Breastfeeding

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Breastfeeding (511kB pdf)

Introduction

Alder Hey promotes breastfeeding as the natural way for a woman to feed her baby and recognises the important health benefits known to exist for both the mother and her infant.

Being in hospital can be stressful and Alder Hey is committed to providing an environment that encourages breastfeeding your baby/providing breast milk for your baby. You are welcome to breastfeed anywhere in the hospital but if you require a private room or a privacy sign then please ask staff. Just like any new skill, breastfeeding takes time and practice and at times can be challenging.  This leaflet has been written to give you basic information you may need to support you in feeding your baby whilst in Alder Hey.  If you have any further questions or needs, then please do not hesitate to ask a member of staff.

Breastfeeding facilities in Alder Hey

Private breastfeeding rooms are available in the Atrium, on medical day case corridor, outpatients 1.2 and 2.1 and the Emergency Department.  There is also a private room outside critical care if your baby is a patient there.  

Ronald Mcdonald House

Reception is staffed 24 hours a day and a pump can be signed out for an hour, maximum. If you are storing your milk in the communal fridge then use a padlock to secure your cage or ask reception for a lockable box. You will need to take expressing packs, bottles and labels from the ward where your baby is and take milk to the ward fridge as soon as you can. Do not put your milk in the freezer, bring it to the ward to freeze if necessary. Do not store your milk in bags, only use bottles. You may be able to borrow a mini fridge to store your milk in your room so ask at reception if you think you would benefit from one.    

Benefits

Every day makes a difference to your baby and the longer you breastfeed, the longer the protection lasts. Here are some of the benefits of breastfeeding or giving your baby breastmilk:

• Reduced incidence and severity of asthma, gastroenteritis, respiratory infections, ear infections, allergies and eczema
• Improved neurological outcomes for your baby
• Reduced risk of SIDS (cot death)
• Improved milk supply
• Helps you to build and strong loving relationship with your baby

How to Breastfeed

Make sure you are in a comfortable position to begin with.  It is important to position and attach your baby correctly to make sure your baby gets enough milk and to prevent breast related issues;

Close – hold your baby close to you

Head – make sure your baby’s head is free to tilt back and can lead with the chin

In line – make sure your baby’s head and body are aligned so neck is not twisted

Nose to nipple – so nipple slips under top lip upwards and backwards to roof of mouth

Signs that your baby is attached and feeding well

• Your baby should be settled
• Your baby should have a large mouthful of breast in their mouth when feeding.
• Your baby’s chin should be firmly touching your breast.
• It shouldn’t hurt you when your baby feeds (although the first few sucks may feel strong).
• Your baby’s cheeks should stay rounded during sucking.
• Your baby should take rhythmical sucks and swallows.  It is normal for your baby to pause from time to time.
• Your baby should finish the feed and come off the breast spontaneously
• Your breasts will usually feel softer post feed

Feeding cues

Breastfeeding is a reciprocal relationship between you and your baby. Your baby will want to go to the breast for nutrition, comfort, pain relief and warmth.  It is a lovely place to be!

You may find your breasts feel full or you need to cuddle your baby when you need to feed. Your baby will do periods of cluster feeding for the first few weeks and this is normal.  

Expressing

You may decide that the best way for you to feed your baby is with expressed breast milk (we refer to this as EBM) or for medical reasons your baby may not be able to feed directly from the breast.  You can either hand express or use a hand or electric breast pump. Ask for a privacy sign if you prefer. An expressing log is included at the back of this leaflet to help you to remember when you last expressed.  It is advisable to express 8-10 times in 24 hours and to do one expressing session overnight.

Hand expressing

This is good for expressing colostrum (your first milk).  Even a few drops are beneficial to your baby and can be used for mouth care. To do this;

Expressing using an electric pump

Breast pumps and expressing packs are available on all wards. It is recommended to express breast milk while beside your baby to increase milk supply.  If you choose not to express at the bedside then look at photos and videos of your baby and take something with their smell on as this helps with milk supply.

After each use, the pack is to be disposed in the yellow clinical waste bins. Packs are not to be re-used or sterilised.  For infection control reasons we ask that you do not use your own pump unless our packs are compatible.You can single or double pump depending on preference, but if you are struggling with your supply or trying to initiate feeding it is advisable to double pump.

• Wash hands and get into comfortable position. Sit well forward to prevent leakage from the collecting set
• Assemble pack as in picture 1, and attach to pump as picture 2
• If your supply is already established (expressing 20 mls combined for 3 consecutive pumping sessions) then use the maintenance programme.  Place the nipple shield central to nipple ensuring a good seal and turn pump on as (power button on left). Then turn middle dial  clockwise up to slight discomfort and then reduce anti-clockwise to a comfortable level. The pump will do fast sucks for 2 minutes to stimulate your let down of milk. Once you see milk, press the droplet button (button on right) and the pump will slow down. Once your milk flow slows you can press the droplet button again to try and stimulate another let down and press it again to slow it down once you see milk.  It should take no longer than 15-20 minutes each expressing session
• If your baby is up to 6 days old or you are struggling with milk supply, then use the initiate programme. Place nipple shield central to nipple ensuring a good seal and turn pump on. Immediately press the button on the right and the pump will do an automatic 15 minutes programme of fast pumping, slow pumping and pauses

On discharge, please make sure you have a freezer pack if you want to take your milk home. Milk should be transported immediately to home fridge / freezer. If a cold environment has not been maintained, then milk must be discarded. Any milk left behind will be discarded.

Home loan pumps

We have a small number of home loan pumps for mums who are not able to stay with their baby.  You must fulfil the criteria for this and if you loan one this must be returned before discharge or if it is no longer required. If you require more information, ask your nurse to do a referral to the infant feeding team.

Breast pump rental

To hire a Medela breast pump call 0161 776 0400 and quote code NICU 35.

Non-nutritive sucking

If a baby is nil by mouth, you may be able to enjoy non-nutritive sucking by attaching your baby to the breast after expressing. Your baby’s medical/surgical team should be consulted before non-nutritive sucking takes place. Place baby to the breast and allow the baby to attach to the breast for comfort. You can also do this if your baby is receiving expressed breast milk via a nasogastric tube to ensure their sucking pattern is maintained.

Skin to Skin contact (Kangaroo Care)

Skin to skin contact has many benefits. It helps with milk supply, is good for brain development, helps boost your baby’s immunity and helps you and your baby to bond. Although your baby may be too sick to breastfeed, place them close to your nipple and let them nuzzle you so they can smell your milk. Place your baby in their nappy only onto your chest. You can do this under a loose shirt or nightdress, so they can be snuggled inside your clothing.

Introduction of solids

The World Health Organisation recommends exclusive breastfeeding for 6 months and then continuing breastfeeding for as long as you can, whilst introducing solid foods. There is no need to rush. Go at your baby’s pace and ask staff to help you making healthy choices from our menus if you need help. The benefits of breastfeeding/breast milk feeding will continue long after you stop so keep going for as long as you and your baby want to.

Looking after yourself

We understand that being in hospital is stressful, but try and get as much rest as possible. Your meals will be provided when you are breastfeeding or expressing, if you are resident with your baby and your baby is up to 6 months old. Only breastfeeding mums on the following wards will be given a voucher to eat in the treetops restaurant; 1C, ED, EDU/PAU and Critical Care. This voucher entitles you to cereal and/or toast for breakfast and a hot or cold meal at lunch and dinner time plus a hot drink with meals.  At weekends, please ask for 2 vouchers at lunch time and get a snack for dinner as the restaurant closes at 2pm.

Smoking

Your breast milk will contain nicotine if you smoke and is not advised whilst breastfeeding. However, the benefits of breastfeeding for smokers are still greater than formula feeding. Smoking increases the risk of cot death (sudden unexpected death in infancy – SUDI) regardless of feeding method. Smoking only after feeding and away from the baby will limit the baby’s exposure. For support and advice for quitting smoking see your GP.

Medications

Tell your baby’s nurse / pharmacist about any medications you plan to or are taking.  Most medications are safe to take when breastfeeding.

It is recommended that all lactating mothers take 10 mcg vitamin D supplement daily.

Midwife visits

The midwife clinic is on Tuesdays and Fridays and you will be offered an appointment by the volunteer team if your baby is up to 28 days old.  If you need to see a midwife on other weekdays then ring Sycamore Midwifery Team on 0151 702 4175 or 0151 702 4177.For all out of hours emergencies please ring Liverpool Women’s Hospital on 0151 708 9988 and ask to speak to a midwife.  Do not take your baby to the visit.

GP appointments

If you do not live local you can either do an econsult/phone consultation with your own GP or register as a temporary resident at Knotty Ash Medical Centre on 0151 228 4369.

Support groups

Information and contact numbers for local / voluntary breastfeeding support groups, peer support service and counsellors is available by visiting www.amazingbreastmilk.nhs.uk or by calling the National Breastfeeding Helpline on 0300 100 0212.

There are useful apps such as Better Health:Start for Life.  You are welcome to access any external services whilst you are an inpatient also.

The following Support Groups are available:

Liverpool BAMBIS – 0151 233 6874 or facebook: Liverpool Community Bambis

Knowsley Bosom Buddies – 0151 244 3269 or www.knowsleyccns.co.uk

Sefton Breastfeeding Support – 0151 291 8010 or facebook: Breastfeeding Support Sefton

If your baby was delivered at the Liverpool Women’s Hospital and is up to 6 weeks old you can call their Infant Feeding Helpline on 0151 702 4293 and arrange an appointment if required.

Whiston Hospital holds an infant feeding clinic for babies of any age. Call 0151 290 4166 for information.

References

1. Bliss (2002) The Best Start, A guide to expressing and breastfeeding your premature baby.

• World Health Organisation (1998). Evidence for the Ten Steps to Successful breastfeeding. Geneva. http://www.who.int/nutrition/publications/evidence_ten_step_eng.pdf

• Department of Health (2012), Off to the best start. Important information about feeding your baby. https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/leaflets-and-posters/off-to-the-best-start/

• World Health Organisation (2014) http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/

• The Breastfeeding Network (2013), Introduction to the safely of drugs passing through breast milk https://breastfeedingnetwork.org.uk/wp-content/dibm/introduction%20to%20the%20safety%20of%20drugs%20passing%20through%20breastmilk.pdf
• First Steps Nutrition Trust First Steps Nutrition Trust

This fact sheet only gives general information.  You must always discuss the individual treatment of your child with the appropriate member of staff.  Do not rely on this leaflet alone for information about your child’s treatment.  

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

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