Feeding and Caring for Your Baby

The three most important hours for mother and her baby in preventing breastfeeding pain.

3 Golden Hours for Breastfeeding

Success by Dr Robyn Thompson

The Thompson Method of Breastfeeding

watch?v=RMe_yrKqlY0

Breastfeeding Your Baby

Congratulations, choosing to breastfeed your baby is the first step. It is a skill that takes practice and you may need support along the way. Knowing where to get the right advice and who to ask can be daunting. We would like to help you find the best places to access the support you need, to make your journey into breastfeeding your new baby a more enjoyable and positive one.

breastfeeding mum in hospital2_edited.jpg

Knowing what to expect in the early days with your new-born prepares you. Your new baby will feed often around 8-12 times in a 24-hour period. Some feeds will be longer than others and lots will be at night. It is not normal for a new baby to sleep for long periods, they have tiny tummy’s that need regular food.

Ideally sleep or rest when they do so that you can manage the regularity of this. Try to feed your baby when they first stir or start to show signs of hunger. This can be sucking their hands, lip smacking with their tongues or turning their heads towards you. Baby’s feed much better at this stage, before they have started to cry.

Your new baby likes to be cuddled, so breastfeeding gives them more than food, it keeps them warm and makes them feel safe (we all love a cuddle). Your baby may only want to settle on you, and this is very normal too. New babies cannot manipulate you, so don’t think you can over cuddle them. Try not to fall asleep with your baby on a sofa. If you feel tired, put them somewhere safe. The lullaby trust is a really good source of information for safe sleeping advice. Breastfeeding for at least 2 months halves your risk of sudden infant death syndrome (SIDS). (https://www.lullabytrust.org.uk/).

Breastmilk provides your baby with all the nutrition they need for the first 6 months and beyond alongside weaning. Breastfed babies do not need additional water (even if it’s really hot out). Your breastmilk changes with the climate and provides your baby with a bespoke meal every time. Don’t restrict how often they feed, sometimes it will be more than others and this is really normal too. Even if you’re unwell, continue to breastfeed, if you can, your milk will make precious antibodies to help your baby fight any illnesses they may encounter.

Early days nappies will be black then gradually turn to a bright yellow/orange colour. A breastfed baby’s bowel movements will be very runny and watery and may look like it has small white bits in it. This is really normal. You may also notice that round 6 weeks your baby may start to not have dirty nappies every day. We would expect to see several wet nappies a day still. If you are concerned, then please contact a health professional for advice.

Here are some useful links for more information and guidance.

https://www.nhs.uk/start4life/baby/feeding-your-baby/breastfeeding/

https://www.breastfeedingnetwork.org.uk/

https://abm.me.uk/

https://what0-18.nhs.uk/

A local breastfeeding support group runs in Totton every Thursday morning, for more information on this and for help and advice, join their Facebook group Bosom Pals. There is also a Postnatal Support group that offers advice on feeding and postnatal care and recovery. The group takes place every Monday (except for Bank Holidays) from St Andrew's Church, Dibden Purlieu, from 10am - 12noon. Click on the link for further details or call Katherine on 07436 848249.

Breastfeeding helplines

National Breastfeeding Helpline: 0300 100 0212

The Breastfeeding Network supporter line in Bengali and Sylheti: 0300 456 2421

Association of Breastfeeding Mothers: 0300 330 5453

La Leche League: 0345 120 2918

National Childbirth Trust (NCT): 0300 330 0700

Drugs and Lactation Database (LactMed®)

The LactMed® database contains information on drugs and other chemicals to which breastfeeding mothers may be exposed. It includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate. All data are derived from the scientific literature and fully referenced. A peer review panel reviews the data to assure scientific validity and currency.

For further details see the link

Breastfeeding nutrition

https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding-and-lifestyle/diet/

You don't need to eat anything special while you're breastfeeding. But it's a good idea to follow the tips above and then also consider adding 1-2 healthy snacks to ensure that you are taking on enough nutrients and calories to support breast milk production such as:

3 litres of water per day (including milky drinks or a 150ml glass of 100% unsweetened fruit juice.
Fresh fruit.
Sandwiches filled with salad, grated cheese, mashed salmon or cold meat.
Yoghurts and fromage frais.
Hummus with bread or vegetable sticks.
Ready-to-eat dried apricots, figs or prunes.
Vegetable and bean soups.
Fortified unsweetened breakfast cereals, muesli and other wholegrain cereals with milk.
Baked beans on toast or a baked potato.

Small amounts of what you're eating and drinking can pass to your baby through your breast milk. If you think a food you're eating is affecting your baby and they're unsettled, talk to your GP or health visitor, or contact the National Breastfeeding Helpline on 0300 100 0212.

Caffeine and breastfeeding

Caffeine is a stimulant and can reach your baby through your breast milk and may keep them awake or restless. Caffeine occurs naturally in lots of foods and drinks, including coffee, tea and chocolate. It's also added to some soft drinks and energy drinks, as well as some cold and flu remedies.

It's a good idea for pregnant and breastfeeding women to restrict their caffeine intake to

less than 200mg a day:

1 mug of filter coffee: 140mg
1 mug of instant coffee: 100mg
1 250ml can of energy drink: 80mg (larger cans may contain up to 160mg caffeine)
1 mug of tea: 75mg
1 50g plain chocolate bar: up to 50mg
1 cola drink (354mls): 40mg

Try decaffeinated tea and coffee, herbal teas, 100% fruit juice (but no more than one 150ml glass per day) or mineral water. Avoid energy drinks, which can be very high in caffeine.

Bottle Feeding

If you are bottle feeding your baby with infant formula, there is some great information on the NHS website www.nhs.uk/start4life/baby/feeding-your-baby/bottle-feeding/. The NHS recommends to use the ‘paced’ feeding method, to ensure your baby takes what they want and has time to rest in the feed. As with our appetite, the amount your baby takes at each feed may vary and the time in between feeds may vary too.

These guidelines will advise you to make up feeds as you need them and not to make them up in advance and store them. Ensure you follow the instructions on the packaging to make the feed up correctly. This is to prevent harmful bacteria causing growing, that could make you baby unwell. If you are going out for the day, take a readymade bottle, that can be purchased in the supermarket, with you. These feeds are made in a sterile environment and are sealed to ensure they are safer.

Try not to follow a time schedule with feeds, follow your baby’s lead and offer food when they start to show signs of hunger. Remember their tummy is small and therefore they will take little and often in the beginning. An artificial formula fed baby’s bowel movements, will be a thicker consistency than a breastfed babies and will be yellow.

Avoid using the ‘hungrier’ baby formula’s and stick to the first milk formulas as they are more easily digested by your new baby. Babies under 6 months do not need additional water, they should get enough water from their feed. You do not need to stick to any one particular formula, you can switch or try a different one if you feel the one you have chosen does not suit them.

The NHS website has lots of really useful information, alternatively, ask your midwife or Health Visitor (number is in your red Child Health Record Book).

Babyproofing Essentials: How to Make Your Home Safe

Unintentional injuries are the leading cause of death of children, and most injuries happen in and around the home. Fortunately, many accidents are preventable if you properly babyproof your home. Following several simple steps can keep your baby safe from the cot to the bathtub and beyond.

Check out the link for more details.

What is weaning?

Introducing your baby to solid foods, also referred to as weaning or complementary feeding, starts when your baby is around 6 months old. Your baby should be introduced to a varied diet, alongside their usual breast milk or first infant formula.

It can be confusing knowing when and how to start introducing solid foods. Please follow this link for further advice and guidance. There is expert NHS advice, helpful videos, tips from other parents, and lots of simple, healthy weaning recipes and meal ideas.

Did you know?

Full term, well babies, should only wear hats outdoors to keep them warm.
Never cover your baby’s car seat/ pram with a blanket to keep them out of the sun. Use natural shade or a parasol to do this to allow air flow around your baby.
In the first few days, the amount of wet nappies should correlate with the number of days old. For example, 3 days old = 3 wet nappies, etc.
A fully breastfed baby’s bowel movements will be bright yellow and very runny, they may also look ‘seedy’.
Babies do not need water if they are being fully breastfed. The milk you produce, adapts to the temperature and meets your baby’s needs.
Bottle fed babies, under 6 months should get enough water from their feeds and should not be given additional water.
You should never sleep with your baby on a sofa (Lullaby Trust).
Your new born baby should only be in a car seat for 2 hours max. If you are going to be out longer, use your pram or make regular stops, if in a car.
Use light clothing in a car seat. Do not use bulky coats or jackets. Blankets should lie on top of straps, not under them.

Swaddling your baby and using slings

Swaddling is a common practice used to help settle young babies and promote sleep. We recognise that in some parts of the world this is also referred to as wrapping, but in the UK is referred to as swaddling. Parents/carers who wish to swaddle should be informed how to do this correctly to reduce the chance of SIDS.

Please follow the links below for further information and guidance.

Helping your baby to sleep - NHS (www.nhs.uk)

https://www.lullabytrust.org.uk/safer-sleep-advice/swaddling-slings/

How to reduce the risk of SIDS

Our safer sleep advice gives simple steps for how you can sleep your baby to reduce the risk of sudden infant death syndrome (SIDS) which is commonly known as cot death. It can give you the peace of mind to enjoy this special time.

Their advice is based on strong scientific evidence and should be followed for all sleep periods, not just at night. Please follow the link for further information and guidance.

Is talcum powder safe?

Please see the link for more information on talcum powder.

Learn about nappy rash

Babies’ skin is thinner and softer than ours, and much more sensitive. It also has a higher pH level, which can make it more sensitive to irritants. Although unpleasant for you and your baby, nappy rash is common and easy to manage with the right care, like using a nappy rash cream to help protect from the causes of nappy rash at every nappy change. If your baby has nappy rash, please don’t feel like you’ve done something wrong – it happens to all of us.

What is nappy rash? Can a cream help?

Nappy rash can occur at any time during your child’s nappy-wearing stage. Up to a third of nappy-wearing babies and toddlers can get nappy rash at any one time. It doesn't usually develop in new-borns, but all babies can get nappy rash. Nappy rash can appear as red rash patches or the whole of your baby's bottom may be red and may have scattered pimples or swellings. The skin may be hot to the touch, look sore and be painful and itchy for your child.

The risk of nappy rash changes as your baby grows. During the first twelve months, your baby’s skin is thinner, more permeable, and has a higher pH level compared to adult skin.

Remember, nappy rash is common, but there's a simple way to help to protect against the causes by using a barrier nappy cream.

If nappy rash does develop, try not to worry, as there are treatments available , please speak to your midwife or health visitor for advice. Nappy rash usually clears up after about 3 days if you follow hygiene tips below.

Causes of nappy rash

Nappy rash is caused by a baby’s delicate skin being in contact with the irritating chemicals in urine and faeces. This can be made worse by a tight nappy which both rubs and may prevent the air circulating. Nappy cream creates a barrier against the harmful effects of urine, faeces and nappies, which helps protect the skin against these causes of nappy rash.

Remember, nappy rash is common, but there is a simple way to help to protect against the causes by using a barrier cream.

When to change a nappy

Babies need frequent nappy changes. Babies have very delicate skin so their nappy needs to be changed as soon as they wet or poo themselves, otherwise their skin becomes sore and red.

Changing your baby’s nappy as soon as possible after they’ve done a wee or poo will help prevent nappy rash.
Young babies may need changing as many as 10 or 12 times a day, while older babies need to be changed around 6 to 8 times.
Make sure you’re using the right nappy size. If it’s too tight, it can cause irritation. Test the nappy with your finger: it should fit easily between the skin and the nappy cuffs.
Let air get to your baby’s bottom as often as possible. For example, let him go nappy-free during winding.
When you go out, remember to take a clean nappy with you, so your child doesn’t sit in a soiled one for too long.
Always clean your baby's bottom from front to back.
Use clean, lukewarm water when washing your baby. Soap can irritate the skin.
After cleaning, allow your baby’s bottom to dry in the open air for a few minutes.
Avoid perfumed toiletries or wipes.
Use the barrier cream at every nappy change, especially at bedtime when the nappy is on for the longest period to help protect against the causes of nappy rash. Lightly massage the ointment into the bottom to protect the skin’s natural barrier and help stop the chemicals in urine and faeces from irritating the skin.
Bath your baby daily – but avoid bathing them more than twice a day as that may dry out their skin.
Do not use talcum powder as it contains ingredients that could irritate your baby's skin.

https://www.nhs.uk/conditions/baby/caring-for-a-newborn/how-to-change-your-babys-nappy/

Skin irritations in babies

There’s nothing quite like the softness of a baby’s skin, and we know that you’ll want to protect that softness for as long as possible. But babies’ skin is naturally more sensitive than that of adults, and can easily become dry, sore, flaky and everything in between.

Causes of skin irritation in babies

From nappy rash to scaling, blemishes to rashes, all babies’ skin irritations stem from the same common problem: the skin barrier becoming damaged.

There are many reasons why the skin barrier is so sensitive in babies, including:

Babies’ skin is thinner than adults’ skin, meaning irritants can permeate more easily.
The surface of your baby’s skin is very large relative to his or her weight, so there’s more scope for irritations.
Until three months old, your baby’s skin has a higher pH than adults’ skin which contributes to a weakening of the skin barrier.
Babies’ skin is still adjusting to life outside of the womb, so it’s more vulnerable in a dry terrestrial environment.

Preventing skin irritations in babies

Here are some quick tips for you:

1. Choose your baby products carefully

Ask your midwife or health visitor to recommend baby products.
Try to look for products that are free from alcohol, soaps or fragrances.
Only use products that have been specially formulated for babies.
Any products that you use should be mild and pH neutral.
For general skincare where baby skin is dry try emollients as they generally contain less sensitisers, e.g. fragrances, and they also provide deep moisturisation.

2. Maintain a good bathing routine

It is essential that your baby's skin is always clean, but many experts do not recommend a daily bath, which can dry out the skin. Instead, clean the face, hands and buttocks with cotton wool and clean, lukewarm water every day.
After bathing, always use an emollient or moisturiser specially formulated for baby which should be applied gently.

3. Maintain good nappy practice

Change your baby’s nappy frequently, and immediately when soiled.
Use a nappy care product after every nappy change, especially at night time . Applying a thin layer to the bottom and genitals can protect the baby's sensitive skin from the causes of nappy rash. It will form a protective layer on the skin to protect from further irritation. Choose an ointment that is also free from colourants, fragrances and preservatives.

Your newborn baby

Your new-born baby’s skin is especially sensitive at this time and will need specialised protection ointment that is so gentle that it can be used from birth to help the most delicate skin, even of premature babies, as it’s free from fragrance, preservatives, colourants or antiseptics. A barrier cream is easy to apply, forms a breathable barrier that helps protect your baby’s bottom from the causes of nappy rash and to keep little bottoms happy and protected.

Nappy rash usually clears up after about 3 days if you follow this advice. You should keep following this advice as this will help prevent nappy rash from coming back.

If the rash is causing your baby discomfort, your health visitor or pharmacist can recommend a nappy rash cream to treat it.

You should apply the cream first and wait a few minutes before you apply the barrier cream.

Other rashes in the nappy area

If the rash doesn't go away or your baby develops a persistent bright red, moist rash with white or red pimples that spreads into the folds of their skin, they may have an infection.

Ask a pharmacist or health visitor for advice. The pharmacist may recommend a cream for you to use.

If the rash is severe, take your baby to the GP who may prescribe cream or medicine. Follow a GP's instructions on whether and when to apply barrier cream as well as the prescribed cream.

It's normal for babies to develop skin rashes, but it's important to know the difference between a minor irritation and a condition that requires attention.

Read more about rashes in babies and children.

Is your baby or toddler seriously ill?

Trust your instincts

It can be difficult to tell when a baby or toddler is seriously ill, but the main thing is to trust your instincts. You know better than anyone else what your child is usually like, so you'll know when something is seriously wrong.

Signs of serious illness in a baby or toddler

Here's a checklist of warning signs that might indicate your baby or toddler is seriously ill:

Temperature

a high temperature, but cold feet and hands
a high temperature that does not come down with paracetamol or ibuprofen

(do not give paracetamol to a baby under 2 months and do not give ibuprofen to

a baby under 3 months or under 5kg, unless prescribed by a doctor)

a very high or low temperature
your child feels hot or cold to touch, or is shivering
your child is quiet and listless, even when their temperature is not high
a high temperature in a baby less than 8 weeks old

Find out more about what to do if your child has a high temperature

Breathing

rapid breathing or panting
a throaty noise while breathing
your child is finding it hard to get their breath and is sucking their stomach in under their ribs

Other signs

blue, pale, blotchy, or ashen (grey) skin
your child is hard to wake up, or appears disoriented or confused
your child is crying constantly and you cannot console or distract them, or the cry

does not sound like their normal cry

green vomit
your child has a febrile seizure (fit) for the first time
your child is under 8 weeks old and does not want to feed
nappies that are drier than usual – this is a sign of dehydration

If your child has any of these signs, get medical help as soon as possible:

during the day from Monday to Friday – it's best to call your GP surgery
evenings and weekends – call NHS 111
if your baby is under 6 months old it's hard for a doctor or nurse to assess them over the phone – you can go to an urgent care (walk-in) centre or, if you're very worried, take them to A&E

Find your nearest urgent care centre

Find your nearest A&E

When to call an ambulance

Call 999 for an ambulance if your child:

stops breathing
will not wake up
has a spotty, purple or red rash anywhere on their body that does not fade when you press a glass against it – this could be a sign of blood poisoning blood poisoning (sepsis)
is under 8 weeks old and you're very worried about them
has a febrile seizure (fit) for the first time, even if they seem to recover
has a severe allergic reaction (anaphylaxis)
if you think someone may have seriously injured your baby

Trust your instincts. You know what's different or worrying behaviour in your child.

Spot the signs of childhood conditions

Learn the signs of serious illnesses that can affect children, including:

Waterside Health & Wellbeing Team

Waterside Primary Care Network

Feeding and Caring for Your Baby

https://www.youtube.com/watch?v=RMe_yrKqlY0

Signs of serious illness in a baby or toddler

Health and Wellbeing Team

Hiowicb-hsi.pcnhealthcoaches@nhs.net