What you might need to know

It’s normal for women who are expecting, or who are thinking about having children, to have some concerns about breastfeeding.

If a relative’s struggled with breastfeeding, that doesn’t mean you will

Only a small number of mums have a medical or surgical issue that affects their ability to breastfeed. 

Everybody and every baby is different. Just because a relative of yours has struggled doesn’t mean you will also. Feeding information has also changed; advice given to women in the past would be different to what it is now. This is the case with safe sleep: research has changed our understanding of infant feeding in this area.

Breastfeeding twins

Yes you can. There are different ways of approaching this, so speak to your midwife or infant feeding peer support worker.

Producing enough breast milk to feed your baby

Your body makes the right amount of milk for your child, and responsive breastfeeding increases supply as needed. Only a small amount of mums have a medical or surgical issue that affects this.

Don’t worry if some feeds are shorter than others: just like us, sometimes baby needs a drink and other times they need a full 3-course meal. Breast milk contains all the nutrition and goodness your baby needs, so short feeds are still crucial. Breast milk also adapts throughout the day depending on: 

• the weather
• growth spurts
• if your baby is ill
• other factors

There are several things you may be wondering about in relation to your breasts and breastfeeding.

Eating and drinking more won’t affect how much milk you make

Breastfeeding mothers should follow a healthy, balanced diet dictated by their appetite and thirst. 

The amount of food and drink you have won’t make a difference to the amount of milk that is produced.

Surgery and piercings

It’s usually possible and safe to breastfeed following cosmetic surgery or piercings – as long as the breast tissue containing the milk is not affected. 

However, it’s recommended you remove your piercing during breastfeeding so there’s no risk of your baby choking. It does not affect your milk supply.

Breast size and piercings

The majority of women have the ability to produce more than enough milk for their child, whatever the size of their breasts. Babies are born with an instinct to breastfeed irrespective of the size of a mother’s breasts. 

There are lots of different positions to try, and there are tips and support available to help all mums. You can contact your infant feeding peer support worker, health visitor or midwife for more advice.

Flat or inverted nipples

The size and shape of your nipples don’t decide how babies feed. Breastfeeding is feeding from the breast irrespective of flat or inverted nipples. The nipple is simply where the milk comes out.

There are lots of different positions you can try, and there are tips and support available to help all mums. 

Establishing breastfeeding in the first few weeks can be difficult: babies feed little and often, and this can feel overwhelming. However, breastfeeding mums are known to produce hormones that help them and the baby sleep. 

Breastfeeding changes as your baby grows, and it gets easier as you, your baby and your body know what you’re doing (compared to preparing bottles and sterilising formula milk). It’s instant: bring baby to your breast and follow safe sleep advice.

Nipple confusion or preference

Many babies have a preference between the left and right breast. Although, this isn’t confusion. Rather, it shows that babies are aware of the differences between nipples and prefer to be positioned on a certain side. 

Artificial nipples / teats

The addition of artificial nipples (teats) can be very confusing, as babies suck differently from a teat, which is why some babies refuse bottles. 

Similarly, breastfeeding may become a lot more difficult after bottle-feeding has been introduced. It’s recommended that dummies are not introduced until breastfeeding is established (at least 6 weeks).

Breastfeeding is learning process, and you may need help and support if you’re running into some issues.

Pain and breastfeeding

Breastfeeding shouldn’t hurt. You may feel a new sensation when you start breastfeeding, but if this is painful, then this is a sign that baby is not latched as well as they could be. 

You can get free support from your infant feeding worker, health visitor or midwife at any stage if you’re struggling, in pain or just need advice. 

There are some medical conditions that can cause pain, like tongue tie, which will need referring to a midwife, health visitor or another professional.

Breastfeeding is one of the best things you can do for your baby, and even more so if they’re not in the best of health. 

Breastfeeding is even more important if your baby is premature

Your breast milk is important to your baby at any age, but even more so if your baby is premature. 

A premature baby should be encouraged to breastfeed as soon as possible.

Although premature babies may not attach to the breast straight away, it’s important for them to have lots of opportunity to be held close whilst learning to make sucking movements. You’ll be encouraged to express your milk so that your baby can be given it as soon as possible. 

Even very ill babies who aren’t able to feed are given mouth care by using drops of their mother’s milk. This is absorbed by the baby and gives protection from infection. Expressing will also ensure you have a good supply for when the baby is well enough to start breastfeeding.

If you or your baby is ill, don’t stop breastfeeding

By continuing to breastfeed, all your antibodies that fight the infection are passed onto your baby, which gives them some protection.

When breastfeeding, it’s important to think about your health, any medication you’re taking and to avoid any substance that may harm your baby.

Medication

Most medicines can be taken safely whilst breastfeeding. However, always tell your doctor or pharmacist that you’re breastfeeding and ask for medication that is safe.

Contraceptive pill

You can take the progesterone-only contraceptive pill whilst breastfeeding and before 6 months post-delivery. 

Taking the pill will not harm your baby whilst breastfeeding. However, pills that contain oestrogen can decrease the production of milk. 

It’s recommended to avoid the combined pill for around 6 months (until the baby is taking other foods alongside breast milk).

Alcohol

It's safer not to drink any alcohol while breastfeeding. 

An occasional drink is unlikely to harm your baby – such as 1 or 2 units of alcohol, once or twice a week – should be fine. 

If possible, allow 2 to 3 hours in between drinking and breastfeeding. You should only do this after breastfeeding is well established. This allows time for the alcohol to leave your breast milk. 

A unit of alcohol is equivalent to roughly: 

• a small glass of wine (125ml)
• half a pint of beer
• a single measure of a spirit (25ml) 

 Never share a bed with a baby if you've had an alcoholic drink. This is linked to the risk of sudden infant death syndrome (SIDS).

Smoking, e-cigarettes and vaping

Any kind of smoking or vaping could be potentially harmful to your baby. 

Smoking

As a new mum, not smoking is one of the most important things you can do to protect your own health and your baby’s. 

However, if you're finding it hard to quit smoking, it's important not to stop breastfeeding. Breastfeeding will still protect your baby from infections and provide nutrients they cannot get from formula milk. 

Avoid smoking before feeding your baby as this will limit the amount of nicotine passed into your breast milk.

E-cigarettes / vaping

While using an e-cigarette (vaping) is a lot safer than smoking, it’s not completely risk free. 

As well as nicotine, e-cigarette liquid and vapour can contain toxic substances, although these are mostly at much lower levels than in cigarette smoke.

New mums are advised to use licensed NRT products for help with quitting smoking and staying smoke free.

However, if you choose to use an e-cigarette to help you stay smoke free, it's still better to carry on breastfeeding as the benefits will outweigh any potential harm. It’s best to do this after a breastfeed and outside to help protect your baby. Any amount of second-hand smoke (also known as passive smoking) can be extremely harmful for your baby.

How to keep your baby safer

The risk of sudden infant death syndrome (SIDS) is higher if you or your partner smokes while you’re pregnant or after your baby is born. 

Follow these steps to help keep your baby safer:

Try not to smoke during pregnancy and after the birth

Yourself, your partner or any other person that lives in your home should avoid smoking as much as possible. If you smoke, the most protective thing you can do for your baby is to stop.

Keep your baby out of smoky areas

Don’t let people smoke near your baby and keep your home, car and other places your baby spends time smoke free. Remember, it’s illegal to smoke in a car or other vehicle if anyone under the age of 18 is present.

Don’t sleep in the same bed as your baby

Don’t share a bed with your baby if you or your partner smoke or if the baby was exposed to smoking in pregnancy.

Find out more about how to quit vaping on the Better Health website

Speak to NHS Stop Smoking Service - Yorkshire Smokefree  for support or impartial advice.

Marijuana

To reduce risk to your baby, breastfeeding mothers should avoid marijuana in any form (such as edibles, oils or other concentrates). 

The chemicals can potentially affect a baby's brain development and result in:

• hyperactivity
• poor cognitive function
• other long-term consequences

The risk of sudden infant death syndrome (SIDS)  is greater if you smoke or use drugs and/or alcohol in pregnancy and after birth.

Being under the influence of cannabis while parenting can affect how you interact with your child:

• you may miss your baby’s/child’s cues for hunger, to be comforted or to play and learn
• it can also affect your ability to judge, to make good decisions and to protect your child from danger

The effects of cannabis can last for several hours. Be sure that there is always someone available who is not under the influence of substances to take care of your child’s needs.

Ways to reduce the risk include: 

• not sharing a bed with your baby as drugs and alcohol can make you more sleepy and less likely to be responsive to your baby’s needs
• providing a smoke free environment for your baby
• don’t smoke in enclosed areas and don’t allow people to smoke around your baby/avoid smoky areas
• cover your hair and change clothes after smoking and wash your hands and face after smoking 

Talking about cannabis use in pregnancy with your midwife or consultant can be difficult, but it’s important to be open and honest so that they can provide the most appropriate care for you and your baby. 

More information

NHS: Food and drinks to avoid when breastfeeding - Start for Life

Breastfeeding Network: Drugs in Breastmilk factsheets

Unicef: Caring for your baby at night and when sleeping

The Lullaby Trust: Safer sleep information

There are many things you may become concerned about whilst breastfeeding. 

Leaking breastmilk

Leaking milk doesn’t happen to everyone. It’s more common when your milk first comes in, and it can be collected and used at a later date. Breast pads can be worn to stop it leaking through your clothes.

Your breast milk will be enough even in hot weather

Breast milk contains all the water a baby needs: the milk naturally adapts to hotter weather. It becomes more refreshing and provides the necessary fluids to keep your baby hydrated.

Formula milk gives babies the nutrients they need to grow and develop. However, breastmilk is more than food. It contains:

• antibodies
• living cells
• enzymes
• hormones that provide additional health benefits for you and your baby

It's designed to give babies everything they need. This includes antibacterial properties in the early days.

Using both breast milk and formula milk

Every drop of breast milk helps your baby. Breast milk alone gives a baby all of the nutrients they need, but some mums choose to give some breastfeeds and some bottle feeds so that family members can help with feeds. 

It’s worth bearing in mind that:

• there’s evidence showing babies benefit from having a consistent carer to feed them
• formula milk reduces the protection to the baby’s tummy and a baby having formula feeds is more likely to develop a tummy infection
• if family members want to help with feeds, it’s much better to express breast milk in advance that can be given to the baby in a bottle
• some mothers manage to successfully give some breast feeds and some formula feeds with no adverse effects on the breast milk supply

You and your baby can carry on enjoying the benefits of breastfeeding for as long as you like. Breastfeeding into your baby's second year, or beyond, alongside other foods, is ideal.

Lots of mothers carry on breastfeeding when they go back to work or education. Read more about breastfeeding after returning to work.

You don’t have to stop breastfeeding if you get pregnant again, either. 

Breastfeeding whilst pregnant

There’s no medical reason as to why you can’t breastfeed whilst pregnant. 

If both mother and baby choose, breastfeeding can continue. 

Some women choose to breastfeed the older child and their newborn baby. This is known as tandem feeding.