Ask our experts

My little girl is 13 months old and I have been breastfeeding her since birth (no formula or bottle feeding). When she turned 12 mths I began introducing a little cow's milk in a beaker each day. I recently queried with my health visitor how many feeds a day I should still be giving my daughter as I wasn't sure if I was feeding too much/not enough. I was shocked when my health visitor was quite negative about breastfeeding and told me that I should be aware that breast milk does not have any of the vitamins, minerals and iron that formula milk has. I have been through considerable stress with extremely sore nipples in the early months and it has taken dedication and determination to stick with it because I believed I was doing what was best for my daughter's health. I am now worried, should I have introduced some form of formula milk at an earlier stage, should I do so now in a beaker or is it too late? I try to give her a balanced diet, so I'm hoping she gets vitamins, minerals and more from her diet. Please advise as I am shocked by this information, I thought breastmilk was the best option.

Hi, Louise, I hope we can help.

 

I am really quite shocked by your health visitor's lackof knowledge about breastfeeding, sorry, and I don't understand why she would have these beliefs.  Breastmilk is the appropriate milk for the human species, and it is just as appropriate whatever a child's age - formula is based on cows milk and while it is changed at the factory stage to make it easier for a human to digest, it has nothing in it that breastmilk doesn't, and is missing quite a lot of what breastmilk has, such as antibodies. In addition, the constituents of breastmilk are in the correct proportions related to one another and naturally enough, they're 'designed' especially for humans!

 

Perhaps you can share the following evidence-based and referenced factsheet with your HV:

http://www.kellymom.com/bf/bfextended/ebf-benefits.html

 

Of course,  a baby of your daughter's age needs other foods as well as breastmilk but I take it she is eating other foods, yes? This would be the same if she was having formula - milk of whatever type is not sufficient for growth and health in older babies.

 

You can be confident that breastfeeding as often as you and your baby want to do will continue to support your daughter's growth, health and nutrition. It is fine for her to have ordinary cows milk in addition to her breastfeeding and her solid food, too - just continue to breastfeed ad lib as she will still need milk as a major part of her diet for some time yet.

 

Please call the NCT breastfeeding line (details at the home page http://www.nct.org.uk) or post again if you would like to talk about this more.  And do think about having that discussion with your HV - just to make sure you heard her right. If you did, then you can help inform her better so she doesn't mislead other mothers. 

 

all best wishes

 

Heather Neil 

 

 

My wife gave birth to our second child last Monday (29th Dec). She breastfed our first for 6 months without problem. However, with the new baby, she already has cracked nipples and is reduced to tears every time he feeds. For the last ~24hrs, she has been expressing and we have fed him by bottle. He seems a lot more content, less hungry, and has slept for longer periods. She is keen to continue breastfeeding, but her nipples don't seem to be healing (she's been applying lansinoh regularly): expressing, while not as sore, is still drawing blood. The conclusion we have drawn (rightly or wrongly) is that he is not latching on properly (and hence not getting as much milk, and feeding for longer/more often). We have sought advice (from midwives per-discharge from hospital and drop-in post natal clinics, health visitor, and NHS breast feeding councellor) but the answer is always the same: he is latching on fine, get on with it. Is there any other source of advice we can use before we have to give up and resort to formula feeding?

Hi, Rb. Congratulations on the birth of your baby. It's bad luck your wife is suffering like this - I wonder if the way she feeds has been looked at by someone really kowledgable? They should check your baby for tongue tie - it's not always obvious when this little anomaly is interfering with happy, comfortable feeding, and it sounds to me as if this has not been ruled out.

 

You can call the NCT breastfeeding line (details on the home page at http://www.nct.org.uk or insist on further expert help from the health service. 

 

Your wife could also discuss self-attachment with her midwife - this is often an effective way to get a pain-free latch. 

 

I hope this helps - post again if you want more details.

 

Heather Neil

hi not sure if u can help im interested in becoming a midwife how can i find out how to get started and what fianacal help i can get as im mum to 7 month old and in lincoln area

Hi Donna,

Thank you for contacting NCT.

While the NCT is not involved directly in midwifery education and application, some NCT professionals are also midwives and student midwives, so I offer the following thoughts:

Have a browse through some of the student midwife chat forums, studentmidwives.co.uk and studentmidwife.net, you may be see contributions from students in your area and there are often discussions about finances. 

If you need to study locally, contact the  universities where you want to apply. They will be able to send you a prospectus. Ask the admissions staff for their advice, particularly the entry criteria, so that you can go about getting any qualifications before or during the application process.

Normally they expect to see evidence of recent study within the last 3-4 years. Some who do not have this, decide to do Access courses locally before they apply. It may also help your application if you can get some experience in a care setting, not necessarily maternity.

They may also be able to help with the ongoing situation regarding finances.

They may even hold an open day during the year, where you can meet staff, and see where the course is taught.

You also need to consider childcare - you will probably have study blocks at university, interleaved by periods of practice in community and hospital, where you may be working shift hours across the 24-hour clock, or being on-call.

Also factor in to childcare arrangements, some study time for completing assignments. 

I hope this helps, and good luck with whatever you decide to do!

kind regards

Barbara Wyant

NCT Antenatal Teacher

how can i get my baby breastfeeding again? i was exclusively breastfeeding, did so for 7 weeks then introduced bottles with expressed milk to ensure how much was being ingested as i was sure my baby was not getting enough milk, i now have a baby that won't suck from the breast. I want to go back to how it is before, please help me i'm willing to try anything and everything. she is now 11 weeks old.

Hi, Eve. I hope we can help.  Sadly, there is a risk with bottles that the baby can start to prefer them to the breast, and it's a real shame you were not helped to build confidence in your milk supply rather than 'test' your baby's intake with a bottle...which does not show what the baby would take on the breast anyway! But the good news is it is not too late by any means to fix things so your baby can feed 'direct' from the breast.

 

You sound motivated and determined, which is a good help. A call to the NCT breastfeeding line 0300 33 00 77 1 will put you in touch with a counsellor, who will talk things through with you and go into more detail and answer your questions. I am assuming you have continued to express breastmilk and you have a good supply? If so, then the strategies to use would be the ones used with 'nursing strike' or being patient, loving, gentle and with no 'forcing' - if you do a web search on nursing strike you'll find more info, and I think this, together with a call to the line, is going to be better than a list of things here (as you may have tried some of them). 

 

So - good luck with a return to breastfeeding and I hope you and your baby enjoy breastfeeding for as long as you wish.

 

Heather Neil, breastfeeding counsellor

I had a fast first birth, under an hour and a half but lots of 2nd grade tearing which was hard to recover from. If I (when I) have my next labour, I'm due in a week, is there any way to control the speed of the birth and reduce this damage? Most hospital staff have told me i probably won't make it to the hospital and as I live in Spain there aren't home birth midwives available so I'm flying solo a bit.

Hi Helen,

Thanks for contact the NCT - I hope you get this reply before your baby arrives!

All labours are different and there is no reason why your second will be the same as the first. Many of the women who have tears during their first labour do not have a repeat experience. The likelihood of tearing can depend on your position during the birth and the position of the baby as well as how quickly the pushing stage of your labour progressed.

It may be that you recognise the signs of labour earlier on during this birth and have more time to get to the hospital. During the pushing stage of the labour it may help to be on your hands and knees. Most importantly, when the baby's head crowns (reaches the perineum) you will feel a stinging sensation - at this point you should avoid pushing until the perineum has stretched to allow the baby's head to be born. Panting at this point will help you to resist the pushing urge.

It is a shame that it is not possible for you to have a home birth - is there a chance you could hire an independent midwife to support you during your labour? I do hope that if you do not have time to get to the hospital that you will have someone there to support you during the birth - perhaps a friend or relative who has experienced childbirth themselves?

Any stitches or tearing should not cause you long-term discomfort. If this is the case, do discuss it with your doctor.

Best wishes,

Kirstie Blackwall, Antenatal Teacher

 

I am really keen to get breast feeding right, and wondered if you offered a service where a counsellor would come into my home for a couple of visits, during the first week my baby is born?
Kindest Regards,

Sally.

Hi Sally

Thanks for your email. I hope that I can help.

NCT Breastfeeding Counsellors are volunteers and so may vary in the services that they can offer. And in different parts of the country there may be a variation in what opportunities there are.

Your local NCT branch would be a great first point of contact. They would have details of any local breastfeeding services or support in your area. It can make a lot of sense to find out about these things before your baby arrives. The NCT Breastfeeding Line - 0300 33 00 77 1 - may be able to put you in contact with a local counsellor or support group, although there is no guarantee what specific support might be available.

NCT Breastfeeding Counsellors are trained to give support over the telephone on a wide range of options, and the Breastfeeding Line is open 8am–10pm, seven days a week. Hopefully this means that there will be help for you whenever you might need it.

I wish you the very best with your new baby.

Kirsty Nicol

Breastfeeding Counsellor

My son is 6 weeks old, and has been breastfeeding well since birth. The problem is that I seem to be producing an awful lot of milk. He feeds for about 5 to 10 minutes on each side, every 2 hours during the day, and every 4 hours at night. I find that when I am feeding from the first side, my other breast leaks or should I say "pours" milk for the duration of the feed. My breasts also pour milk from the breast he is feeding from. I also find that during the day and night in between feeds my breasts leak a lot, and I am going through so many breast pads, bras and tops a day. this is getting to be quite frustrating, especially during the night when I am waking up soaked through my breast pads, bras and all over the bed sheets! Do you have any advice about maybe why I am producing so much milk, and if there is any better way of dealing with it? I also find that my son has to gulp very fast to keep up with the pouring milk from my breasts, and is then often sick after a feed. I am really keen to continue with breastfeeding him as I want him to have the best, but it is becoming more frustrating with being uncomfortably wet. I hope you can help. Jane.

Hi Jane,

Some mums do struggle with an over active let down and with too much milk. It sounds as though you feel you have both these problems. The postition you use to feed your baby can help him to deal with the force of the milk better. If you can lean back so that he is feding against gravity, in a more upright position, that can help. See here for more detail on positions. If you are at home and able to, taking your baby off the breast when he triggers the let down  nd catching the first spurt in a towel can help. If your baby is gaining weight well and all seems fine, then you may wish to try feeding from just one side each feed. As the breasts are stimulated dless frequently, this helps to trigger the breasts into producing less milk. Applying something cold to the breast you are not using to feed, or gentle pressure with the heel of your hand on the side or the nipple can help stop the flowing of milk that you describe. You can find more information on this in the webpage on positions. You may also find that changes in homones, the growth pattern of your baby and time will make things easier as time goes by. If you find that these suggestions are not enough to tackle the issues, then please ring the breastfeeding line and you will be able to talk through in detail other strategies that can help with too much milk.

Good luck

Lisa Rabin-Smith

Breastfeeding counsellor

Are there any problems associated with trying to concieve whilst breastfeeding - I realise the chance are slim - but if successful would it harm either baby?

Hi Jacky, there is no problem with conceiving while breastfeeding - many women do so and go on to feed both babies after the birth. The chances of conceiving while breastfeeding are good. The contraceptive effects of breastfeedding are at their height in the first 5 months while the baby is still exclusively breastfed, and feeding frequently. After this fertility continues to increase. Some women may find they need to drop a feed to get pregnant but many do so, even before thier periods have returned. Some women are advised to  stop breastfeeding if they  have suffered from multiple miscarriages, but the uterine contractions associated with breastfeeding are present at all times. The body is able to support a developing baby as well as a feeding one, although you might find you get more sensitive nipples, and that you want to take care of yourself - eating a balanced diet, resting - the babies will always make sure they get the nutrition they need, whatever you eat, but early pregnancy can be tiring at the best of times.

Best wishes

Lisa Rabin-Smith

Breastfeeding Counsellor

My baby is two weeks old. I am breastfeeding him. We have been having problems for the last week with him not settling at nightime. From about 11pm til 2/3am he is constantly fighting at the breast and won't feed properly, suffering from bad wind and over the past two days has started vomiting much more than normal after he has been winded. He screams constantly and will not sleep and it is very tiring. He sleeps and feeds beautifully in the daytime. Could it be colic or might it be something else? He has had a slightly blocked nose for the past two days which may be making things worse. My health visitor and midwife just said I should persevere.

Hi Lisa,

it is hard to tell exactly what is happening with  your son. Colic is generally described as any type of excessive crying and there is a great deal of disagreement over exactly what it is what causes it and even whether it occurs. There are many reasons why your baby might be unsettled and fighting at the breast. Without more information it is difficult to see exactly what is happening. It could be that he is struggling with the let down, or finding it harder to latch on and feed if you are in a different position at night. It could be that he is more settled during the day when it is slightly noisier. The blocked nose could contribute - things like colds always seem to be worse at night. Windiness and struggling or fighting at the breast may be connected to the fast milk flow, or to thrush or positioning. If you ring the breastfeeding line, I am sure that you will be able to talk this through in detail and find some support in how to deal with the difficult nights. Talking it through will give a much clearer picture - there are lots of questions I would like to ask to know more, and I am sure you will be able to share more information with one of our line counsellors! Good luck

Lisa Rabin-Smith

Breastfeeding Counsellor

Lisa Rabin-Smith

my little boy is 11 weeks old and for the past 4 weeks all day time feeds have been a nightmare. He will latch on and feed for about 5 minutes quite happily then will start stretching out and crying and it becomes a fight to feed him. I try to sit him up to wind him but that is a fight! I then offer the other breast which he takes then 5 minutes later the same thing happens. He is gaining weight well but I am getting stressed out as it all seems such a struggle. His night feeds don't seem to be a problem as he feeds about 10 minutes of only one breast then falls asleep. He is going between 2 to 3 hours between feeds. Also when could I expect him to go longer at night as I am now exhausted and worried that we will never get him in a bedtime routine! If things don't get better soon I will have to put him on formula and I really don't want to !! help.

Hi Becky.

Thanks for your email. I hope that I can help. You've described how, after about five minutes, your son seems to want to stop feeding. You've also said that he is gaining wait and going for up to 3 hours between feeds.

Becky, it might be worth considering calling the NCT Breastfeeding Line on 0300 33 00 3771 and talking things through in more detail, to consider what might be hgappening here. You would be able to talk to the counsellor about some further useful pointers to your son's feeding - such as how many wet and dirty nappy he's producing.  The facts as you have described them - weight gain and feeding frequency - do suggest that feeding is going well. I wonder if it could be that your son is actually feeding very efficiently at the breast, and after 5 minutes or so, he's had enough? After the first weeks, breastmilk production, and a baby's feeding skills can work together very neatly so that your baby gets a good feed much more quickly than may have happened a couple of months ago. This is one reason why length of feeds, and gaps between them, may not be the best indicators of how breastfeeding is going: timings can vary hugely from baby to baby, and as the weeks go past. Your baby's wet nappies can let you know that he's taking in plenty of liquid, though, so checking these out can be a great source of reassurance. If you do feel that your son is getting plenty of milk, then you might want to consider following your baby's behaviour, rather than thinking about the clock. You could let your baby finish when he seems to lose interest, (just holding him near your breast or cuddling him upright against your shoulder may distress him less than traditional winding). If he shows interest in the second breast after a little while, then you could follow his lead. You might find this feels less stressful for both of you.

The pattern of night-feeding that you have described is within the normal range for a baby not yet three months old. His tummy is only around the size of his fist, and he is still very much focussed on yourself as a contact point to help him feel settled and secure. Many babies do change their sleeping patterns in the next few months, and in the meantime looking for ways to make night feeds as restful as possible can help both you and your little boy move towards a more settled and restful situation. Bring the cot up against your bed (and maybe losing the cot side) ca help your baby gain reassurance from your closeness and can help you to settle your baby. It can also make night feeds easier, as you can feed your baby lying down, so that both of you do not feel too disturbed.

Becky, if were to call the Breastfeeding Line, the counsellor would be able to talk through some more options with you, so that you find some solutions which felt comfortable to you. I do hope that this helps.

Kind regards

Kirsty Nicol

Breastfeeding Counsellor