Feeding your baby

Breastfeeding has many health benefits for you and your baby. Your breast milk provides all the nutrition your baby needs to grow and develop. The composition of your milk will change to meet your baby's nutritional requirements as he/she continues to grow and develop.

Breastfed babies are:

• Less likely to suffer from colic and reflux
• Less chance of diarrhoea and vomiting
• Fewer chest and ear infections
• Less likelihood of becoming obese and therefore developing type 2 diabetes and other illnesses later in life
• Less chance of developing eczema and asthma

Why breastfeed? 

• Breast milk is the most natural food designed for your baby
• Breast milk contains vital immunological properties which help protect your baby from infections and diseases
• Breastfed babies are more likely to gain the right amount of weight as they grow rather than becoming overweight.
• Breastfeeding helps build a strong emotional bond between mother and baby
• Breastfeeding burns extra calories helping mothers to lose pregnancy weight faster
• Breastfeeding lowers the risk of breast and ovarian cancers in mothers
• Breast milk is free!

Meeting your baby’s needs

Your new baby will look to you for food, comfort and reassurance as they learn about the world. Holding, cuddling, talking to and responding to your baby helps them release hormones that support their brain development, and make them feel secure. New babies cannot be spoiled by responding to their needs and breastfed babies cannot be overfed, so you can offer your breast for comfort as well as for food. Cuddling and feeding your baby also helps to keep you calm and allows you to sit, rest and enjoy your baby.

If you have decided to bottle feed your baby, this information page will support you to do this as safely as possible.

You may be feeding your own expressed milk with a bottle or you may have decided to feed formula milk only. If you are feeding your baby formula milk in addition to your breast milk it is important to continue to give as much breast milk as possible because of the health benefits breast milk provides. If you want to return to full breastfeeding at any time, ask your midwife or health visitor for help.

Bottle Feeding and Skin to skin contact after birth

Even if you have chosen to formula feed your baby giving them thier first feed whilst in skin to skin contact will help build a close and loving realationship.

When a baby is born, skin to skin contact takes place when baby is dried and placed directly on their mother’s bare chest. Holding your baby against your skin for at least one hour or until after the first feed will help to comfort and calm your baby. It will also regulate baby's heart rate and breathing, helping your baby to better adapt to life outside the womb.

You can enjoy skin contact at any time and as often as you wish, it is the perfect opportunity to cuddle and make a connection with your new baby!
The Liverpool Women’s Hospital is no longer able to store opened bottles of formula milk in a fridge.

This is due to health and safety reasons as outlined by the Care Quality Commission (CQC). Therefore all mums who choose to bottle feed their baby will need to bring infant formula 'First Milk Starter Packs' into Hospital with them. Please do not bring in larger bottles of milk as we will be unable to store them safely once opened.

The First Milk Starter Packs can be bought at most supermarkets and include 6 single use ready-made formula bottles and teats. Please note, more expensive milks are not necessarily better than cheaper milk. Once again, please do not bring in larger bottles of milk as we will be unable to store them safely once opened.

If you have any questions please don't hesitate to contact the Infant feeding Team via the Main Switch Board on 0151 708 9988.

Guide to bottle feeding

For information on formula milk please visit:

Unicef - a parents’ guide to formula feeding

First steps Nutrition: Infant feeding milks – a simple guide

What is colostrum?

All women produce colostrum during pregnancy and in the early days of breastfeeding. Colostrum has concentrated protective factors by coating baby's gut reducing the risk of infections and allergies. Colostrum comes in very small quantities.

Typically a baby in their first day will only have about a teaspoonful each feed. A healthy full term baby does not need large volumes of breast milk. They have built up reserves to call on so the first feeds are for protection.

Hand Expression

Antenatal Hand Expression

Antenatal expressing is hand expressing your colostrum (the first milk you produce from approx. 16 weeks of pregnancy) in your final few weeks of pregnancy (from 37 weeks gestation). Mothers who are having multiple births sometimes start this sooner, if giving birth earlier is more likely. When hand expressing in the antenatal period please be guided by your midwife.

Bringing Colostrum in to Hospital

You can bring syringes of frozen colostrum in to hospital using a freezer block and an insulated bag.The freezer to store all antenatal breast milk (regardless of what area you are on in the hospital) is on matbase the postnatal ward. Please inform your midwife upon arrival if you have brought some colostrum with you so it can be stored as quickly as possible in the breast milk freezer. 

Always ask for support and advice to hand express should you be having any difficulties either in the antenatal period or after baby is born. Most mothers who have collected their colostrum in the antenatal period feel more confident with hand expressing should it be required after baby is born and also have more confidence in their milk supply. 

How to hand express?

Step 1) Gently massage your breast with the pads of your fingers to stimulate the milk ducts

Step 2) Cup your breast and place your finger and thumb in a C shape about 2cm away from the base of your nipple. With finger and thumb gently press backwards & compress this area.

Step 3) Once the milk comes forward, release the pressure keeping your fingers there and building up a rhythm. (Avoid sliding your fingers down the breast) 

Colostrum can vary in colour and consistency. It may appear quite thick & yellow or orange, at other times it may be clearer and thinner this is all normal.

You can continue to collect small amounts of colostrum in the same syringe throughout the day (storing in the fridge between expressing sessions) at the end of the day (or within a 24 hour period) the colostrum should then be frozen.

Place the syringe in a zip lock bag and label the syringe and the bag separately with the date and time you expressed. If you fill a whole syringe at one expression you can place this straight into the freezer as advised. The frozen colostrum can be stored for up to 6 months in the freezer.

When a baby is born, skin to skin contact takes place when baby is dried and placed directly on their mother’s bare chest. Holding your baby against your skin for at least one hour or until after the first feed will help to comfort and calm your baby. It will also regulate baby's heart rate and breathing, helping your baby to better adapt to life outside the womb.

Skin to skin contact after birth is the best time to start your first breastfeed if you chose to do so. Baby will have gone through 9 stages of instinctive behaviour to find the breast to have a feed. If you need any help, your midwife can support you with positioning and attachment.

You can enjoy skin contact at any time and as often as you wish, it is the perfect opportunity to cuddle and make a connection with your new baby!

Positioning and attachment

How does your baby attach effectively at your breast?

• Baby should have a wide open mouth
• Their head should be tilted backward
• Tongue down
• Chin leads and will touch the breast first
• Nose pointing towards nipple
• Bottom lip to touch breast well away from base of nipple
• Bring baby quickly to your breast (always baby to mum )
• Nipple aimed towards roof of mouth as baby coming forward to attach at breast

Signs of good attachment

• Wide open mouth
• Chin indenting the breast (this helps to massage your milk ducts and baby will get more milk)
• Full rounded cheeks
• No pain for you after baby brings your nipple to the back of their mouth
• Your baby will be contented at the breast and stay attached
• You will see a change in your baby’s sucking pattern (initially short rapid sucks changing to long drawn out sucks and swallows with pauses as the milk flows)

How a baby feeds at the breast

Why is correct attachment and positioning important?

• Ensures efficient milk transfers from you breast to your baby
• Ensures sufficient milk supply to your baby
• Prevents your nipples from becoming sore

Attachment is what the baby does to obtain milk.

Positioning is what the mother does to help the baby to attach.

Poor attachment – baby attached to little breast tissue, mainly nipple stem. Lips are pursed, mouth not wide open against breast and tongue behind the lower gum. Compression of the jaws gains little milk, tongue cannot work efficiently.

Good Attachment – baby draws in nipple and breast tissue

What happens if my baby does not attach well?

If your baby is not correctly attached at your breast and your nipple is too far forward in your baby’s mouth this can cause rubbing of your nipple and can cause your nipple to become sore and cracked. This will mean your baby will get smaller drops of milk rather than a good flow of milk. This may result in longer and more frequent feeds.

Signs of poor attachment:

Positioning is what you do to help your baby to attach at your breast correctly

Close – your baby needs to be close to you to take in enough breast

Head free – to tilt head back allowing chin to lead

In line – head and body in alignment so your baby’s neck is not twisted

Nose pointing towards nipple – so your nipple slips under top lip upwards and backwards to the roof of the mouth

It is very important that you are taught how to effectively position and attach your baby for breastfeeding from the first feed

Birth to 6 weeks

Frequency of breastfeeding – It is normal that your baby should be breastfeeding between 8-12 times in 24 hours

Urine output – expect one wet nappy on day one, increasing gradually to 5-6 wet nappies by day 5. Urine should be pale and mild smelling

Bowel output – Day 1 meconium should be passed (black and tar like in consistency)

Day 2-3 changing stool (green in colour)

Day 5+ yellow stool (soft to watery)

Weight gain – if your baby is gaining weight at the expected amount (your community midwife and health visitor will discuss this with you) then you can be reassured that your baby is getting enough of your breast milk. If your baby loses more than 10% from their birth weight in the early days your midwife will check that your baby is feeding effectively at your breast and that baby is feeding a minimum of 8 times in 24 hours and that you are offering both breasts at each feed. Further support will be offered and you can attend the Infant Feeding specialist feeding clinic at the women’s hospital for additional support. You will need to contact the Infant feeding advisor on 0151 702 4293 to make an appointment at the feeding clinic. (support details should be given to you before you are discharged from hospital in your feeding pack, please ensure you have this before you are discharged). Baby should regain their birth weight by 2 weeks.

Other positive signs – After feeding breasts should feel softer and baby settled. Baby is alert, active and meeting developmental milestones.

As a partner your role is to respond to your baby's need for love, comfort and security. Your support and understanding will help your partner to breastfeed. Women are much more likely to breastfeed for longer when they have their partner's or another person's support. This leads to a greater sense of achievement for mum, and health benefits for both mum and baby.

Things you can do:

• Attend antenatal breastfeeding classes
• Give emotional and practical support
• There are many other ways you can bond with your baby such as bathing baby, skin contact and changing nappies, helping with these things means mum gets a rest

• When babies are first learning to breastfeed it is important to avoid giving them anything other than your breast milk
• Giving formula milk will make your baby full and less likely to want to feed at the breast, this can then affect your milk supply at this crucial time and your body will produce less milk for your baby's needs
• The health benefits of breastfeeding for you and your baby are increased if you can avoid giving formula feeds
• If your baby requires any formula for medical reasons, you can still express your milk and continue breastfeeding. This will help maintain and increase your milk supply for when you are able to resume exclusive breastfeeding
• In hospital, if your baby needs a supplement it should always be given by a feeding cup and not a bottle and teat. A member of staff will show you how to cup feed whilst you are in hospital