Infant feeding

C – Close
Baby should face the breast and be as close as possible to gain a deep latch

H – Head free
Supporting the baby around the neck and shoulders rather than by the head will allow them to tilt their head back and open wide to take in your breast tissue

I – In line
Have you tried swallowing with your head twisted over your shoulder? You will soon get tired. Babies also need to have their head in line with their bodies to help them swallow.

N – Nose to nipple
The chin should lead and the mouth should be wide open when the baby latches with the nipple pointing up toward the baby’s nose so that when you latch it reaches far back into the baby’s mouth.

S – Sustainably
Will you be able to sit in this position for a whole feed? Do you have water nearby?

Reference:CHINS acronym developed by Dr Lynette Shotton, Northumbria University

How do I know if my baby is latching on properly?

• they take a large mouthful of breast tissue and you can see more of the darker area of your breast (areola) at the top of the baby’s mouth.
• Baby should have rounded cheeks
• the chin should be the first thing to touch the breast and should indent the breast and massage the tissue during the feed
• Baby’s lips (top and bottom) should be turned outward
• you should hear a 2:1 suck and swallow pattern after the initial let down.

While breastfeeding can be uncomfortable, especially for first-time mothers, it shouldn’t be painful. If you experience pinched, sore or bleeding nipples, or your baby still seems hungry after a feed, these could be signs that your baby isn’t attaching well. Seek help from your midwife.

Really Good Drinking video
Unicef Baby Friendly Assessment Tools
Unicef positioning advice with video

Try different positions

Rugby	Cross cradle	Koala
Reclining	Lying down

https://globalhealthmedia.org/videos/breastfeeding-positions/

https://www.babycenter.com/baby/breastfeeding/good-positions-for-breastfeeding_8784

If you are finding breastfeeding painful, having difficulty getting your baby latched on, worried about your milk supply or want any other information or advice around breastfeeding please ask for help. You can:

• speak to your midwife or health visitor
• email huh-tr.homertoninfantfeeding@nhs.net

If you live in Hackney you can attend a breastfeeding drop-in run by NCT 

If you live in City of London there are breastfeeding drop-ins on

• first Wednesday of every month  11am-1:30pm
  City Child & Family Centre @ The Aldgate School, EC3A 5DE
• third Wednesday of every month 10am – 12 pm
  Barbican Children’s Library, EC2Y 8DS

This booklet gives lots of information about feeding your baby including how to prepare in pregnancy, different positions for breastfeeding, what to look out for, and how to seek help.

If you are booked to give birth at the Homerton you should be given a printed copy antenatally. If you don’t have one you can ask your midwife for a copy.

You cannot over feed a baby who is only having breast milk. Often babies will feed for comfort as well as for nutrition and responsive feeding means breastfeeding whenever your baby shows feeding cues that it wants to be fed. It also means you can offer a breastfeed if your breasts feel full or for your own needs. Feeding regularly will ensure that you have a good milk supply and that the baby feels loved and supported. However, it is not usual for babies to have large gaps between feeds so if your baby is going for a long time (more than 3 hours) without showing feeding cues try to wake them and offer the breast - a baby should feed at minimum eight to ten times in 24 hours, with feeds lasting between 10 and 45 minutes. If your baby comes off the breast, this can mean the breast is nearly empty, so you can offer the other side.

If your baby is getting enough milk, they should relax during breastfeeding and not be agitated. The best way of knowing how much they are drinking is to see what is coming out. After the first week they should have at least six or more wet nappies and at least two dirty nappies a day. If your baby still seems hungry, they may not be latching on properly and you might need some extra support, so drop into one of our breastfeeding drop-in’s or use the support contact below.

Colostrum is a concentrated yellowy fluid produced from the breast for the first few days of your baby’s life to provide complete nutrition for them while their stomach is still tiny.
Colostrum is packed full of antibodies and white bloods cells which help build your babies immune system and protects the baby’s digestive system from infections.

Being able to hand express colostrum will give you the confidence to provide food in the early days to your baby. Expressing colostrum before you give birth ensures that your baby will have access to your milk early and can be particularly useful for:

• diabetic mothers
• twin Pregnancies
• expected Pre-term pregnancies
• small babies
• women who have breast abnormalities
• anyone on Beta-blocker medications

Ask your midwife for a colostrum harvesting pack.
Download a PDF of our expressing pack https://www.homerton.nhs.uk/download/doc/docm93jijm4n7855.pdf?amp;ver=16371

Expressing - basics of breast massage  and hand expression video

Expressing – milk storage

You can store breast milk in a sterile container:

• in the back of the fridge for up to 6 days
• for 2 weeks in the ice compartment of a fridge
• for up to 6 months in a freezer, if it's -18C or lower

Storing breast milk in small quantities will help avoid waste. If you're freezing it, make sure you label and date it first.

Defrosting frozen breast milk
It's best to defrost frozen breast milk slowly before giving it to your baby. If you need to use it straight away, you can defrost it by putting it in a jug of warm water. Use it straight away.

Never re-freeze milk that's been defrosted
Once your baby has drunk from a bottle of breast milk it should be used within 1 hour and anything left over should be thrown away.

Breastfeeding is the healthiest way to feed your baby. If you are unable to, or choose not to breastfeed, we will support you in this decision. Advice and support is available from your midwife and health visitor. 

When preparing formula it is important to remember to:

• sterilise all equipment that comes into contact with formula milk
• use a first stage formula for babies up to one year
• make up the formula according to the manufacturer’s instructions; add the boiled water to the bottle first and then the scoops of powder (never add more or less powder than prescribed).

We recommend using tap water rather than bottled water to prepare formula feeds as bottled water can contain high levels of sodium.

Responsive bottle feeding - it is important to be responsive to your baby’s feeding cues and also pick up on when they might be full as it is possible to overfeed a bottle-fed baby. Hold the bottle at a horizontal level and pace the feed so the baby can take breaks and let you know when it has had enough. Never force a baby to finish a bottle. Any formula milk remaining in the bottle at the end of a feed should be discarded.

For more information on bottle feeding please visit: https://www.nhs.uk/start4life/baby/feeding-your-baby/bottle-feeding/

For unbiased information on the different formula milks available please visit: https://www.firststepsnutrition.org/infant-milks-overview

Tongue Tie
If you had your baby at Homerton Hospital we provide a service to assess tongue tie and if necessary undertake a frenulotomy (tongue tie division). Referrals can be made by contacting your midwife, Health Visitor or GP to complete a referral to the service. 

https://www.eventbrite.co.uk/e/homerton-antenatal-infant-feeding-class-tickets-235895940107

To access information on infant feeding in other languages please visit:

https://globalhealthmedia.org/topic/breastfeeding/ for helpful videos in many different languages

https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/foreign-language-resources/ for written information in several languages.