Breastfeeding - Getting off to a good start when challenges arise

This second instalment from lactation consultant, Sally Etheridge, helps you understand baby’s first feed and colostrum. She also offers information about feeding a baby that might have arrived a little bit early (34-37 weeks).


Guest pregnancy blog by Sally Etheridge IBCLC, Deputy Chair of the Lactation Consultants of Great Britain, 04/08/2017

The first feed

Most babies will seek the breast and take their first feed in the first hour. However, some babies may take longer, especially if birth has been complex, lengthy, or involved interventions. You may need more support or trained help until things are on-track.


All new mothers produce colostrum, the first milk that is made from around halfway through the pregnancy. Sometimes known as the baby’s first immunisation, it is full of protective qualities that prepare and prime the baby’s delicate gut.

Produced in very small amounts to suit your new baby’s tiny tummy, with unrestricted time close to you, they will get just what they need. Lots of cuddling and skin to skin in the early days can help ensure your baby learns how to get comfortable and enjoy plenty of time grazing and suckling. This way, when your milk ‘comes in’ around the third or fourth day after the birth, the transition to more milk and fuller breasts will happen most easily.

If your baby is taking a little longer to start breastfeeding, ask for help from staff to express your colostrum early and often. The drops you express can be given to your baby by syringe, while you continue with skin to skin to allow your baby to smell and feel your skin, lick and taste your milk. Where breastfeeding has yet to take-off, frequent expressing is important for a good milk supply later.

Storing your colostrum

For parents who know they may need extra help with starting breastfeeding, antenatal collection, or ‘harvesting’ of colostrum may be the answer. Hand expressing your colostrum beforehand, collecting the droplets in a syringe and freezing it ready for your baby after the birth can really help take off the pressure. Ask your midwife what your hospital protocol is.

Visit the La Leche website for more information about antenatal collection of colostrum or download Kingston Hospital’s handy PDF guide.

Breastfeeding if baby has arrived a little earlier than expected

One group of babies who may receive less support to start breastfeeding, but may need it most, are those babies born at 34-37 weeks; the Late Preterm babies.

These babies may not need to go the NNU. They may stabilise quickly, and be discharged after a few days of observation. Yet these babies, and their parents, often need trained help and ongoing support to get breastfeeding established. They are usually small, with little mouths. They may tire easily, fall asleep after a few sucks, and so take little milk in. Their ability to sustain and coordinate sucking will take some time still to develop. Without guidance and support, parents may not be aware their baby is not feeding effectively. Others may start to give bottles of formula milk, unsure how else to make sure their baby is ‘getting enough’. 

Parents can feel tremendous guilt if they are told their precious baby has lost too much weight, or needs to go back in to hospital due to jaundice, and may quickly decide breastfeeding is too stressful or difficult. Recognising the signs that a baby is getting enough milk is important for all parents. Watch your baby for any signs that they are ready to feed, to give yourself time to bring your baby close to the breast, and allow them to latch on well; get to know the signs your baby is  actively drinking, and relax together with your baby. It is natural for parents to take a great interest in their baby’s nappies! This is a great way to know if your baby is likely to be getting enough milk.

See NCT for a useful visual guide to what to look for and expect.

A wonderful resource with numerous short videos for breastfeeding parents, including breastfeeding a small or early baby, can be found at

Why we’re celebrating World Breastfeeding Week and the theme of sustainability

Breastfeeding is what mothers and babies do all over the world, and have done across the millennia. It is what has ensured the survival of the human race. Every single one of us is proof that breastfeeding works – without it, none of us would be here today. Right now, in every town and country, and in every corner of the globe, mothers are nurturing their baby with their milk. Breastfeeding is the most efficient food production system we know and it gives all babies an equal start in life.

Thank you

We would like to say a big thank you to Sally for writing these guest posts for us, and for helping us to celebrate World Breastfeeding Week. Find out more about the Lactation Consultants of Great Britain by visiting or emailing [email protected].

More on breastfeeding

More pregnancy news and blogs

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