Breast milk adapts and changes according to your baby’s needs and the environment you find yourself in. It often does so without you even noticing, until you find that your baby’s feeding patterns have changed or notice that your milk has suddenly become very watery when you express.

As we move into the summer months, I am frequently asked whether breastfed babies should be supplemented with water and how to manage breast feeds when babies seem to want to feed a lot more frequently. Here are a few pointers to consider.

• Breast milk is primarily made up of water with other components suspended in it. When your baby feels hungry, he will ask for milk and when he is thirsty, he will also ask for breast milk.
• You may find it helpful to keep a note of a three hourly rhythm when you offer him a big feed, maybe from both breasts if he will have it. If he asks for milk in between the three hourly feeds, consider this as a drink of water, rather than a full feed and offer him milk again when his next three hourly feed is due.
• If you do this and find that his poops turn spinach green, feed from one breast at a feed (let’s say the right breast at 7am). If baby needs another feed or drink before the next feed is due, offer him the same side you fed from (i.e. the right breast). When the next feed is due (let’s say at 10am), offer him the second side (left breast) and if he needs a drink before the next feed is due at 1pm, only offer baby the left side.

Ensure that you are maintaining your fluid intake so that you too are well hydrated. In doing this, you will be able to provide enough fluid rich milk to keep your baby hydrated, so that you can both enjoy the summer.

We believe that information and education leads to a great breastfeeding experience. If you are having a baby in July, come and join us for a fun, friendly and intimate breastfeeding workshop.

We only have 4-6 mums per class which allows for plenty of discussion time and a chance to address individual concerns.

Our workshop is truly unique and the perfect preparation for breastfeeding your newborn.

For more information see our workshops page

Breast milk is perfectly designed for your baby. Even from the very beginning, your body will provide everything your baby needs, starting with colostrum.

To you and I, the tiny amounts of colostrum seem far too little to satisfy the needs of a new baby. However, the composition and volume are perfectly suited to your baby’s needs and will begin to change as your baby’s needs change.

Why should your baby have tiny droplets of colostrum rather than a full bottle of formula after birth? Here are three reasons to consider.

• Your baby has a tiny tummy.
  As adults we forget how small a baby’s tummy is. Our idea of what a ‘good size feed is’ is often a lot more than our baby needs. When your baby is born his stomach capacity is only 4ml – 7ml, about the size of a marble or hazelnut. It is helpful to bear this in mind in when you first start nursing your little one.
• Colostrum is perfectly designed to meet your baby’s needs.
  Even just a tiny amount of colostrum is packed with everything your baby needs and is designed with your baby’s anatomy in mind. It is so concentrate and packed with goodness that your baby will receive anti-infective properties, growth promoting components, enzymes designed for an immature needed for digestion and so much more in a feed of only 2ml -20ml in the early days.
• Your baby’s systems are still very new and immature.
  Your baby’s digestive system and kidneys aren’t designed or ready to cope with large volumes of fluid until later on. For the first three days of your baby’s life, he may only need between 2ml – 30ml at each feed and this is in line with the growth of his tummy capacity.

Mother’s milk is perfect for your baby. It changes in volume and composition as your baby grows to meet your baby’s growing needs. As your milk is so bio-available and readily absorbed, you will find that even small feeds satisfy your baby’s nutritional needs.

The long term health benefits of breastfeeding are well documented. We know that 13 weeks of breastfeeding will protect a child for 7 years against gastroenteritis and diarrheal disease , 15 weeks of breastfeeding will provide 7 years of protection from respiratory infections and umpteen other infections and diseases.

‘Researchers have shown that breastfeeding causes children to do better at school. The research conducted by Oxford University and the Institute for Social and Economic Research, Essex University, found that as little as four weeks of breastfeeding for a newborn baby has a significant effect on brain development, which persists until the child is at least 14 years old.’ PhysOrg.com

As breastfeeding is more likely to be practised by women of a higher IQ and higher social status, the researchers wanted to establish whether the relationship between breastfeeding and brain development was a direct result of breastfeeding or whether it was because women who breastfed would have more successful children anyway.

Breastfed and non breastfed children were matched as closely as possible on a number of characteristics, including age, sex, birth weight, family structure and looked at 12000 children born in Bristol in the early 90′s. Their parent’s attitudes to breastfeeding before birth were also recorded.

Test scores showed a significant difference between children who were breastfed matched with children who had not been breastfed. The children were tested 3 areas in reading, writing and mathematics at ages five, seven, 11 and 14 years old in this study.

Co-author Dr. Almudena Sevilla-Sanz, from the Department of Economics and the Centre for Time Use Research at Oxford University, said: “Comparing the test scores of groups of children matched in this way, we are effectively estimating the causal effect of breastfeeding. We find that breastfeeding does have a causal effect on children’s cognitive outcomes. The difference is statistically significant across English, maths and science scores, and persists into secondary school. Indeed, there is some evidence that the effect tends to grow over time.”

This study has not yet been peer reviewed.

Whilst the act of breastfeeding is an art and a skill which develops with a little practice, human lactation itself is such a wonderfully new and exciting science to be a part of.

A new study conducted by a team of scientists at Durham university lead by Prof Barton, have found a relation between the duration of breastfeeding and the size of the baby’s brain. It appears that the longer the baby breast feeds, the bigger the baby’s brain is.

“What we don’t know at the moment is if there is anything in mother’s milk that helps the brain to grow.”

The direct link between breastfeeding and brain size is not known and the scientists are not sure whether this new finding is due to nutrients of mothers milk but it certainly gives us more cause to encourage longer duration of breastfeeding where possible.

The study looked at a selection of 128 mammal species to determine whether there was a link between how much time was invested in the baby’s upbringing and the size of the brain. It found that the longer the gestation and the longer the duration of suckling, the larger the brain.

“In general terms it does support the idea that ‘breast is best’ and that the World Health Organisation’s guideline that you should breast feed for 18 months to two years are correct,” said Prof Barton.

I would be interested to learn whether this is linked to the act of suckling or whether it has to do with the composition of breast milk and how this is advantageous for breastfed babies.

Wouldn’t it be great if we could have our meals perfectly prepared to these specifications, taking into account calorie requirements and adjustments to warmer or cooler climates to ensure we remain hydrated?

Well, without much input from you, your body gets to work and produces meals to these specifications and higher at each breast feed.

Many new mums I speak to are concerned that they are not producing the right kind of breast milk to meet their baby’s needs. This is very unlikely and often all that is needed is a slight tweak here or there, to their feeding pattern.

I am surprised when these concerns arise even when babies are gaining weight well and piling on weight each week. The concern then becomes one of overfeeding. So, the question I pose is whether breastfed babies can be overfed and whether it is necessary to control their milk intake in order to prevent them from becoming too podgy?

It is well documented that breast milk is packed with benefits and one of the benefits of breastfeeding, is that your baby is able to decide when she has had enough milk. You may have been told that over-feeding a breastfeeding baby is pretty difficult, however it is possible, especially when mums have a fast flowing milk or quite a lot of it. Usually babies learn to cope with a fast flow or a high volume of milk, so it is not a problem.

Whilst not knowing how much milk your baby has actually had at one feed may leave you feeling a little uncertain when she pulls away from the breast after a very short feed, but evidence in the form of wet and dirty nappies and weight gain, will quickly reassure you that she knows what she needs and she will ensure that she gets it, provided she has access to the breast.

Soon your confidence will grow as you watch her more closely and respond to her cues. This is better than being guided by a chart on the back of the tin, which may suggest that your baby needs more than she really does. (if bottle feeding, give your baby short breaks after 30-40mls and allow her to decide if she would like more or not.)

Even if your breastfed baby seems to be piling on more weight than necessary, be reassured that studies comparing breastfed and formula fed babies, found that breast fed babies became ‘leaner’ sooner than formula fed babies.

Breast milk being tailor made to suit your baby’s individual needs, is more readily absorbed and therefore her tummy will empty sooner on breast milk feeds than formula feeds. So it is not surprising that a breastfed infant will want to nurse more frequently than a formula fed baby. Don’t restrict her feeds to reduce calories, she will only take what she needs.

Remember that you provide so much more than food to her. Suckling at your breast comforts and calms her, provides all the nutrients she needs and quenches her thirst.
If your baby is bringing up milk after feeds and your GP is happy that she is well and healthy, she may just be taking in more milk than she needs (maybe you have a fast flow or a lot of milk).

If your baby has unwittingly taken on more milk than she needs, it is not unusual for her to bring up the excess milk. Provided she seems comfortable once she has brought up milk, there is nothing to be concerned about.

If you are still feeling a little unsettled, speak to a breastfeeding counsellor about whether you are interpreting her cues correctly. It can be tricky to distinguish different cries in the beginning and this can lead to mums offering the breast more frequently that she needs.

Knowing how long your baby should feed for, will come with time and as you get to know him better. Whilst I appreciate that this is not a cut and dry answer, I feel it is important to acknowledge that all babies are different, milk volume available to baby varies during the day and lastly, that your baby will feed according to his needs, which may vary from feed to feed, just as our portion needs vary from meal to meal.

It is important to look at your baby, rather than watch the clock. Some babies who are efficient feeders, will take everything they need to in a small window of 5 or 10 minutes. Other babies made need to feed for considerably longer to get their fill at a 45 minute feed.

New babies have small tummies and are still learning the skill of breastfeeding which is why you may find that your little one nurses for longer periods in the early days and weeks. As his tummy gets bigger, he will be able to take in more milk at each feed and possibly go a little longer in between feeds.

Having free access to the breast will allow your baby to take what he needs when he needs it. This helps to establish a great milk supply and also encourages your baby to find his own pattern, rather than following a pattern an expert who doesn’t know him suggests. Be aware of your baby’s output in a 24 hour period. If you feel that your baby is not passing as much as you would expect, offer him the breast even if he isn’t asking. He can only say no so no harm done.

We expect breast fed babies to feed more frequently than formula fed babies as breast milk is more readily absorbed and digested than formula. A portion of breast milk is is half digested in a 48minute period whereas the same size portion of formula will take 78 minutes. (Cavell1981) Expecting a breast fed baby to follow a feeding pattern of a formula fed baby is not going to work, although I have met breastfeeding mums in my practice who have found that their newborns refused to eat frequently from a very young age, but still gained weight well. Babies are all different, so no one rule applies to everyone.

The suck swallow pattern of a baby is a great indicator of how effectively baby is drinking milk. The more your little one swallows, the shorter you can expect your feeds to be. The opposite is true too, if your baby has to suck for a period of time before a swallow, your feeds will naturally take longer.

If your baby is still young, you may find that he has a bowel movement during the feed. This is nothing to be concerned about and is simply a reflex stimulated by food entering your baby’s stomach. The valve between the small and large intestine open and leads to a rhythmic squeezing of baby’s gut and ultimately ends up as a bowel movement.

As your baby gets older, you may notice that bowel movements become less frequent and he seems to save them up for you. Remember to keep an eye on his urine out put and provided that is clear, you can be assured that he is well hydrated.

There are times when supplements are necessary and no matter how hard we try, we simply can’t ignore this fact. However, there are many instances when a new mum feels confused and worried about her baby and thinks that formula is the answer. Let’s explore some two common situations in which a mum may feel she needs to supplement soon after birth.

My newborn baby has jaundice
In order for your baby to effectively pass the excess bilirubin, she will need to have a number of bowel moments as this is how the body flushes it out. Naturally a mum who has not felt her milk come in will be concerned that her baby is not getting anything from the breast. Whilst this is understandably stressful, it is important to remember just how small your baby’s tummy is. Your baby really doesn’t need a large volume, just 1-2 tablespoons. Colostrum has a laxative quality which your baby needs in order to get rid of the bilirubin. Giving your baby formula in this instance is not going to help, as it takes a lot longer to digest. In fact, giving your baby formula may make matters even worse. (Bertini,2001; De Carvalho 1985)

My baby’s blood sugar levels are too low
Eeek, yes this could cause you to reach for the formula if you didn’t know that your baby’s blood sugar levels will naturally drop within the first 2-3hours after birth, as she doesn’t have the constant hit of glucose she received in the womb via the umbilical cord. Keep your baby close to you, preferably skin to skin and if she is not able to latch, hand express a little colostrum and even just rub that onto her lips. Breastfed babies are better able to cope with low blood sugar levels than babies who have had formula. There is no benefit to treating low blood sugar levels or hypoglycemia without symptoms with a formula top up (Boluyt, 2006) and simply giving a supplement routinely is totally unnecessary.(ABM,2006) In fact, I have found that when my clients are told to top up, it really affects their confidence and often leads to mums feeling the need to continue with top ups which in turn negatively affects breastfeeding long term.

Keeping your baby close to you soon after birth has so many benefits, which is why if you are reading this and have not yet had your baby, it is something worth remembering. When your little one is born, her gut system is sterile and she is only introduced to the bacteria in or on your body. If there is any harmful bacteria present and she is able to access the breast at will, she will receive antibodies through your colostrum.

This will help her regulate her blood sugar and get that all important hit of laxative she needs. If your baby is taken away from you, she will be introduced to unfamiliar bacteria and will not have access to the breast, as readily as if she were right next to or on top of you.

For some, it is easy to think of breast milk as just milk but it is so much more. It is a living fluid bursting with healing properties that no other substance can better provide for your baby. I am sure you have heard about many of the components of breast milk already, but I feel that it is important to realize just how important every drop of breast milk is.

Whilst breastfeeding comes easily for many mums, there are mums who struggle to nurse their little ones and often feel that moving onto formula will be a lot simpler. Well, this is not necessarily true. You see, the more breast milk your baby has, the better developed and stronger his immune system will be.

Your baby will slowly start developing immunity of his own, but whilst his little system is so new, he really relies on your breast milk to help protect him. As you live in the same environment and are exposed to the same bugs, you are best able to produce exactly what he needs at exactly the right time.

Think of it in a way that every time you give your baby breast milk, you are actually giving him a booster shot, a booster shot that will benefit him for life. The amazing thing is that this booster is constant, regardless of how high or low your milk supply is. As your milk supply decreases, the concentration of immune factors get higher, similar to levels found in milk just after birth.

It is therefore expected that the more breast milk your baby has, the healthier he will be. However, even if you have started supplementing, continuing with breastfeeding or expressing, will still benefit your baby. Breastfeeding is a great way to support the development of your baby’s immune system, until he is better able to produce more of his own anti-bodies.

It is for this reason that I feel mums who choose to breast feed for long periods, should be supported. Whilst we live in a first world country, have modern medicine and all the rest that people throw at them, breast milk continues to provide invaluable elements that no other food can.

“Women of the World – is a joyous celebration of the formidable strength and inventiveness of women – a pioneering, ground breaking annual festival, which will present, recognise and celebrate women, and act as a conversation space for issues of all kinds.”

The Women of the World festival hits the Southbank next week 11th March and it has reminded me of just how hard women have to work to get ahead. Jude Kelly took over as artistic director of London’s Southbank Centre 6 years ago in 2005 which some thought would never work. Jude has enjoyed a great deal of success but has also dealt with deep sadness. She is a mum of three and sadly lost a baby to cot death at 3 months, which was devastating. However, as Jude says – “You realise that you are not the centre of your own world . . . But I am rather anti the ‘look what’s happened to me’ thing.”

What I admire about Jude Kelly, is that she doesn’t give up on what she believes. Regardless of the put downs and sniping, she just got on with her job and turned it into something wonderful. She breast fed her little ones between meetings and rehearsals which is fantastic and is a testament to her dedication to getting and keeping the right balance between work and family life. Jude has a wonderfully supportive husband who rearranged his diary in order to help her juggle her different roles.

Not all mums have a husband or partner who can support them so brilliantly, which is why I believe that as women who understand the pressures of being a mum and wanting to do what is best, we should support each other. (Even from afar.)

I have had a stream of women question me about my choice to support mums, without bias, without judgement or prejudice. Doing some research, I am surprised that they can be so cruel, harsh as they genuinely seem like they want to support mums.

I wonder if they realise that they are not really attacking me (I sadly don’t have children – which again somehow makes them more self righteous because they do) but they are judging you – my clients, other mums, other women in the same boat as they are about the choices my clients make for their families.

Surely they can’t honestly think that their way of doing things is superior to the way that other mums do things – I mean, who are these women? What gives them the right to judge, rebuke and reprimand anybody who doesn’t agree with them?

Wouldn’t it be great if women could just enjoy one another’s company, individuality, achievements and support one another through tough times and heartache.

My hope is that women will support each other with love and kindness, regardless of their cultural practices or their lifestyle choices and that if they don’t have a good word to say – they will refrain from saying anything at all.

We are after all, doing the best that we can.

This coming weekend we celebrate women – we look forward to seeing you there!

For more information about Women of the World festival click here.