The Rotunda Hospital recommends breastfeeding because it is the best start in life for babies. We are accredited as a ‘baby friendly’ hospital, which means that we provide care, which is researched based and recognised as best practice, so that pregnant women and new mothers receive the support they need to breastfeed successfully.

We support informed decision making for women and we will support mothers whatever decision they make about feeding their baby. It is not necessary to make this decision until after you have held your baby skin to skin after birth. We recommend that you take the time to read through this section and discuss any questions you may have with your midwife or doctor.

You will hear lots of opinions and stories about other people’s feeding experiences. While much of the advice and information you get from friends and family will be very useful, some of it may confuse rather than guide you. In this section we aim to give you the information that you need to help you decide what is best for you and your baby.

If your baby is born prematurely or is unwell then it will be vital that you provide breast milk for your baby. You will be advised and supported by the midwives on how to establish and maintain your milk supply.

How breastfeeding works

The first milk your breasts produce is called ‘colostrum’. This milk is ideal for your baby for the first few days. It is made in small quantities so your baby will feed frequently, which is perfectly normal. The more your baby feeds the more milk you will produce. As well as providing nutrition for your baby,Colostrum contains large numbers of antibodies and an abundance of other molecules that helps your baby to fight infections. 

After about three days your breasts may become engorged. They may feel heavy and full. This is normal and is due to an increase in the blood and milk supply to your breasts. It usually settles within 24 – 48 hours with frequent feeding and if necessary by using cold compresses on your breasts between feeds. Sometimes when this happens you may have to hand express to soften the areola (area around the nipple) so that the baby can attach properly to the breast. 

When your baby is feeding effectively at the breast, at the begining of the feed the milk is higher in water and carbohydrate and lower in fat content. After the first “let down” and as the feed progresses the fat content increases. 

It is important that you don’t restrict how long your baby spends feeding. Babies will vary the length of their feeds. Just like us, they may fancy a quick snack or will want to settle in for a full three-course feast! Offer your baby the second breast when baby stops feeding effectively with long deep bursts of sucking and swallowing. Always offer your baby the second breast although they may not take it. Offering the second breast increases your milk supply. The more milk baby removes, the more milk you make. Throughout a breastfeed your baby’s sucking will send messages to your brain to ‘order’ milk for the next feed. 

If there is a medical reason why you cannot give your baby skin to skin contact immediately after birth, your partner can hold your baby skin to skin. If you have a caesarean section under general anaesthetic, skin to skin contact can start when you are alert and awake. Babies that require non emergency transfer to the neonatal unit will be given skin to skin contact and an opportunity to breastfeed before transfer. Babies requiring immediate transfer to the neonatal unit can have skin to skin contact as soon as their condition improves. 

Baby led feeding means that no restrictions are placed on the frequency or duration of breastfeeds for healthy babies. If there is a medical reason why your baby needs scheduled feeding, this will be discussed with you. Your baby is likely to want to feed frequently, and it is important that your baby feeds a minimum of 8 times in 24 hrs in fact your baby may want to feed  10 to 12 feeds  in 24 hrs,this is normal in the early days. 

Your baby will usually give you plenty of warning when they want food. 

Early signs to watch for are when your baby: 

• Eyes fluttering 
• Moving their hand to their mouth
• turns its head looking for the breast
• opens its mouth and puts out its tongue. 

After these early signs your baby may then start to: 

• make noises; 
• cry loudly. 

Responding to early feeding cues allows your baby to navigate and latch to the breast in a quiet alert state. When you see these early signs, it is a good time for you to prepare for feeding by going to the bathroom, have a glass of water at hand and make yourself comfortable. Babies cry for lots of reasons not just for feeding. In time you will recognise your own baby’s signals and what they mean. Sometimes to get your baby ready to feed you may have to calm and comfort them first. 

It is important that you find a comfortable position. If you are sitting down to feed, try to make sure that: 

• your back is well supported; 
• your lap is almost flat; 
• your feet are flat on the ground Or supported on a foot stool/other support; and 
• you have extra pillows to support your back and arms or to help raise your baby to the level of your breasts. 

Breastfeeding lying down can be very comfortable and handy if you have had a caesarean section and for night feeds. Lie on your side with a pillow supporting your head and back, with another pillow between your legs. Once your baby is feeding well, you will be able to feed them comfortably anywhere without needing pillows. 

Laid back feeding or biological nurturing is a lovely natural position that enables baby’s feeding reflexes to engage. 

feeds. Lie on your side with a pillow supporting your head and back, with another pillow between your legs. Once your baby is feeding well, you will be able to feed them comfortably anywhere without needing pillows

There are various ways that you can hold your baby for breastfeeding. Whichever way you choose, here are a few guidelines to help make sure that your baby is able to feed well: 

• Hold your baby close to you. 
• Baby should be facing the breast, with head, shoulders and body in a straight line. 
• Baby’s nose or top lip should be opposite the nipple. 
• Baby should be able to reach the breast easily. 
• Remember always to move your baby towards the breast rather than your breast to the baby. 

It is important to make sure that your baby latches onto the breast correctly, otherwise, baby may not get enough milk during the feed and your nipples could become sore. 

Position your baby with their nose or top lip opposite your nipple. Tease the baby with the nipple in a downward direction. Wait until the baby opens its mouth and guide the baby onto your breast so that its lower lip touches the breast as far away as possible from the base of the nipple. This way, your nipple points towards the roof of your baby’s mouth. In the laid back position there is very little guidance needed,a term alert baby navigates the breast instinctively in this position. When your baby is properly attached to the breast you will notice that:  

• your baby’s mouth is wide open and they have taken a big mouthful of breast tissue; 
• Your baby’s cheeks are full 
• your baby’s chin is touching the breast; 
• your baby’s bottom lip is curled back; 
• feeding should not hurt you; 
• if you can see any of the areola (the brown skin around the nipple) more should be visible above the baby’s top lip than below its bottom lip; and 
• your baby’s sucking pattern will change from short sucks to long deep sucks with pauses. 

Feeding should not be painful. If you feel some tugging when the baby first attaches to the breast, this sensation should fade quickly and then the feeding should be comfortable. 

If it is uncomfortable throughout the feed, this can mean that your baby is not attached properly. Remove the baby from the breast by: 

• placing the tip of your little finger into the side of the baby’s mouth so that the suction is broken. 

You can then help your baby to reattach correctly. If the pain continues, ask a midwife for help. 

• You and your baby will have skin to skin contact after birth. This is a great opportunity for your baby’s first breastfeed. 
• ‘Rooming in’ is hospital policy. This means that you keep your baby near you throughout your stay in hospital so that you get to know your baby and their feeding cues. 
• Good positioning and attachment. 

The midwives will assist you with breastfeeding while you are in hospital. Make sure that a midwife checks that your baby is positioned correctly and is well attached to the breast during your stay in hospital. The lactation midwives are available in the hospital Monday to Friday. The midwives on the wards will contact them if special assistance is required. Once you are discharged from hospital you may ring the lactation midwives for support by phoning 01 817 1700 or you may attend the breastfeeding support group sessions held weekly. 

Responding to baby’s feeding cues is critical to long term milk supply. Responsive feeding also helps your baby to feel secure and has positive effects on their long term eating behaviours. 

Babies feeding patterns vary enormously and it is normal for them to feed very frequently in the first few weeks. If you just feed your baby whenever they are hungry, you will produce plenty of milk to meet their needs. This is called ‘demand’ feeding. Each time your baby feeds, messages are sent to your brain, which then sends signals to your breasts to produce more milk.  

If your baby does not breastfeed at least eight times in 24 hours, you may notice that you do not produce enough milk to meet your baby’s needs. Therefore, whenever your baby is hungry put them to the breast. If your baby has been fed and is still unsettled, check if the nappy needs changing or if your baby just wants a cuddle or to be soothed. If none of these settle your baby then offer them another breastfeed. 

More feeding = more signals = more milk 

Each time your baby feeds, the milk supply is being built up. While your baby is learning feeds may last quite a long time. Many mothers worry that frequent feeding means that they do not have enough milk to feed their baby. Providing that your baby is properly attached to the breast, this is very unlikely to be the case. Ask the midwife if you are unsure. Once you and your baby are used to breastfeeding, it is usually very easy. The milk is always available at just the right temperature. In fact, there is really no need to think about it at all. Your baby lets you know when it is time for the next feed. 

How do mothers know if breastfeeding is going well?

Breastfeeding is going well when your baby: 

• is alert and waking for feeds; 
• has a minimum of six wet nappies, yellow and seedy in consistency, and four soiled nappies every day after the first week; 
• is gaining weight after the first week; 
• settles and sleeps between feeds; and 
• your breasts or nipples are not sore. 

It is important that you rest, eat well and drink for your thirst. Avoid alcohol and limit how much caffeine you take in drinks like coffee, cola and tea. 

Breastfeeding is nature’s way of making you take it easy for the first few weeks after the birth. This is good as your body undergoes huge changes in the days following the birth and lots of rest will help you to recover. 

Try to have as much help around as you can. If you have other children, arrange relatives and friends to help you with them. 

Your partner will have the job of caring for you while you feed your baby. They can spend plenty of time with your baby between feeds while you are resting. 

There will be no shortage of nappies to change or cuddles to give your baby. It is a good idea to have the freezer stocked with meals and foodstuff before the baby arrives making it easier for you and your partner. 

While you may be excited to introduce your precious new baby to all your family and friends it is actually a good idea to keep visitors to a minimum for the first week or so. Newborn babies do not like being over-handled and can become upset and fretful if passed from one person to another.