Breastfeeding - common concerns and questions

What if I don't make enough milk?

There are very few women whose bodies can't physically make enough milk for their babies if the baby is comfortably attached at the breast and feeding frequently when they want to. Twins and triplets can also be completely breastfed, though it helps to have another pair of hands in the house at first.

It is common for friends or relatives to relate anecdotes of 'not having enough milk' as a reason for switching to formula feeding, and many women in the past have themselves not been supported to breastfeed. Its normal for breastfed babies to want to feed frequently, in the beginning especially. They have small stomachs, breastmilk is very easily digested and this helps to keep them close to their mum. As they grow older they can be encouraged to go longer between feeds if that’s what you want.  Advice from a friend or relative may be well-meaning, but if you are worried about whether you are producing enough milk for your baby, it may be more helpful to check with a midwife or breastfeeding counsellor.

Read more here: 'what can I do if my baby is not getting enough breastmilk?' And 'What’s in a nappy?'

Breastfeeding to a schedule (rather than  to the baby's needs), restricting the length of  feeds andgiving 'top ups' with formula while breastfeeding can all lead to a reduction in the supply of breastmilk, especially in the first few weeks while your body is still getting used to producing the right amount of milk for your baby. Breastfeeding works on a demand and supply and system – read more.

If you don’t think your breasts can actually  produce enough milk, in the short or longer term, then you don't need to switch to formula if you still want to breastfeed. Your baby can have breastmilk and formula milk. Read more about mixed feeding.

I don't think I will want to breastfeed

If you’re not sure what you want to do, you can wait until your baby is born and see how you feel when you are cuddling your new baby. Your breasts will make colostrum – the special first breastmilk with extra antibodies and growth factors - for your baby anyway. You might decide to give this to your baby even if you don’t plan to breastfeed long-term or you might just take it one feed at a time. Your breasts will fill with milk about three days after your baby is born and breastfeeding will help you relieve the tightness.

Whatever your plans, cuddling skin to skin with your baby gives you the best time to get to know and bond with each other.

If you stop breastfeeding and start to give formula, it is possible to change your mind and start breastfeeding again but it can take time and patience. An NCT breastfeeding counsellor will be able to give you appropriate support (0300 330 0771).

For a very few women breastfeeding is not possible for medical reasons (usually surgery or severe illness). Other women don’t feel comfortable with the idea or, for personal reasons, do not want to do it. See information on formula feeding.

However, in this country most women find themselves using formula after having wanted to breastfeed because they have not had the support they need or they have been made to feel uncomfortable with the idea of breastfeeding, have been embarrassed or have had to feed their baby in private so they were isolated from other people.

I don't know if I will be able to breastfeed and continue my medication

If you need to take medication regularly you can find out about breastfeeding from your doctor or pharmacist while you are pregnant. You needn't assume that any medicine you need to take will stop you breastfeeding. Check with your doctor to see if your medications are safe while breastfeeding, or if not, if there is an alternative. Certain cancers and illnesses such as HIV will mean you may be advised not to breastfeed. Always check with a health professional; you can also download factsheets on drugs and breastfeeding from the Breastfeeding Network (see below).

Difficulties with breastfeeding

Some new mothers have a difficult time establishing breastfeeding or have a traumatic birth and are not well enough to breastfeed. Your midwife will be able to help you express milk or bring your baby to you for breastfeeds. If your baby needs special care, you can learn how to express milk until he is big enough to learn to breastfeed. You will need lots of support to do this, but many women have expressed milk for weeks or months and successfully gone on to breastfeed. Babies with cleft palate or lip, or tongue tie are also likely to have problems breastfeeding, but you can still  express milk, so that you can breastfeed when they are able to do so comfortably or combine breastmilk with formula if you want. BLISS is an organisation dedicated to helping parents of premature and special care babies. Whether you choose to express milk, or formula feed, you are entitled to good support.

What about negative feelings towards formula?

If you planned to fully breastfeed, you might feel unhappy about using formula, and even guilty or angry. You might think people are criticising you.
 
Or, you might not have planned to breastfeed at all. Regardless how you feed your baby, you are entitled to support, something most sensitive people understand. If you’re feeling concerned about using formula, share this with someone who can help you feel more positive. More on using infant formula.

Long term expressing

Some mothers decide for whatever reason not to breastfeed directly, but are still able to express their milk and feed it to their baby in a bottle. See the expressing milk section for more information.

Remember, you can put your baby to your breast whenever you want, even if you decide breastfeeding isn’t for you, and whether or not your baby actually breastfeeds; you can give your baby the closeness of skin to skin contact, and give the bottle like that, too.

You can call the NCT breastfeeding line on 0300 33 00 771 for support with any of these issues.

More resources:

See Breastfeeding Network for answers to frequently asked questions – breastfeeding and smoking, drugs and illness; http://www.breastfeedingnetwork.org.uk/faqs.html

Also you can download factsheets on medication, drugs and breastfeeding http://www.breastfeedingnetwork.org.uk/drugs-in-breastmilk-information-a...

Cleft lip and Palate association: information on feeding babies with cleft lip or palate.
http://www.clapa.com/

BLISS – charity supporting families with premature and special care babies. Information on feeding: http://www.bliss.org.uk

The Department of Health 'Feeding your baby' guide, available in hard copy or download from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/di...

NHS guidance on breastfeeding is available at www.breastfeeding.nhs.uk

Association of Breastfeeding Mothers: http://abm.me.uk/

Bump to Breastfeeding DVD: your midwife should be able to provide a copy for you to borrow, or go to www.bestbeginnings.org.uk