow for breastfeeding to become established.

Baby Teeth Matter

It is important to protect a baby’s teeth from about six months of age or when teeth first appear. Brush your baby’s teeth twice a day every day, using a small smear of fluoridated toothpaste. Do not forget to use the toothbrush pack that your Health Visiting Team gave you at the six-eight week review. Never let babies suck directly from baby food pouches as doing so can cause dental problems.   

Introducing Solids

In a healthy breastfed baby it is recommended to wait until your baby is around six months before giving them any other food or drink. The guidelines then recommend continuing to breastfeed alongside solid food until your baby is one year old and beyond.
 
Giving solids before this time will reduce the amount of breast milk your baby takes due to the solids taking the place of the milk in your baby’s tummy. Breast milk is made on a supply and demand process. The foods available for younger babies are limited in order to reduce the risk of allergy. Foods such as baby rice, pureed fruit and vegetables contain fewer nutrients and calories than breast and formula milk and are less likely to meet the demands of a growing baby. Younger babies can only swallow food and not chew so it needs to be pureed and be runny in consistency.
 
Remember every day of breast milk counts.
 
Infants given solids before six months will push food out of their mouth with their tongue. This is a reflex which is the body’s way of saying it is not ready for solid food. From about six months this tongue-thrusting reflex will disappear. Trying to give solids earlier can increase the risk of allergies such as eczema and asthma and also infections such as gastroenteritis.
 
These signs indicate when your baby is ready for solids:

• They can sit in an upright position and hold their head steady
• They can chew food – even with no teeth present
• They can pick up food and co-ordinate to put it in their mouth.

Infants at this age quickly progress onto family meals, so this provides a great opportunity to be included in family meal times and to start to learn the social aspects of eating.
When babies are introduced to starting solids they can start with baby-led weaning which enables babies to eat at their own pace. Start with foods that are easy to pick up – thick sticks or long strips. Introduce new shapes and textures gradually so that your baby can learn how to handle them.

Don’t expect your baby to eat much at first. During the first few months of baby-led weaning, many babies eat only small amounts. Most healthy family foods can be offered to your baby. These include vegetables, meat, cheese, fruit, well-cooked eggs, bread (toast), rice, pasta and most fish. Offering a variety of foods will give your baby the chance to discover different tastes and textures. Always supervise your baby when offering food.

Never let babies suck directly from baby food pouches as this can cause dental problems.

You can legally feed your baby wherever and whenever you choose to. You cannot be asked to leave any premises to breastfeed your baby. By breastfeeding your baby in public you are also helping to normalise breastfeeding and help other breastfeeding mothers to do the same.

At first it may seem a little embarrassing or scary to breastfeed away from home. It may be easier to practise breastfeeding at home with the clothes you are likely to wear when you do go out for the first time. Wearing new or different clothing may not be easy at first to undo. Your next step could be visiting one of the breastfeeding clubs in Derby, where there are like-minded mums who can share hints, tips and experiences. This may help you to develop your confidence.
 
You may find it beneficial to try on your clothes in order to find out which will be more comfortable to wear when breastfeeding away from home. If you have a new bra make sure you know how to open it and you can do so easily. Most mums use their existing clothes but there are clothes designed for breastfeeding mums such as tunic-style tops and shawls. But ordinary T-shirts can be just as effective. Some mums drape a muslin cloth or beach wrap over them or wear a waterfall style cardigan to feel more discreet. Some mums like to wear a vest top under their T-shirt which can be rolled down to keep their tummy covered. There are now capes and screens aimed at helping mums feel discreet. They are expensive and sometimes make you more noticeable. Have a try feeding in front of the mirror to see what others see rather then what you see when you look down. Others will not see as much as you!
                                                                   
Set yourself realistic goals; probably avoid the first couple of weeks before you go out and about to feed so you have gained more confidence with positioning and attachment.
 
A tip to help you feel more relaxed breastfeeding your baby when away from home is to have a trial run. Plan your trip, for example to a café, at a time when it is less likely to be busy – so avoid lunch time. Get all your belongings ready, including the changing bag, pram in the car and then offer your baby a feed before you leave home. Go straight to the café and get your drink. Choose a part of the café where you would feel most comfortable. It is likely that your baby will be calm and relaxed after having had a recent breastfeed which makes the situation much easier. Then offer your baby a breastfeed. A lot of breastfeeding mums have found having a trial run really helpful even if their baby only had a brief feed. Why not give it a try!
 
If you are travelling by car you could buy a sun visor for the side window and sit in the back to feed.

There are a number of places local mums feel comfortable when breastfeeding – see below, ‘Breastfeeding Friendly Places’.

Continuing to breastfeed when you return to work or study helps to keep the close relationship you’ve built up, providing your baby with extra comfort and security for as long as you both want.
Breastfeeding after the first few months is still important to your baby’s health because your milk continues to protect your baby from infections.  Even one or two breastfeeds a day will still benefit your baby’s health.  It’s good for you too as it continues to reduce your risk of getting breast and ovarian cancer.
 
Some ways in which it could work for you:

• Try to have your childcare close to your work or college so you can breastfeed during breaks.
• Breastfeed at home and express milk so that your baby’s carer can feed your baby while you are at work.
• Express milk at work by hand expressing or using a pump
• Talk to your employer about flexible working hours
• Let your employer know that you are breastfeeding and want to express milk or breastfeed during the time you are at work before you return.  This is so they can make plans to support you.

If you would like to discuss returning to work or study and continuing to breastfeed please contact chathealth by text and request the infant feeding team on 07507 327754.

Nationally, there has been an increase in the number of children with rickets which is associated with a lack of vitamin D.
Our main source of vitamin D is from the action of sunlight on our skin, but in UK the sunlight is not strong enough to make vitamin D in the winter months.

Due to this, during pregnancy all women are advised to take a daily supplement of vitamin D to prevent babies being born with depleted stores. It is recommended that pregnant women take vitamin D supplement of 10 micrograms or 400units daily.
Women who breastfeed are advised to continue to take the vitamin D supplement. The amount of vitamin D in the mother’s breastmilk will depend on her vitamin D intake and vitamin D stores; so as a precaution, it is now suggested that breastfed babies be given additional vitamin D, 8.5 to 10 microgram per day from birth until one year, as well as their mother.
 
If you are if you are eligible for the Healthy Start Scheme you can get vitamins free for your child from one month of age up to their fourth birthday and for yourself until your baby is one year old. If you are not entitled to the scheme you can buy vitamins at local retail outlets - please check the amount to be given as brands can state different doses.

You can exchange your Healthy Start vouchers for vitamins locally from:

• Peartree Clinic
• Sinfin Health Centre
• Revive Healthy Living Centre
• Coleman Health Centre      

Here is a list of places in and around Derby where mums have felt welcome to breastfeed. If you would like to recommend somewhere please contact the Infant Feeding Team.

Parent Rooms

• Derby Intu Parent Rooms
• Marks & Spencer Baby Changing Room

Restaurants and pubs

• McDonald's (Ashbourne Road)                       
• Olive Restaurant – Derby Intu
• Cherry Tree (Toyota Roundabout)      
• Nandos - Derby
• Pizza Express – St Mary’s Gate, Derby          
• Deda at Cathedral Quarter, Derby
• Jonty Farmer – Kedleston Road, Derby          
• Ikea – Nottingham 
• Mundy Arms – Ashbourne Road, Derby         
• Debenham’s Café – Derby Intu                        
• Zizzis - Derby
• Starbucks – Derby Intu                        
• Slug & Lettuce – Derby                        
• Bluebell Farm – Spondon
• Bonnie Prince Public House – Derby      
• Hackwood Farm - Mickleover
• Finton’s Bakehouse Tea Rooms
• The Book Café, Derby                                    
• The Good Green – Sadler Gate, Derby
• Brambles Café – Derby Intu                 
• Jacks of Melbourne
• Carluccio’s  – Intu / Nottingham          
• The Broadway – Duffield Road, Derby 
• Costa Coffee – Wyvern/Kingsway

Others

• QUAD – Derby
• Markeaton Primary School
• Children’s Centres
• Tesco, Long Eaton        

You are legally allowed to breastfeed your baby or child anywhere you choose to.

For support or advice from the infant feeding team please contact us via chathealth by texting 07507 327754.

The following nationalhelplines are also available:

National Child Birth Trust

Helpline: Telephone: 0300 330 0700  (8am – 10pm)

La Leche League

Telephone: 07980 262358

24 hour help line

*Automatic connection to local advisor

Monthly meetings in Derby City Centre – learn more on the La Leche League website.

The Breastfeeding Network

Supporter Line – Telephone: 0300 100 0210

9:30am – 9:30pm

*Automatic connection to local advisor

UNICEF Baby Friendly website The Unicef UK Baby Friendly Initiative

Supporter Line in Bengali and Sylheti

Telephone: 0300 456 2421

9.30am – 9.30pm

*This system recognises the area code of your phone to do this. You will therefore not be connected to a local supporter if your telephone number is withheld or if you use a mobile phone.

National Breastfeeding Help Line

Telephone: 0300 100 0212

9.30am – 9.30pm

Run by the ABM and the Breastfeeding Network