“Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby.” – La Leche League International
Nature intended mothers and babies to stay together as much as possible because breastfeeding is the normal way to care for a baby – providing him with the comfort and security of his mother’s presence as well as with milk. It also helps protect him from any infections he may come into contact with. Babies and separation
“In the early years the baby has an intense need to be with his mother, which is as basic as his need for food.” – La Leche League International
A breastfed baby’s ‘primary attachment figure’ is likely to be his mother. Separation from her will be distressing for him unless he is in the care of another person with whom he has already formed an attachment, such as a family member or friend. Being left with a stranger, however kind and caring that person may be, is frightening for a young child. Many babies and toddlers show distress at separation by becoming upset or misbehaving. Others become quiet, withdrawn or may sleep a lot.
It’s important to know that a quiet baby is suppressing his emotions and is in need of intensive care and attention just as much as a baby who cries or protests his distress. These behaviours are less likely when a baby knows and trusts his carer. Before a baby you will be caring for is left with you, allow as much time as possible for him to form an attachment to you whilst still in the presence of his mother. Once the baby has got to know you, the next step could be you caring for him for a short time and, when he is comfortable with this, long enough for him to be offered a single feed. A breastfed baby is more likely to allow someone else to feed him if his mum isn’t present.
Try to keep separation as short as possible at first, especially for a very young baby. It helps if the baby’s mother can nurse just before she leaves and immediately she returns. A full baby and comfortable breasts make for a good start. Avoid offering a large amount of milk or other foods shortly before a baby’s mother is due to return – a mum will probably need to feed her baby as soon as she arrives if her breasts are feeling full. Breastfeeding is the perfect way for mother and baby to reconnect after time apart. There are huge benefits if a mother can see and nurse her baby part-way through longer separations. For the mother, it reduces her need to express milk while she’s away and she may not leak as much. Her baby will benefit from contact with his mum and need fewer feeds while he’s with you, making looking after him easier.
Breastfed babies are often very good at moderating their intake of food and drink and not taking more than they need. A happy baby is more likely to take any food and drink that is available than go hungry or thirsty. If a baby is eating solid foods, this will help if he is reluctant to take much expressed breastmilk. Many foods contain water, especially fruits. It’s also possible to offer expressed milk mixed with solid foods. Some babies are happier to take a drink if it is given with solids, so a drink with a small snack may be an option in between mealtimes. Bear in mind that current guidelines recommend that healthy full term babies are not offered solid foods until around six months of age. Nowadays mothers often allow their babies to feed themselves instead of spoon-feeding them.
Breastfed babies often fall asleep at the breast, and may find it difficult to go to sleep alone. Mothers may encourage their babies to sleep when they need to rather than having set times for naps. Being cuddled and rocked, carried in a sling or perhaps taken for a walk in a pushchair can help a baby ease into sleep when he’s showing signs of tiredness.
A baby can be offered breastmilk in several ways depending on his age, what he finds comfortable and his mother’s preferences. Many breastfed babies never have a bottle – even when separated from their mothers.
A mother’s own milk is the best possible food to help her baby grow and develop and is full of antibodies, live cells, and other substances to protect him from infection. Expressed breastmilk is remarkably resilient and stores well due to its antibacterial properties. Comprehensive information on how to store breastmilk is available on our page here.
Using either an open cup or a baby beaker with a simple spout (no valves) is an option for a baby from three months old. A younger baby can be fed his mother’s milk using a small flexible plastic cup, medicine cup or spoon filled half-full. Swaddle the baby in a blanket if needed and hold him upright in your lap. Rest the cup gently on his lower lip and tip it so a small amount of milk touches his lips. This will encourage him to extend his tongue to lap the milk. Don’t pour milk into his mouth. Leave the cup in position as he swallows, then offer again. Let the baby set the pace, lapping the milk. An oral/medicine syringe (ask for one in your local pharmacy) can also be used to drip milk slowly into his mouth just inside his lower lip or gum, so he has chance to taste then swallow without choking.
It’s difficult to determine how much milk to expect a breastfed baby to take when separated from his mother. Much will depend on his age, how well-fed he is beforehand and for how long he is left. If you care for a baby regularly you will soon get a good idea of how much he usually takes. There’s evidence that fully breastfed babies require less milk than formula fed babies—as much as 25% fewer calories at four months. Most breastfed babies take between 60–120ml (2–4oz) about 8 to 10 times per day. It’s unlikely that a breastfed baby would take 240ml (8oz) of breastmilk at one feed. It can be useful to tell the mother how much milk the baby takes so she can leave enough milk next time. Don’t be surprised if the baby doesn’t drink much milk whilst in your care. A baby may adapt to his mother’s working hours, taking very little milk from his caregiver and then nursing very frequently when his mum is around and this is perfectly normal.
If you’re used to feeding babies to a routine, learning about feeding cues may help. Fussing, rooting and fist sucking are all early signs of hunger. A nursing baby is used to feeding frequently so offer his mother’s milk quickly, before he gets frantic with hunger—little and often works well for most breastfed babies.
A nursing mum and baby will find it hard to be apart from one another. The separation will be so much easier on both if the baby has formed an attachment to you and his mother knows she can trust that you’ll do your best to meet his needs whilst she’s away.
If the baby’s mother leaves powdered infant formula, you need to follow NHS guidelines for its preparation carefully, as it is not a sterile product. The NHS leaflet, Bottle feeding, provides information on making up each formula feed fresh using water at 70°C. Cool the bottle of formula to body temperature before giving it to the baby. Anything used to give infant formula needs to be washed in hot, soapy water and sterilised so artificial feeding is as safe as possible. Never give infant formula to a baby without his mother’s permission. Infant formula, given when not essential to meet a baby’s nutritional needs can encourage an unnecessary end to breastfeeding. It can also put a baby’s health at risk and may have social and financial implications. Whilst a decision to stop breastfeeding is reversible, the practicalities of re-lactation aren’t always easy. NHS leaflet: Bottle feeding is available from health visitors and online at:
Unicef – Resources for Parents – DoH Bottle Feeding Leaflet
Bottles can confuse breastfed babies, as nursing at the breast is different from sucking a bottle. Once breastfeeding is well established this is less likely to be a problem, though some breastfed babies will not take a bottle. The following tips can help a breastfed baby take a bottle with the least effect on breastfeeding.
- Choose a teat with a small hole to help prevent the baby being overwhelmed with milk.
- Offer a bottle before he is too hungry. Watch for early feeding cues.
- Cuddle him in a fairly upright position, supporting his neck and head if needed.
- Encourage the baby to open wide by placing the teat across his upper and lower lips and with its tip at the ridge between the upper lip and nose.
- Give him some control by allowing him to take the bottle teat into his mouth himself.Avoid just pushing the teat in.
- Tip the bottle just enough to give a gentle flow so the baby is not overwhelmed with milk. As the bottle empties, gradually tip the bottle more.
- Encourage frequent pauses to mimic breastfeeding by tilting the bottle just enough to stop the flow. Allow the baby to decide when he has had enough. Different feeding positions can help:
- Holding the baby in his usual nursing position.
- Supporting him against your raised legs.
- Holding him with his back to your chest.
- Wrapping him in something that smells of mum.
- Moving rhythmically – rocking, walking, or swaying from side-to-side while feeding him.
Written by Karen Butler, Sue Upstone and mothers of LLLGB. Photo courtesy of Benaifer Bhandari.
This information is available to buy in printed from the LLLGB Shop.
Copyright LLLGB 2016