Antenatal Breastfeeding Information

Making a decision about how to feed your baby can be complex, as it is not uncommon to hear alarming stories about breastfeeding from well-meaning family and friends.  At The Royal Surrey we recognise how difficult this decision can be and want to do our very best to support you in your chosen method of feeding.

To make a decision it is helpful to have some facts:

Breastfeeding is best for you and your baby.  You may have heard this before but do you know why it is best?

For you:

  • It changes your metabolism so the weight that you put on in pregnancy will begin to be used to feed your baby.
  • Reduces the risk of developing breast cancer and ovarian cancer.
  • Reduces the risk of hip fractures in later life.
  • Reduces the risk of heart disease
  • Helps your womb go back to its normal size
  • The hormones involved with breastfeeding help you cope with less sleep and helps you get back to sleep quicker at night.

For your baby:

  • It provides the ideal environment for the colonisation of healthy gut flora in the bowel. If there is a healthy colonisation of bowel flora the child and subsequent adult will be healthier.  The foundations of health start at birth and the following few days and it reduces the chance of your baby being admitted to hospital.
  • Less allergies and increased immunity to infections.
  • Reduces the risk of tummy bugs, chest infections, ear infections.
  • Helps to prevent obesity.
  • Helps to protect from childhood cancers.
  • Reduces the risk of your baby developing diabetes and heart disease in later life.

Breastfeeding is so much more than the deliverance of food, it provides all the calories your baby will require for the first 6 months of their life and all the hydration that will be needed, even if its hot weather.  Breastmilk has natural beta endorphins in it which act as a pain relief.  This can be useful for your baby after birth to soothe any discomfort they may have and later when they have just had their vaccines.  Breastfeeding is an excellent way of comforting an unsettled baby and the beauty is it is not possible to over feed a breastfed baby.

The World Health Organisation recommends exclusive breastfeeding for 6 months.

Any colostrum or breastmilk, even if just a few small drops, is amazingly beneficial and should be celebrated.

Formula milk is mainly made from cow’s milk and often lists milk, egg, fish and soy in the ingredients.  The early introduction of cow’s milk protein can be linked to allergies and to a change in gut bacteria as the gut pH becomes more alkaline.


What you can do to get breastfeeding off to a good start?

Develop a relationship with your baby

bumpBy taking time to think about your baby, talking to him or her, noticing when he or she moves will help you to form a relationship with your baby before birth and help you to be responsive to their needs once born.  When born your baby will probably show the same wakeful periods as when you were pregnant and its probable this will mean your baby will feed more frequently at night than during the day in the early weeks.  Your baby will begin to hear from quite early on in your pregnancy so encourage your partner and any siblings to talk to your baby as well so that all the family build a connection.

Research shows that the way a baby is parented has a long-term impact on their development.  When babies are brought up in a loving, nurturing environment they are more likely to become confident and secure adults.    Being Responsive to your baby’s needs and allowing your baby to have lots of cuddles for closeness, comfort, reassurance and love will not make a spoilt or clingy baby but rather a happy and secure baby.

Skin to skin

Here at the Royal Surrey County Hospital we encourage every new baby to have skin to skin as soon as possible after birth and in the earlyskin-to-skin few days and weeks.

Your baby’s only fully developed sense at birth is their sense of smell.  Your baby has been bathed by their amniotic fluid for nine months and knows the smell of this fluid very well. Skin to skin after birth allows your baby to “stamp” you as mummy and the sticky substance on their skin (vernex) encourages some of your skin flora to stick to their skin, this allows your skin flora to begin to colonise their skin.  This is extremely important as the skin is our first line of defence against infections.

The other benefits of skin to skin are:

  • It keeps your baby warm
  • Regulates your baby’s breathing and heart rate
  • Reduces your baby’s need to use their brown fat reserves to regulate themselves
  • It is a place of safety for your baby helping to muffle sound and light
  • Helps to stimulate natural breast seeking behaviour
  • It is amazing for bonding and attachment as there are oxytocin receptors on our skin. Oxytocin is the hormone of love.  Gentle touch and massage increase the levels of this hormone. If there are high levels of oxytocin there will be low levels of adrenaline as the two counter balance each other.  Adrenaline is produced when a person is stressed and so doing this will reduce stress for your baby.  Adrenaline and its by product cortisol in high levels have been shown to inhibit brain development.

After the first feed your partner can enjoy skin to skin too, it can be useful to pack a loose button up shirt to aid this.


Rooming in

On the postnatal ward we encourage you and your baby to stay together unless a medical need means your baby is on our Special Care Baby Unit (SCBU).

By staying near your baby:

  • Your baby continues to build up immunity against any new infections.
  • You will learn and have the opportunity to act on your baby’s early feeding cues.
  • Your baby feels safe near you
  • Allows for responsive feeding.

Responsive feeding

Responsive feeding ….what does this mean? Responsive feeding is acting on your baby’s hunger cues, rooting, head bobbing, sucking on hands or fingers (not waiting for crying) or/and you responding to your own needs i.e. if your breasts feel full or you would like to rest….in other words it’s a reciprocal relationship.

Responsive feeding is about encouraging and developing a relationship between you and your baby.  The breast should be offered at times of distress as well as at times of hunger.  It enables your baby to reconnect with you and gather itself in a safe and familiar place and feeding will enable you and your baby to relax.

Please be aware that it is not possible to over feed a breastfed baby and it is always appropriate to offer the breast. Responsive feeding is for both breastfeeding and bottle feeding babies.

A baby is born with a very small tummy and only requires frequent, small feeds.  In the first 24 hours some babies look to feed regularly and others less so.  Offer your breast regularly and if you baby does not look to feed hand express drops of colostrum onto their lips.  Colostrum is very high in sugars and by regularly dropping drips on to your baby’s lips your baby will not need to use their brown fat reserves. Below shows the average size of a baby’s tummy in the first few days.  It shows that it is not necessary for your baby to have large amounts of milk and its ok for the stomach to naturally stretch over a few days.


After the first 24 hours you baby should feed a minimum of 8 to 12 times in 24 hours varying in length between 20 and 40 minutes.

Day 2:  This is often the day when your baby looks to feed frequently, particularly at night.  Your milk will be beginning to come in and your baby can taste the difference and so instinctively knows to stimulate your breasts so your milk comes in fully.  Night feeds are very important to ensure a good milk supply as your hormones are higher at night.

The regular feeding can lead to worry that your baby is not getting enough.  Be reassured your baby is on a mission to get your milk to come in and by feeding frequently there will be no need to give your baby any other milk.  The maternity staff are there to support you.

Day 3 to 4: Generally your milk will come in today, your breasts will feel full and hot and your baby may find it harder to attach your baby to the breast. Feed regularly today and if your baby is struggling to attach hand express some milk to soften your breasts. Your breasts are at their fullest on day 5 and then begin to adjust to your baby’s needs.

Your baby will require no other fluid other than breastmilk for the first 6 months even if it is really hot outside.  Your body is very clever and will adjust according to your baby’s needs.

Attachment and positioning

Once you have had your baby the staff on the wards will teach you how to position your baby to the breast and show you how to recognise the feed is going well.

Good positioning and attachment is very important to ensure that your baby feeds well, is able to stimulate your breast and remove the milk but also to ensure your nipples don’t get sore.  It is not normal for breastfeeding to hurt.


Hand expressing

Hand expressing can be practised whilst you are pregnant and is an excellent way of getting breastfeeding off to a good start.  Hand expressing can be used to feed your baby drops of colostrum if they are sleepy in the first few days, will help soften your breasts once your milk comes in and can help to soften lumpy areas of the breast if there is a blocked or over full duct.  If you ever have worries about breastfeeding or want to give your baby a little more milk hand expressing can be a cheap, easy and quick way of doing this.

For a video clip see

hand-expressingThe Royal Surrey County Hospital runs a colostrum harvesting clinic every Thursday afternoon 2.00 to 4.00 pm in the parentcraft room.  This is a drop-in service and is aimed at supporting those who would like to have some more information on collecting and storing colostrum for when their baby arrives.

Colostrum harvesting can be really useful.  Expressing colostrum during pregnancy could lead to an increased supply once your baby is born, give you some reserves to keep in the freezer and research shows those who have tried hand expressing in pregnancy are more likely to have a positive breastfeeding experience.

Please read this leaflet on Antenatal Hand Expressing

If you have ANY questions on feeding your baby please ask a member of staff or see your community midwife.

For more information about breastfeeding:

Antenatal Breastfeeding Class

In the Parentcraft Room, Royal Surrey County Hospital

2nd Wednesday of each month from 13.30 to 15.00


4th Wednesday of each month from 19.00 to 20.30

After birth the RSCH runs two Breastfeeding Drop-ins to support breastfeeding.

9.30 to 11.30 Monday at Hazel Avenue Childrens Centre, Guildford.

10.30 to 12.00 Wednesday at RSCH, Parentcraft room.

©2018 Royal Surrey County Hospital

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