Introduction

How to feed your baby is one of the most important decisions you will make once they are born. We will provide you with support to feed your baby irrespective of the method you choose.

You can also find breastfeeding and bottle feeding advice on the NHS website.

Our Health Visitor Teams Commitment

Our Health Visitor teams wish to make sure that all parents have the right information and knowledge regarding infant feeding.

If you are a parent reading this we guarantee that our Health Visiting staff will support you in your choices. We are however mindful of the large quantity of research that confirms that breastfeeding is the healthiest way to feed your baby. We recognise that breastfeeding is much more than food. Your milk is unique and changes during each feed, with the time of day, your diet and the baby’s needs and protects and comforts your baby. We therefore will encourage you to breastfeed your baby.

How will we support you

• During your pregnancy, you will be able to discuss breastfeeding individually with your health visitor.
• All our staff have been specially trained to help you breastfeed your baby.
• A Health Visitor will be available to give additional advice if problems occur.
• We will show you how to express your milk by hand and will provide written information to help you.
• We will encourage you to keep your baby close to you or your partner, relative or friend whenever you can. We will also support you to manage night feeds.
• You will be encouraged to feed your baby whenever your baby seems to be hungry. We will show you how to tell if your baby is getting enough milk.
• We recommend that you avoid using bottles, dummies and nipple shields while your baby is learning to breastfeed as this can confuse your baby and interfere with your milk supply.
• We will inform you that most babies do not need anything other than breast milk until they are six months old. If your baby needs other food or drink before they are six months old, we will explain the reason for this.
• We will help you to recognise when your baby is ready for other foods (normally at about 6 months) and explain how these can be introduced safely.
• We welcome breastfeeding within all of our premises. We will give you information to help you breastfeed when you are out and about.
• We will give you details of breastfeeding helplines and support groups.

Breastfeeding your baby

Breastfeeding is the healthiest way to feed your baby. Exclusive breastfeeding (giving your baby breast milk only) is recommended for around the first 6 months (26 weeks) of your baby’s life. After that, giving your baby breast milk alongside other food will help them continue to grow and develop. Breastfeeding also has lots of health benefits for mums.

Breastfeeding helps protect the baby against:

• asthma
• breast cancer
• coughs
• diabetes
• severe diarrhoea and vomiting
• chest infections
• eczema
• sudden Infant Death (cot death)
• syndrome Ear infections
• obesity

Breastfeeding also protects mums from ovarian cancer, osteoporosis (weak bones in later life) and obesity (helps you lose weight).

What should I do if I am concerned

We have specially trained Health Visitors who are available to assess your babies feeding and if necessary offer this procedure. Please seek information from your Health Visitor if you wish to be referred for this assessment.

In summary, we believe that breastfeeding is the healthiest way to feed your baby, with important benefits for both mother and baby. We are therefore committed to offering you the support that you require to feed for as long as you wish to.

Breastfeeding volunteer support

We launched a volunteer support scheme in November 2016. The volunteer supporters recruited are mothers of any age who have breastfed their own babies or are still breastfeeding and want to support other mothers to have a positive breastfeeding experience.

Following routine DBS checks, the volunteers will support groups with their local Health Visitors. Our volunteer colleagues will support the encouragement of breastfeeding and improve the sustainability of feeding, they have the unique quality of being able to relate to mothers from a similar community, culture and values set. We are hoping that they will also provide evidence based information and research which enables mothers and families to make a fully informed choice about how they would like to feed their babies. Training is offered to these colleagues on an annual basis by the Health Visiting Service.

We are keen to promote volunteers working alongside our service to support infant feeding because we are aware that:

• evaluation shows breastfeeding volunteer support is valued by new mothers, increases breastfeeding initiation and continuation and builds social capital
• volunteer supporters provide a valuable role in helping mothers to make informed decisions about feeding their new baby and continuing to breastfeed for as long as they want
• volunteer support can succeed in reaching women who do not easily identify with health professionals
• volunteer supporters who have accessed training are women who have experience of breastfeeding, giving them a ‘belief’ in breastfeeding which helps them to motivate and encourage new mothers
• there are benefits to the women who train as volunteer supporters as well. Evaluation shows they grow in confidence, often going on to further training and new careers.  This helps build social capital with women bringing new skills back to their communities
• volunteer support plays an integral part in building community capacity and helping communities become supportive of breastfeeding
• volunteer support can also help towards the attainment of UNICEF Baby Friendly Initiative accreditation

We feel that Volunteer Supporters are uniquely positioned to give brief interventions and signpost women to other important services. For example smoking cessation, healthy lifestyles support and domestic abuse support. The programme will also help reduce social isolation and offers parents an opportunity to socialise and exchange experiences.

If you are interested in joining this programme please contact your local Health Visitor.

Somerset Positive About Breastfeeding Award

Somerset Positive About Breastfeeding Award is being given to venues that have made a significant commitment to uphold the rights of mothers by supporting their choice to feed their babies how and wherever they choose. Find out more about Somerset Positive About Breastfeeding on the Healthy Somerset website.

Frenulotomy (Tongue tie division)

Tongue-tie (also known as ankyloglossia) is caused by a tight or short membrane under the tongue (the lingual frenulum). The tongue tip may appear blunt or forked or have a heart-shaped appearance. The membrane may be attached at the tongue tip or much further back. Sometimes it is difficult to see a tongue-tie but it can be detected by feeling the floor of the baby’s mouth with a finger. There is often a family history of tongue-tie. It is thought that as many as 1 in 10 babies are tongue-tied, with half of those likely to have feeding difficulties.

Feeding problems caused by a tongue-tie

Most babies have no feeding problems at all – others may be helped by optimising the baby’s latch on the breast with specialist help. There seems to be no correlation between the severity of the tongue-tie and the effect on feeding.

The effects on feeding for the mother may be:

• sore and damaged nipples
• misshapen or discoloured nipples after a feed
• recurring mastitis
• reduced milk supply
• distress due to frequent feeding
• inability to establish breastfeeding

The effects on the baby may be:

• difficulty maintaining a latch on the breast and coming on and off and being unsettled during the feed
• ending the feed due to exhaustion but wanting to feed soon after
• clicking noises during the feed
• weight loss or slow weight gain
• colic
• wind

Many babies will manage to bottle feed but some also have difficulty with a bottle with dribbling and spurting milk out from the sides of their mouths.

Tongue-tie treatment

Treatment is not necessary if your baby has a piece of skin connecting the underside of their tongue to the floor of their mouth. They can feed without any problems.

If feeding is affected, the tongue-tie needs to be divided.

Tongue-tie division

Tongue-tie division involves cutting the short, tight piece of skin connecting the underside of the tongue to the floor of the mouth. It’s a simple and almost painless procedure that usually resolves feeding problems straight away.

The National Institute for Health and Care Excellence (NICE) supports the use of tongue-tie division. It is safe and there is evidence it can improve breastfeeding.

Weaning your child

• Weaning from 6 months: NHS – Your baby’s first solid foods
• When to weigh: NHS – Your baby’s weight and height
• Portion sizes for toddlers: Infant and Toddler Forum – Portion sizes for toddlers