If the number of books on infant feeding is anything to go by, there are literally thousands of approaches that are ‘guaranteed to work’. You may have even read about some of these in preparation for the birth of your baby.
Be mindful that not all approaches work for all babies, or even for you! You don’t need to blindly follow other people’s advice – trial and error is often the best way of finding out what works for you and your baby. Above all, trust your instincts.
Attachment is the two-way bond that develops between you and your baby as you communicate with each other by touch as well as talking. Strong attachment helps your baby's brain to grow, particularly the part of the brain that is important for communicating and forming relationships with others. Your baby feels safe, secure and loved and so learns to love others.
Feeding is a really important time for developing this bond whether you choose to breast or bottle feed. It isn't just about giving your baby energy to grow into a healthy child and adult. Responsive feeding describes how you recognise and respond to your baby's hunger signals or 'cues'. Hold your baby close to you, make eye contact and talk in a loving way. Learn to understand when your baby is no longer hungry and trust your baby's feeling of fullness. Sometimes your baby will only want to feed for a few minutes, sometimes for much longer, in the same way we sometimes just want a drink and a quick snack and at other times a three course dinner!
There are a few differences between responsive breast and bottle feeding:
Responsive bottle feeding
Responsive feeding of expressed and formula milk:
TOP TIP when bottle feeding:
Hold your baby in an upright position and keep the bottle more horizontal rather than facing downwards. Stop the feed regularly to give your baby a rest.
Look for early feeding cues. They may start to wriggle when they wake up, find something to suck especially with their hands. Crying is a late sign and you may need to soothe your baby before trying to feed. Remember crying does not always mean your baby is hungry. They may want a cuddle or need their nappy changing. They may have drunk too much and feel uncomfortable or are feeling unwell.
Pace the feed:
Overfeeding bottle fed babies:
Size and volume of a newborn's stomach
Did you know? this picture shows the approximate size of your baby's stomach and how much milk it can hold at each feed.
first breast milk your body makes is known as colostrum. This is the perfect
source of nutrition for your baby because it:
contains antibodies which protect your baby from
infection and help their immune system to develop.
helps your baby’s digestive system to develop,
which protects your baby from allergies.
encourages your baby to open their bowels and
pass ‘meconium’ (your baby’s first black sticky poo) which reduces the risk of
jaundice. Colostrum is very concentrated. At birth, a baby’s stomach is about
the size of a marble, so they will only need a small amount of colostrum to
receive all the nutrients they need.
your pregnancy, your breasts will start to produce colostrum (the exact timing
varies from person to person). You can collect and freeze this milk during the
last few weeks of your pregnancy. This is known as ‘colostrum harvesting’.
Harvesting your colostrum will be especially beneficial for your baby if they
are likely to have difficulties with feeding or maintaining their blood sugar
levels during the first few days after birth.
may be because your baby:
is large or small for their gestational age
is a twin or triplet
has a cleft lip or palate
has Down’s syndrome or a heart complication
harvesting can also be beneficial for your baby if you:
are taking beta blockers to control high blood
have developed pre-eclampsia during pregnancy
are diabetic or have developed diabetes during pregnancy
have polycystic ovary syndrome
have breast hypoplasia (a condition in which the
breast doesn’t fully develop) or you have had breast surgery
have a raised body mass index (BMI)
plan to give birth by Caesarean section
your baby needs extra feeds, you may be able to use your colostrum instead of
Before you start colostrum harvesting
may be advised not to harvest your colostrum if you:
have a cervical suture (stitches) in place
have experienced premature labour in the past
have had contractions, vaginal bleeding and/or
premature rupture of membranes (your waters breaking early) during this
would recommend reading a helpful booklet called ‘Off to the best start’ which
explains the technique for hand expressing breast milk in more detail. Ask your
midwife for a free copy or download it from the NHS Start 4 Life website: www.nhs.uk/start4life/breastfeeding-more-help
How to start colostrum harvesting
you would like to harvest your colostrum, you can start hand expressing for a
few minutes once a day when you are 36 to 37 weeks pregnant. Gradually build up
to gently expressing for about five to ten minutes at a time, two to five times
a day, and then as often as necessary in the first few days after you give
birth. If your baby is premature or unwell, you will be encouraged to start
expressing within two to three hours of giving birth.
can harvest your colostrum while you’re pregnant by hand expressing in the same
way that you will express milk when your baby is born. While you’re pregnant
you should only use your hands for expressing. Do not use a breast pump until
after you have given birth.
Hand expressing your colostrum
To collect your colostrum you will need a clean, sterilized syringe and a
clean, sterilized larger container.
Make yourself comfortable and try to relax. Warmth will help, so try expressing
in the shower or bath at first. You can gently massage your breasts with a warm
Use your hand to cup one of your breasts. Your hand should be in a ‘C’ shape
around the nipple with four fingers under the breast and the thumb at the top.
Your thumb and fingers should be about 2-3cm away from the base area around the
Use your thumb and index finger to gently squeeze. Release the pressure and
then repeat to create a rhythm. This shouldn’t hurt. Avoid sliding your fingers
over your skin as this may cause discomfort. If the colostrum doesn’t flow, try
moving your fingers slightly towards the nipple or further away, finding the
spot that works best for you. You could also try gently massaging your breast.
Collect your colostrum with the sterilised syringe and if necessary decant to
the larger sterilised container. Colostrum is very concentrated and will come
out of your breast drop by drop. At first, only a few drops will come out at
each session, but with practice and time, you should get more.
When the drops slow down, move your fingers round to try a different section of
your breast and repeat.
Repeat the process for your second breast. The amount of colostrum you collect
when you express can vary from just a few drops to a teaspoon full. Every drop
counts, so don’t lose heart if you feel you haven’t collected much colostrum.
This doesn’t mean your baby will find it difficult to breastfeed.
Patient information factsheet: www.uhs.nhs.uk
is very rare for colostrum harvesting to cause the onset of labour. You may
feel your womb tightening and relaxing. This is called a Braxton Hicks
contraction and isn’t a cause for concern. If you begin to feel ‘period-like’
cramps or mild labour contractions, stop expressing, rest and then start again
Storing your colostrum
Label the syringe or container with your name and
the date and time you expressed the colostrum.
Put the syringe or container in a clean
re-sealable bag and place it in your freezer– it can be stored for up to two
weeks in the ice compartment of a fridge (-6°C) or for up to six months in a proper freezer (-18°C)
You can store your colostrum or milk in the back
of the fridge at a temperature of 2-4°C for up to 24 hours before you freeze
Colostrum or breast milk that has been
frozen can be defrosted in the fridge. It must be used within 24 hours.
Fresh colostrum / breast milk that has only been
stored in the fridge (4°C ) must be used within five days.
can express and freeze your colostrum at home and bring it into hospital when
you have your baby.
bring your colostrum into hospital you will need:
re-sealable food bags
a small cool bag
two large ice blocks
you go into hospital to have your baby, put a few of your (labelled) frozen
syringes into a re-sealable food bag. Place this inside the cool bag between
the two ice blocks.
your midwife that you have colostrum with you when you arrive. It will be
labelled with the date and time it was removed from your freezer and stored in the
hospital fridge or freezer.
Feeding your baby with colostrum
newborn babies are unable to feed well at the breast and others are unable to
maintain the necessary blood glucose levels. In these situations you can feed
your baby with your colostrum. Your midwife will take your colostrum out of the
hospital fridge or freezer and check the label with you first. The syringe of
colostrum will need to be brought to room temperature. You could immerse a
plastic bag containing the syringe of colostrum in a bowl of warm water or
place it next to your skin. Your midwife will show you how to feed your baby
with a syringe or a small cup. Having a small feed will give your baby energy
and increase their blood sugar levels. It often encourages babies to breastfeed
Patient information factsheet
We hope this information will be a useful introduction to
colostrum harvesting. You can also talk to your midwife who will be able to
answer any questions you may have.
For more advice and information see:
This is the easiest way to feed your baby when out and about. You do not need to take any equipment with you, just yourself. Breast milk is the correct temperature, amount and no preparation required.
How do I re-heat my expressed breast milk?
From the fridge
From the freezer
We do not recommend using a microwave to warm any of your baby's milk or food. Microwave cooking causes hot spots which can burn your baby's mouth.
Did you know?
To support breastfeeding mothers to feel more confident to feed their baby in public, Breastfeeding Welcome Schemes are being introduced in many towns and cities. Private and public sector buildings are welcoming mothers to breastfeed their baby.
Remember you are protected by law to breastfeed in public.
Pre made formula
This is the easiest way to feed your baby formula when out and about.
Formula Preparation Machines
At present there is no published research and insufficient evidence that these machines are safe in preparing infant formula. The Department of Health recommend that powdered infant formula is made up with freshly boiled water and left for no more than 30 minutes so that it remains at a temperature of at least 70 degrees.
Children and adults are all shapes and sizes, most of which are healthy. In this section we want to explain the growth charts and help you understand what you can do to help your baby grow up healthy and happy.
In your Personal Child Health Record (PCHR) you will find growth charts. Do read the information pages that come with them. The chart describe the growth patterns of thousands of normal, healthy, breastfed babies and toddlers from around the world and older children from the UK. Healthy bottle fed babies should follow the same growth patterns as breastfed babies. The lines are called 'centiles' and they simply describe how your baby's weight, length and head circumference compares with other children of the same age and sex. For example - if your baby's weight is on the 25th centile this means that if you weighed 100 babies of the same age and sex and ranked them from light to heavy, 75 babies would be heavier than yours and 24 lighter. We expect a baby to gain weight along one of these centiles or in their own channel between two of the centile lines. Which centile is healthy for your baby depends on where they started out - their birth weight - and factors they inherit from their parents . There is no 'best' centile. There will be variation above and below their centile and it is wise not to weigh and measure babies too often because these natural fluctuations can cause unnecessary concern - what matters is the pattern over time. Usually no more than monthly weighs are necessary for the first six months, every two months from six months to a year and every three months after that; unless there are particular concerns and your health care professional requests that you have your baby weighed more often for a period of time.
Generally speaking a healthy baby's length and weight will be 'in proportion' i.e. will have their length and weight within one of the major centile lines of each other and certainly no more than two.
Weight is fantastic for assessing the health of a baby. Crossing the centiles up and down may be a cause for concern. Historically most emphasis has been on monitoring babies who appear to be gaining weight too slowly - and your midwife and health visitor will watch out for this. It is likely to become apparent quite early on and the most common cause is difficulties with feeding. It is normal - and healthy - for a baby to lose some weight in the first few days of life and only is this exceeds 10% will your midwife be concerned. There is some evidence that this early weight loss helps 'set' appetite and feeding patterns for the rest of the child's life. These days poor weight gain is pretty rare and for this generation we are much more worried about babies who cross the centiles upwards across the chart because this is very unlikely to be healthy. The illustration shows several typical patterns of weight gain - healthy and unhealthy.
This is never and easy topic to broach but it is, without doubt, the most worrying risk to the future health and happiness of your baby. The research evidence is absolutely clear:
Do' and don'ts to help prevent your baby becoming overweight or obese:
Myths about weight:
'Obesity is inherited' - No it isn't. The obesity 'epidemic' has developed over the past 20 years but our genes haven't changed in that short time - they have generations to alter. Instead our lifestyles have altered and eating behaviour tends to run in families. Try to make your family healthier - it's worth it
'Breastfed babies cannot becomes overweight' - Yes they can. It is much rarer but happens. The longer you breastfeed the lower the risk. Breastfeeding is only partly protective and the choices you make about starting solids, the portion sizes, the foods you offer and swapping to bottle feeding will all have an impact.
'My baby is always hungry' - No, they aren't. Many families describe this and are tempted to either give up breastfeeding, try milks for hungrier babies (which are unnecessary) to introduce solids too early. Remember that babies cry for all sorts of reasons and it is important to recognise the difference between hunger cues and a baby who is crying about something else. Provided your baby is growing and gaining weight along their centiles they do not need any extra calories.
'My baby will slim down when they start exercising' - This is unlikely. Feeding habits start to develop in the first days and weeks of life. Not only are babies who are overweight at a year of age highly likely to be overweight when they start school, but they also have higher blood pressure. Yes - health differences even at a year!
'A big baby is a healthy baby' - Only if designed to be. We come in all shapes and sizes. It does not matter where your baby is on the growth charts provided they are not crossing the centiles up or down and their weight is within one major centile of their length. There is no 'best' centile. Encouraging your baby to cross the centiles upwards is rarely healthy even for a baby born small.
'We are a big-boned family' - Body Mass Index (BMI) allows for this. BMI is a simple index of weight-for-height that is commonly used in classifying overweight and obesity. Most of you will know that a healthy BMI for adults is somewhere between 19-25, a range which allows for some people having a larger frame or being 'big-boned' - this is not a reason for having a higher than healthy BMI. In growing children, the healthy range varies with age and there are BMI charts for children over two. Your health visitor can show you these.
Babies just need breastmilk or an appropriate first infant formula for around the first six months of life. From six months they are likely to to start showing the signs of readiness for the introduction of solids alongside breast milk or formula.
Sometimes families think that a baby who is waking in the night when they have previously slept through, wanting extra milk feeds or chewing their fists is ready for solids. These are just normal behaviours when a baby grows and develops, not signs of hunger.
Even if your baby is bigger than other babies of a similar age, it doesn't mean they will need to start solids any earlier than six months.
If you think your baby is ready for solid foods before six months, or before all three illustrated signs appear, it is a good idea to talk to your health visitor or health care professional first.
Babies need to be included in meals with you and your family as soon as they start to eat solid foods. There is no need to make special foods for babies. Babies learn about enjoying food & how to behave at mealtimes by watching those around them. Being overweight often runs in families and this is thought to be at least partly due to the eating behaviours they see at home. It is important to try and set a good example to your baby by giving them lots of opportunities to try a wide range of healthy foods.
Sometimes babies need to try a new food several times before they accept it, so do not worry if your baby spits out foods to start with. Never force your baby to eat - just as with milk feeding, your baby needs to understand when they have had enough so they do not put on too much weight.
For further information about starting your baby on solid foods see:
Your baby is ready if they can:
NOTE: It's rare for these signs to appear together before six months.
When the time comes for you to return to work, it is beneficial for both you and your baby if you are able to carry on breastfeeding, even some of the time. You will both continue to get the health benefits from breastfeeding as well as being able to continue to get the health benefits from breastfeeding as well as being able to continue to enjoy that special closeness that it brings - it is a lovely way to be reunited when you are together again at the end of your working day. It is worth thinking about how you will manage this several weeks before you go back to work and you can get help with this from your health visitor or from the following:
Don’t be afraid to ask for support and information to help you with feeding. No problem is too small – if something is worrying you, the chances are that other parents/carers will have felt the same. Your midwife, health visitors or a breastfeeding counsellor to help you position your baby may help boost your confidence and improve feeding for you and your child. For more information on how to contact your local Health Visiting team please click here.
Click here to download a PDF of the Healthy Infant Feeding Booklet