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Infant feeding support and resources for parents during COVID 19

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Dear Families


This is a very worrying time for everyone and especially for new parents. We want you to know that at Brighton and Sussex University Hospitals we are doing everything we can to care for you and your baby at this important time.

Breastfeeding/chestfeeding takes time and practice and can be a real challenge for so many women/people in the early days. One thing this coronavirus is forcing us to do is stay indoors and avoid close contact with others. This is a great opportunity for you to get to know your baby and begin to learn how to breastfeed/chestfeed together. This is a new skill and takes time. We are here for you.

Human milk offers valuable immune protection for your baby. Every single drop contains millions of living cells and antibodies.

However you feed your baby, this is a significant time for infant brain development. Comforting and cuddling your baby will contribute to optimal brain development. Babies can never be spoiled by too many cuddles!

Please look on the Trust website My Pregnancy Matters feeding pages for information and also check out our Twitter feed and Facebook page.

In addition to this we have put together some other useful video links and resources. These resources will help you in the coming days as you start to get to know your baby.

If you have any worries or concerns around feeding and caring for your baby do not hesitate getting in touch with us. The Community Midwives telephone number is on the front of your notes.



BSUH – Attend Anywhere.

Drop-in virtual feeding support clinic.

Open 4 days a week:

Mon, Weds, Fri and Sat, 9am – 5.30pm.



Attend Anywhere is run by experienced Midwives dedicated to supporting you with your feeding journey and helping you achieve your feeding goals. This is an NHS England video consulting programme. It is secure, private and easy to use.

Following the link above, you will be taken to a page where you put in your details and join our virtual waiting room. It takes just a couple of minutes to join. We are waiting to support you. Come and give it a try!

We also have a dedicated feeding support telephone helpline.

Please call 01444 441 881. Extension: 8349.

9am-5.30pm on Monday, Wednesday, Friday & Saturday.


Will I be able to stay with my baby and have skin to skin
contact if I have suspected or confirmed COVID-19?


Yes, provided your baby is well and doesn’t require care in the neonatal unit, you will be kept together and supported in skin to skin contact after you have given birth.


Can I breastfeed if I have covid-19?


At the moment there is no evidence that the virus can be carried in breastmilk. The benefits of breastfeeding your baby outweigh any potential risks of giving your baby COVID-19 through breastmilk.

Breastmilk is the best source of nutrition for infants and provides protection against many illnesses. Breastfeeding is particularly effective against infectious diseases because it transfers antibodies and other important immune factors to the baby. If you were thinking of giving up breastfeeding, perhaps continue until this pandemic ends.


What are the main risks of breastfeeding if I have COVID-19?


The main risk of breastfeeding is close contact between you and your baby, as you may share infective airborne droplets. This could lead to the infection of your baby after birth.

If you have confirmed COVID-19 or have symptoms you should take all possible precautions to avoid spreading the virus to your baby.

  • Try to avoid coughing or sneezing on your baby while breastfeeding.
  • Consider wearing a face mask, if available, while breastfeeding.
  • Wash your hands regularly and always before touching your baby.
  • Wash your hands after changing their nappy.

What if I am too unwell to breastfeed?


If you are too unwell to breastfeed you may still be able to express breastmilk for your baby. Someone else who is well could give this expressed milk to your baby in a bottle.

If you choose to feed your baby with formula or expressed milk it is recommended that you follow the sterilisation guidelines carefully. If you are expressing breastmilk in hospital, a dedicated breast pump should be used.

We will keep looking at the evidence about breastfeeding and COVID-19 as it develops. Please look at the guidance from the Royal College of Obstetricians and Gynaecologists on their website


Useful Resources


Lullaby Trust: Safe sleeping.

Dr Amy Brown, Swansea University.

We Recommend these videos from The Breastfeeding Companion for all mothers:

  • Skin to skin.
  • Normal feeding patterns.
  • Foremilk and hindmilk.
  • Comfortable breastfeeding.
  • Breastfeeding positions.
  • One breast or two.
  • My baby won’t latch.
  • Sleepy babies.
  • Breastfeeding with flat or inverted nipples.
  • Hand expressing.
  • How to boost milk supply.
  • Sore nipples.
  • How breastfeeding works.
  • Exclusive pumping.
  • Bottle feeding a baby (paced feeding).
  • Handling and storing breastmilk.
  • Expressing milk by pump.
  • Breastpumps.
  • Engorgement.
  • Reverse pressure softening.
  • Mastitis.
  • Breast abscess.
  • Breast engorgement.
  • Breast compressions.
  • Tongue-tie.
  • Blocked milk duct.
  • Thrush.
  • Induced lactation.

The Unicef Baby Friendly: Best beginnings series includes effective ineffective attachment and hand expressing.

Global Health Media: attaching your baby to the breast.

Kelly Mom.

Low Milk Supply.

NHS UK.

The GP Infant Feeding Network.

Breastfeeding Support.

Breastfeeding Network.

Association of Breastfeeding Mothers.

National Childbirth Trust.

La Leche League.

Unicef: bottle feeding.


Specialist Team Support – Infant Feeding


Helping your breastfed baby to get all the milk they need:
what should I do if I need to increase my milk supply?


A mother’s milk supply is established and increased by regular and effective milk removal.

If you need to increase your milk supply:

  1. Be sure your baby is latched on well. Good attachment at the breast is key to good effective milk removal. Signs of good attachment include: mouth open wide, chin indenting the breast, head slightly tipped back. Feeding is more effective when your baby is positioned facing the breast with its head, neck and body in line, is in close contact with mum and well supported. Feeding should be comfortable. If it is uncomfortable, ask for help.
  2. Be sure that baby is actively swallowing. You should be able to hear or see this. Look for deep, rhythmical, jaw dropping movements, with pauses, that are sustained for a period of time.
  3. Nurse frequently. Your baby will usually feed 8 to 12 times in twenty four hours. The more often the breasts are stimulated, and milk removed, the more milk they will make. Follow baby’s feeding cues, which include tongue darting, lip smacking, head bobbing. Try not to schedule feedings. Crying is a late hunger cue.
  4. Offer both breasts at each feed. this will ensure that your baby gets all the milk available and that both breasts are stimulated frequently. Allow your baby to indicate they are finished on the first breast, and then offer the other breast.

Some babies are sensitive to milk flow, and can lose interest in feeding when the flow slows, but before they have had enough milk. Breast compression and Switch feeding can help your baby to get more milk at the breast and can increase milk supply.

  1. Breast compression. This helps to keep your baby interested in nursing and increase fat consumption. Squeeze the breast firmly with your thumb on one side and fingers on the other to increase milk flow. Hold the pressure and keep squeezing until your baby is no longer actively sucking, then release. Rotate fingers around the breast and squeeze again. Squeeze firmly but be careful not to cause injury to your breast tissue.
  2. Switch feeding. This can help your baby actively feed for longer by taking advantage of the first stronger milk ejection. As your baby’s jaw dropping movement slows, and before they go into a deep sleep, switch to the second breast for as long as they actively feed, and then return to the first again. The baby can nurse at each breast several times during one feed.
  3. Sucking needs to be at the breast where your baby will be getting food and stimulating your breasts to make milk. Try and avoid using a dummy in the first six weeks as it could result in missed feeding cues and feeding opportunities.
  4. Skin-to-skin is always valuable and helps support breastfeeding. It stimulates your baby’s neonatal feeding reflexes. It increases your oxytocin and is an opportunity for you and your baby to connect. It is your baby’s natural habitat.
  5. Keep your baby close. Your baby will have easy access to the smell, taste and feel of your body and milk. This can help you be responsive to your baby’s feeding cues so they may feed better. Some baby carriers, slings or wraps are a great ‘hands free’ way to keep your baby close.
  6. Expressing. Frequent effective milk removal (8 times in 24 hours) is key to increasing and maintaining a full milk supply If a baby is not able to do this well enough or weight gain has not been at the expected rate, expressing milk can be an effective way to increase milk supply. It also provides additional milk if you need to supplement.

How will my baby’s weight change?


Your baby may lose weight during the first three or four days and from day five you should expect steady weight gain. Your baby should regain their birth weight by the time they are 21 days old or sooner. After that, most breastfed babies gain an average 170 grams (6 ounces) per week.


How will I know if my baby is feeding enough?


By day five your baby will be feeding 8 to 12 times in 24 hours. You can expect 5 to 6 really wet nappies per day plus a minimum of two bowel movements of at least as big as a £2 coin. The stool should be runny, yellow and no longer black or green. At around six weeks old they may poo less often and still gain weight well but until then their poo is a good way to check how much milk is going through.

Your baby’s behaviour will tell you that they are satisfied and full. They will come off the breast spontaneously and will seem contented.


What if my baby has been diagnosed with a tongue-tie?


Many babies can breastfeed without any problems with a tongue tie and some will struggle. if your baby is having problems they will refer you to the tongue tie clinic. Please use our video or telephone consultation service. We are here to help.

Here are some resources to help you if your baby is struggling to take the milk they need. Remember, milk supply works on demand and supply: milk needs to be removed to be made. If milk isn’t removed from your body frequently, your body’s production will gradually slow down. Protect your precious supply!

Unicef breast feeding advice: Maximising your breastmilk.

Increasing the amount of milk your baby gets at the breast whilst feeding, if their tongue is restricting the amount of milk that can be transferred:

Supplementing your baby with extra breastmilk after a breastfeed. Try collecting your milk by whatever works for you:

If your baby is slipping on and off the breast and or ‘clicking’, try nipple shields as they can help with this.

The ‘flipple’ or exaggerated attachment technique can help a baby get a deeper latch at the breast.


What is the best way to express milk (pump)?


  • Make sure you are relaxed, warm, hydrated and not hungry before you sit down to pump.
  • Skin to skin with baby before pumping is key to increasing your output.
  • Check the size of your flange. This is the plastic piece on the breast pump that fits over your nipple. There is no standard nipple. A flange that is too small or too big will affect greatly your output and supply.
  • Sterilize pump parts once a day and wash with soap and hot water in between pumping sessions.
  • Whether using a double or single pump, do it for around 20 minutes to mimic a full feed. Pumping for less time might miss the end of the feed or fatty milk. Another suggestion is to pump until the flow of milk is minimal and then pump for a further minute.
  • When pumping after a feed do it for just 10 min. This can help empty the breast when baby struggles to do it themselves.
  • Use the highest setting that feels comfortable. It should not be painful.
  • Pump at least eight times in 24 hours. Do not exceed five hours between pump sessions.
  • Pump at least once between 1am to 5 am, this is when the milk hormones are highest.
  • Add what you pump in the same bottle and collect throughout the day.
  • Expressed breastmilk can stay out of the fridge up to six hours, at the back of the fridge up to five days and in the freezer up to six months (guideline below).
  • When feeding baby your expressed breastmilk, use the PACED method.
  • Research shows that ending a pumping session with hand expressing and or doing breast compressions while pumping make a significant difference in output and supply.
  • When pumping to increase supply whilst also putting baby on the breast, consider POWER PUMPING (mimics cluster feeding, essential to increase supply) and or PARALLEL PUMPING (pump from one breast for 20 minutes while the baby feeds from the other).

Safe storage of breastmilk in the home


Fresh breastmilk (including colostrum) can be kept at normal room temperature for 6 hours. It can be kept in the fridge (5 to 10°C) for 3 days. It can be kept at 4°C or lower for 5 days, but if temperature rises above 4°C after 3 days it must be used within 6 hours or thrown away.

Frozen breastmilk (at minus 18°C or lower) can be kept for 6 months.

To defrost after freezing, it will take about 12 hours to defrost in the fridge. You should use the milk as soon as it is fully defrosted.

Milk can be transported within safe storage times, provided storage temperatures are maintained. Previously frozen milk must be used immediately when fully defrosted.

Fresh milk can be transported within 24 hours, provided fridge temperatures are maintained using an insulated box and deep frozen ice packs, and total storage and transportation times do not exceed the recommended storage times. If no ice packs are used when transporting, use within 4 hours.


What kind of breast pump should I use?


We recommend double electric pumps where possible. They save precious time.

ARDO are offering a £10 discount at this time for BSUH people on their hospital grade hire pumps. This reduces the price of the standard pump hire from £47 to £37. Enter code AGENTSNCT at checkout.

Other pumps can be bought online. We sell the ARDO double Calypso £125 for purchase while in hospital.


Who can I contact for further information and advice?


Specialist Team Support:

Infant Feeding, Brighton and Sussex University Hospitals Trust:

Helplines



This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

Publication Date: April 2022

Review Date: September 2023

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