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Breastmilk is important for all babies but it is particularly important if your baby is born premature or if they are unwell. It is the best medicine you can give your baby.
If you know your baby is going to be born early or need to spent time on the neonatal unit get in touch with one of our neonatal infant feeding team. We can help provide antenatal information about getting off to the best start in your feeding journey.
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Cheryl Allison (RAH/RHC) |
Marjorie Clark (PRM) |
Gillian Bowker (all sites) |
Some of the benefits of breastmilk for your baby include:
Breastmilk is completely tailor-made to your baby. It is like a medicine that only you can provide. Following a period of skin to skin with your baby, your milk will contain the most up to date antibodies for your baby within a few hours. These antibodies will be passed onto your baby when they are given your breastmilk.
For Mums, breastfeeding also lowers the risk of:
Hear a mum talking about why breastmilk mattered to her and her baby and her experience of expressing when her baby was born early.
If your baby is premature or unwell they probably won't be able to feed from the breast at first. Instead, we will encourage and support you to express breastmilk for your baby so your baby can be fed through a tube into their stomach. Although your baby may not be able to feed from the breast initially, we will support you and baby to have lots of skin to skin together.
Skin to skin contact (kangaroo care) means holding your baby against your skin on your chest with only a nappy on. This is a lovely way to bond and has many benefits for you and your baby. It will also help with your hormones that make milk.
The earlier and the more you express, the more milk you will produce. Ideally, you should aim to express within 2 hours of your baby being born.
This video talks about early expressing and introduces our infant feeding team and NCT breastfeeding peer supporters.
Supporting early expressing in the Neonatal Unit (Youtube)
As well as the staff on the unit, we have a team dedicated to supporting your feeding journey. These include Neonatal Infant Feeding Advisors, Breastfeeding Champions and NCT (National Childbirth Trust) peer supporters. They will support you in the early days with making milk for your baby and later with transitioning to breastfeeding if that’s what you want to do.
If this is your first time breastfeeding, it might take some time to get used to expressing and breastfeeding. Try not to worry if it’s taking longer than you thought – it will get easier as the days and weeks go by.
Expressing means collecting breast milk which you can store and feed to your baby later. This can be done by hand expressing or using a pump. The neonatal unit will provide you with all the equipment you need to express. There are pumps and privacy screens to use on the neonatal unit at your baby’s bedside, in addition some units have a dedicated expressing room. You will also be shown where to clean your pump equipment.
Pumps, comfortable chairs, snacks and drinks are provided in all units.
There is also a loan pump service so you can take a breast pump home with you whilst your baby is in the neonatal unit. When you baby gets home you can use your own breast pump but if needed you can hire a hospital grade pump from Medela if required using the discount code MEDNICU.
Getting off to a good start
The earlier you start expressing your milk the more milk you will produce. In labour ward you will be supported to hand express and shown how to use the breast pump as soon as possible after your baby is born. Ideally this will be within the first two hours.
Breast massage before expressing can help to stimulate your milk flow. You should do this for at least two minutes before you hand express.
This video below shows you how to effectively express by hand.
Colostrum
Your breasts will produce colostrum in the first few days after birth. It is thick and usually a golden yellow colour. This is known as liquid gold for your baby. Colostrum is really important for your baby. It helps to boost your baby’s immune system, reduces the risk of infections, aids brain development and helps them grow.
You may be worried about not producing enough milk in the first few days. This is normal – colostrum is produced in tiny volumes in the early days. This will increase gradually the more times you express. Around two to four days after giving birth, you may notice your milk becoming more white and your breasts might feel fuller. This is often referred to as your milk ‘coming in’.
Every drop of your colostrum you express will be given to your baby. This can be placed in their mouth and absorbed into their cheeks (‘buccal colostrum’). The taste and smell of the colostrum will be familiar and soothing for them.
How often should I express milk?
In the early days, expressing frequently (about 8-10 times a day) will help you make enough milk for your growing baby in the days and weeks ahead. It is important to fit your expressing times around your lifestyle rather than at set times each day. This will help you find time to care for yourself.
Double pumping (expressing from both breasts at the same time) helps to save time and also increases your milk supply. The nurses will show you how to use the different settings on the pump and check that your breast shield fits correctly. Using the breast pump shouldn’t be painful
If you are sore or are worried about how much milk you are making ask your nurse/midwife for help with this.
For more information about using the breast pump see the video below.
A practical guide to using the breast pump (Youtube)
If you are worried about your milk supply speak to the nurse caring for you and your family who will be able to help. You can also access additional support from our breastfeeding champions/infant feeding team.
Cluster Pumping/power pumping
Cluster pumping is when you express frequently in a short period of time. It may be useful if you are trying to increase your milk supply in the weeks after your baby is born. It mimics a baby’s cluster feeding pattern which can often happen in the evenings. It aims to increase and maintain your milk supply for your growing baby. You might find it helpful to set aside an hour for this and express for 20 minutes, rest for 10 minutes, pump for 10 minutes, rest for 10 minutes and pump for 10 minutes. You can watch an episode of your favourite series and set timers on your phone so you can zone out and relax.
Tips from other mums that have helped:
As soon as your baby is stable, you and your baby will really benefit from spending time in skin-to-skin contact. This can be a special time for you both. For all babies skin to skin contact for many hours a day is the best place for them to grow and develop. Next to you they hear the familiar sound of your heartbeat and recognise your smell. During this time their brain forms positive connections which last a lifetime.
Skin to skin contact with dad can also be a lovely time for bonding and building strong close and loving relationships.
It helps to steady your baby’s heart rate and breathing and keeps them snug and warm. Skin-to-skin contact helps babies grow, reduces their stress levels and is the perfect way to soothe and calm them after a medical procedure. Skin-to-skin contact will also calm you both. Spending lots of time in skin-to-skin contact with your baby has been shown to shorten hospital stays and help them learn to feed.
How Dads can help
Some Dads worry that they are missing out on bonding with their baby if they are unable to feed them. However, there are so many ways to bond and feel close to your baby. These include:
As a new Dad, you might think there’s not much you can do to help with expressing and breastfeeding. Supporting your partner may mean she is able to express and breastfeed for longer. And as well as being good for your baby’s health it’s good for hers too.
Tips from Dads
Nipple pain if your baby is breastfeeding:
It can take some time to feel confident with positioning and attaching your baby at the breast, particularly if they were born a bit early. Don’t forget that you are both just learning! There is lots of support available to help get things off to a good start. Your nipple should be right at the back of your babies mouth, if it is pressed against the roof of your baby’s mouth during a feed this can cause damage and pain. Ask a member of nursing staff or infant feeding team to observe a feed and offer information and support to make sure your baby is well attached. If you experience pain or discomfort during a feed, use a finger to very gently ease your baby from the breast and reposition. Ask for information on other positions to try until you find what works well for you.
Tongue tie
Tongue-tie is where the piece of skin connecting the tongue to the bottom of the mouth is shorter or tighter than usual. This can sometimes cause nipple pain and challenges with breastfeeding. Not all babies who have a tongue tie have challenges with feeding. It is important that diagnosis includes a skilled assessment of feeding and tongue function. If you are worried that your baby has a tongue tie speak to your nurse who can refer you to the infant feeding team and then ENT if needed.
Nipple pain if expressing:
Using the breast pump should not cause discomfort or damage to your nipples. If you do find this uncomfortable, check that you have the correct funnel size for you. Nipples come in all shapes and sizes, and so we have lots of options for funnel size too. There should be enough space for your nipple to move freely, but not so much space that your areola (the area surrounding your nipple) is also within the funnel. If in doubt ask a member of staff to help you assess this. Check also that the vacuum is not turned up too high – turn the dial until you feel slight discomfort then go back a level or two until you feel comfortable. Expressing should be sustainable and pain-free!
This page on the Medela website shows you how to check the shield size is correct
Self care for nipple pain:
Wear a supportive cotton bra and change this regularly, if using breast pads try to avoid those with plastic-backing and change when they become damp. Express breast milk onto your nipples to help with healing and expose to the air when possible. Continue to feed/express as normal.
Breast pain
It is normal for your breasts to feel full and uncomfortable in the early days after your baby is born, and there are some simple steps you can take to ease this discomfort. Wearing a well-fitting, supportive non-wired bra is important. You may find that your usual bra size will change so if you can, get measured or measure yourself to determine the best size for you.
Engorgement
If your breasts are engorged, they may feel hot, lumpy and painful. This can happen while you are establishing your supply of breast milk, or later down the line if you have a bigger gap than usual between feeds or expressions. Again, a well-fitting bra will help to support your breasts and relieve some discomfort. You may find that a hot or cold pack is beneficial too. If your baby is feeding from the breast, they may find it more difficult to attach to a very full breast; hand expressing some milk beforehand will make things easier. If expressing, try not to leave big gaps between sessions.
Mastitis
Mastitis means ‘inflammation of the breast’ and covers a wide range of symptoms, such as heat, pain, redness, a lump in the breast or nipple discharge. This leaflet from the Breastfeeding Network has lots of information on the causes and treatment if you are experiencing Mastitis. If you feel flu-like or unwell it is important to let a member of staff know, so that you can be assessed for infection and supported to manage the symptoms.
Breastfeeding Network Mastitis leaflet
Dwindling supply
You may find that while your baby is in the neonatal unit your supply may fluctuate, particularly if your baby is not quite ready to feed from the breast. You may find it helpful to use the ‘Expressing Log’ to keep track of how much milk you collect each time. If you notice that this has reduced there are lots of things we can do to help get you back on track. There is a very useful Expressing Assessment Chart in your ‘Feeding Journey’ booklet which either you or a member of staff can use to consider if any tweaks need to be made to your expressing regime. Checking the size of your pump funnel can help too, as the size you need may change over time. Make sure you have lots of skin to skin cuddles with your baby and allow them to nuzzle and lick at the breast – this will help boost the hormones needed to produce milk and is a lovely chance to help you relax and let your baby practice feeding. Speak to a member of staff at the earliest opportunity so we can support you to get your milk supply back on track.
Expressing and breastfeeding assessment tools
There are lots of resources available to help with your breastfeeding and expressing goals. Every baby in the neonatal unit will have a booklet called ‘My Feeding Journey’ which has lots of useful information and tools for you and the neonatal staff to use.
This includes a handy checklist for assessing when expressing is going well, and things to try if you have concerns.
There is also an assessment chart for when your baby is ready to start feeding from your breast which will help you to see your baby’s progress and support you with moving towards responsive breastfeeding.
There are pages for notes which the nursing staff and infant feeding team will use to record any support given. You can also use them to write down your thoughts about expressing/feeding your baby. This will be given home with you when your baby is discharged for you to refer back to if needed.
Donor human milk is breastmilk donated to a human milk bank by mothers who have extra to spare. Donors are screened using a health and lifestyle questionnaire and have blood tests taken. Milk is tested for bacteria before being heat treated. Just like with blood, milk is freely donated and it’s use is tracked and recorded.
You can find out more from the NHSGGC Milk Bank Scotland information page.
Recipients:
Your colostrum (first milk) and the milk produced in the first few days, is the most suitable first feeds for your baby. Donor milk is usually offered on a temporary basis as a supplement to mothers' own milk whilst building their own supply. Donor milk is not the same as your own milk because it has been frozen, thawed and heat treated. Your own milk contains special antibodies made for your baby. These are not present in formula.
Donor milk is most needed for babies who are born very early or very small or who are unwell.
If there is not enough or your baby is not able to have your own milk, donor milk is the preferred option for babies being cared for on a Neonatal Unit.
We do occasionally provide donor milk for babies receiving care in other wards or at home on a short term basis. You can find out more from the NHSGGC Milk Bank Scotland information page.
Donors:
Donated breastmilk helps to save the lives of premature and sick babies whose mothers are unable, for many reasons, to provide them with sufficient breastmilk of their own. If you have breast milk that is surplus to your own baby’s needs, you may be able to donate it. We don’t have a limit on how old your baby is when you donate. We can also take stored milk that is less than 90 days old.
There is a screening process which we do online. The screening form includes questions about your medical history, lifestyle and diet. Once this is returned, we ask you to get a blood sample taken at your GP Practice and returned to the milk bank for screening.
We provide everything you need for this and bottles and labels for freezing your milk at home. If you already have a stock of milk in breastmilk bags, the milk bank may accept this, although the fat in the milk is not released from breastmilk bags as well as it is from milk bank bottles. Premature babies rely on high-fat milk to grow, and the bottles milk banks use are designed to increase the available fat as much as possible.
You can find out more at the NHSGGC Milk Bank Scotland Donor page. We will also arrange collection of your frozen milk by our Glasgow Children’s Hospital Charity Volunteers.
You can donate milk if you:
You cannot donate milk if you:
If you had a tattoo, piercing or blood transfusion in the last 4 months, you could still donate but we would need to delay your blood tests.
If you would like more information about donation or to get a donor pack please use the Contact Us form on the NHSGGC Milk Bank Scotland page and we will get back to as soon as we can.
Feeding your baby is a very special time. After all your effort expressing, it can be the perfect reward when your baby begins to feed directly from you. Learning how to feed a baby in the neonatal unit is a new experience for most families. We will help you to learn how your baby communicates with you about feeding and how to recognise their cues.
You can begin to practise how to hold your baby for feeding long before they are able to fully breastfeed. Holding your baby in skin-to-skin contact will help you to notice early feeding cues (opening their mouth, poking their tongue out, turning toward your breast). Letting them lick and nuzzle at your breast (after you have expressed) is a good way of helping your baby get to know the shape of your breast and smell of your milk. Even after your baby has had a first breastfeed, it can still take time for them to be fully breastfeeding, so it is best to take each day or even each feed at a time.
Tips to help get breastfeeding off to a good start:
You will feel a drawing sensation as baby begins to feed, but it should not be painful. Look and listen to your baby and notice if they are swallowing, as this will tell you that they are getting your milk. If your baby doesn’t seem comfortable, try changing the way you hold them. Ask the nurses to help you find a position that suits you both.
This video from Parent Club explains how to recognise if your baby is well attached at the breast
When your baby is starting to feed more often at the breast you might wonder how you know how much milk they are having. There are a few things that will help with that:
In the early days of transitioning from tube feeding your baby may have a slight weight loss. This is normal and staff will work with you to make a feeding plan. Over the next few days you will see your babies weight starting to increase
Learning to feed is an important milestone for your baby. Most full term babies are able to feed right from birth but preterm babies or babies who have been unwell may need special help as they learn to feed. Cue based feeding means that we use your baby’s cues to help us to know when your baby is ready to start feeding, and how to progress their feeding. During the feed we will also watch for cues that tell us when baby wants to stop feeding.
Cues are your baby’s way of talking to us. Your baby talks to us through changes in his or her behaviour - facial expressions, breathing, posture, movement and wakefulness.
Cue based feeding also helps us keep track of how well your baby is feeding (the quality of feeding), and how your baby’s feeding is progressing.
To start with your baby may only manage to suck small amounts and the rest will be given through a feeding tube. This is a fine tube that is threaded through your baby’s nose and into their stomach. This makes sure that your baby is having the amount of milk that they need to grow and develop and learning to suck. The tube will stay in until your baby no longer needs it. The feeding tube does not cause your baby any discomfort.
Your baby’s cues and medical needs help guide the feeding and will change as your baby learns and grows. The amount your baby sucks is important, but the quality of feeding is more important. A successful feed is a safe and enjoyable experience for both baby and you, and one that matches your baby’s individual stage of development.
You will be given information and support to recognise and understand what your baby is telling you. This will guide you on how to feed your baby, whether it should be a suck feed or tube feed, and also when your baby is telling you that they need to rest or stop sucking.
The Feeding Readiness Scale and When to Stop guidance (seen below) is used to assess what your baby’s feeding cues mean, and to know when it is right to offer your baby a suck feed. We will show you how to match your baby’s cues to a score at each feeding time.
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The score will tell you whether baby should be offered a feed or should have their milk through their feeding tube. The scores are 1-5. If baby scores a 4 or 5 then it is safe to offer baby a suck feed. A score of 1, 2, or 3 tells us that baby should be given their milk through the feeding tube. There will always be a nurse to guide you.
It is important to respond to baby’s cues and allow them to suck, even in the early stages when they may only suck for a short time. They are telling us that they are only ready for a short feed - they stop when their need is satisfied, or they become tired, but it is important that they are given the opportunity to suck when they are ready and stop when they
We will also show you how to recognise cues and signs that will tell us when to stop feeding. It is very important that you do not to try to encourage your baby to feed when they are showing STOP signs. Encouraging can tire your baby and they will not enjoy feeding. It may cause them to be reluctant to suck at the next feeding time and can delay baby’s progress. The Readiness and the STOP charts are on the wall so that you can easily see them and refer to them. You will also find them attached to the cots and incubators. The cues and scoring will mean the same whether your choice is breast or bottle feeding.
The things you do to help your baby feed well are important
Your baby will guide the pace at which feeding progresses. Babies are individuals and show their unique personality from birth, this means that some babies will show feeding cues early and some babies will show cues later. The timing of your baby’s cues will not delay your baby being ready for home.
It is important to hold your baby close to you when breast or bottle feeding. Spending long periods of cuddling your baby, particularly skin-to-skin holding (also known as Kangaroo Care) has short and long term benefits for both baby and you. We encourage you to be with your baby as much as possible. Please ask about how we can best support you to do this.
We firmly believe that you are the most constant influence in your baby’s life and that your role as a parent is a very significant one at all stages of your baby’s journey. Being with your baby at feeding times is important for progressing to suck feeding. Staff will always be available to help you.
We have family rooms where you can stay with your baby to help you prepare for going home. During this time there will be lots of opportunities to learn more about caring for your baby and staff to support you in your journey.
We have breast pumps available for you to use when you are with your baby on the neonatal unit. We also have a stock of pumps which you can use at home when you are not at the hospital. These are exactly the same as the pumps you will use in hospital. You can have this pump for the full time your baby is in hospital. The only exception would be if your baby gets moved to a hospital which is nearer home for you and no longer in GGC.
Before lending you a pump we will ask you to fill out a form with your contact details and sign a contract saying you agree to return the pump when your baby is discharge. Please ask your nurse if you need a breast pump while your baby is in the neonatal unit.
On the Neonatal Unit there is lots of support for you and your baby. The Neonatal Infant Feeding Advisors (IFAs) will be present on the unit and you can also contact them using the details listed below:
Gillian Bowker (Neonatal Infant Feeding Lead)
07813521614
[email protected]
Sinead Young (Neonatal IFA Royal Hospital for Children)
[email protected]
Cheryl Allison (Neonatal IFA Royal Alexandra Hospital/Royal Hospital for Children)
07977741987
[email protected]
Marjorie Clark (Neonatal IFA Princess Royal Maternity)
07977741983
[email protected]
There are breastfeeding champions on the Neonatal Units who are available for practical, face to face support and help with feeding your baby. Ask your nurse if you would like to speak to one of them.
On the Neonatal Unit we work closely with the charity National Childbirth Trust (NCT). We have NCT peer supporters who are available to help with feeding your baby.
If you want to contact them at any point during your stay you can sign up for the service by texting:
FEED to 62277
One of the peer supporters will get back to you usually within 24 hours. They can then offer you support at your baby’s bedside or via a virtual appointment on attend anywhere. We have tablets available to support virtual appointments if you don’t have access to a smart phone.
They have a very helpful and supportive Facebook group which you can join: NCT Glasgow Breastfeeding Buddies Neonatal Group
NCT also have an infant feeding support line. You can call 0300 330 0700.
The Parent Club have lots of helpful resources
The National Breastfeeding Helpline is open 9.30am-9.30pm every single day of the year, offering non-judgemental, evidence based, friendly breastfeeding support and information to anyone in the UK who needs it. Call 0300 100 0212.
There are local breastfeeding support groups in most areas. These are led by healthcare professionals and provide a space for you to meet other Mums and babies who are breastfeeding. Details of local groups can be found on the map below (use the + button to zoom in). If you can't see the map you can access it here.
Glasgow Breastfeeding Buddies Neonatal Support Group meet virtually (online) on a Wednesday from 1pm-2pm - see the flyer for more information here.
Last reviewed: 18 December 2024
Next review: 31 December 2027
Author(s): Gillian Bowker
Approved By: NHSGGC Neonatal Infant Feeding Advisors
