In this section, we shall cover the following topics:
- Expressing / Feeding Support
- Buccal Colostrum
- Breastmilk
- Practical and Peer Feeding Support
- RSV and Infant Feeding
Expressing / Feeding Support
Please watch the guidance videos on expressing milk for your sick or premature baby.
- Hand expressing: Unicef UK Baby Friendly Initiative - Hand expression
- Using a breast pump: Expressing Breastmilk - Patient Information Video
- Establishing breastfeeding: Breastfeeding Your Small Baby
It is important to:
- WASH YOUR HANDS BEFORE EXPRESSING
- Start expressing both by hand and using a breast pump within 2 hours of birth.
- Continue to express 8-10 times in 24 hours including once overnight.
Please email our Infant Feeding Lead, Liz Jennis with any questions or queries on
Contact Liz if:
- you have not expressed any colostrum by day 3
- Your milk is not increasing in volume by day 5
- Your 24 hour milk volumes are less than 500ml by day 14
- Your milk volumes drop to below 500ml once expressing is established
- You have any breast / nipple pain, redness or trauma
Further details can be found on our
Feeding and Nurturing padlet
Buccal Colostrum
Colostrum is the breastmilk produced in the first few hours and days after birth. It can be collected by hand expressing up to 48 hours before a planned preterm birth, during labour or immediately after your baby is born.
Buccal colostrum is where drops of colostrum are given directly into your baby’s cheek. This is sometimes called Oral Immune Therapy.
The benefits of buccal colostrum include:
- Boosting the immune system to help your baby fight infections
- Creating a shield in your baby’s mouth that stops harmful germs from sticking inside it
- Supporting the growth and development of your baby’s tummy
We will support you to give your baby’s first buccal colostrum immediately after birth, before they are transferred to the neonatal unit.
We will continue to give your expressed colostrum buccally until your breastmilk increases in volume. Using your breastmilk for mouthcare until your baby is responsively breastfeeding will have the same benefits.
Breastmilk
Breast milk is the best milk for your newborn baby.
Breast milk is especially beneficial for premature or critically ill babies. Therefore, one of the best things you (and only you) can do for your baby at this time is to provide your breastmilk. Your breastmilk will provide nutrition to help your baby grow but also antibodies to protect them from infection while they are in hospital and for years to come.
Your breastmilk is unique for your baby. The earlier you start to express and the more often you express, the more milk you will produce for your baby's growing needs When your baby is admitted to NICU we will give you an information pack and a cool bag. The pack will contain advice about how you can express your milk. We would like to give your baby some of your expressed milk within 6 hours. Your breastmilk will first come in tiny drops of colostrum but every drop you produce is valuable.
- Download the "Milk as Medicine" parent leaflet
At St Peter's we aim to help you express as soon as possible after birth. All members of staff are qualified to help you to express. Both our maternity and neonatal services at St Peter's are accredited as "Baby Friendly" by UNICEF UK Baby Friendly Initiative for Excellence in Support of Breastfeeding and Parent-Infant Relationships.
The earlier you start to express and the more often you express, the more milk you will produce for your baby's growing needs. Ask your midwife and our neonatal nurses to help you start.
We advise and recommended by UNICEF:
- Start expressing within two hours after giving birth
- Combine hand expressing and using a breast pump
- Aim to express 8-10 times in 24 hours
- Ask your neonatal nurse to check your expressing technique
- With each day, the amount of milk you express should increase. Tell your nurse/ midwife when your breastmilk volumes increase to 20ml per expression or your breasts feel fuller
- Please label your expressed milk with your baby's name date and time. Milk can be stored in the fridge for 48 hours and frozen for 3 months.
If your baby was born very early you may need to carry on expressing for many weeks and at times this can feed relentless. Double pumping will save time and increase your milk supply. We have a small room with 2 expressing pumps that you can use to express. We also encourage expressing by the cot side and have screens that we can use for privacy.
Whilst some mums have no problems expressing breast milk, others struggle. Having a baby on the Neonatal Intensive Care Unit (NICU) is stressful, and that stress can inhibit milk production. Some mothers might have their own health problems that prevent breastfeeding. Mothers own milk is always best, but where this is unavailable or insufficient and the baby is very premature or sick, donor breastmilk is used in preference to formula milk for a limited period.
Practical and Peer Feeding Support
All neonatal nurses are qualified to help your baby gradually establish responsive feeding. We have a dedicated Lactation Consultant plus Speech and Language Therapists and Dietitians to support your baby’s feeding progress.
Feeding support beyond discharge home is provided by our Neonatal Community Outreach Team.
The Ashford and St Peter's Maternity Feeding Team and the Health Visitor team also run community peer and feeding support groups throughout the week.
- Maternity feeding support groups in the local area can be found on the feeding and nurturing padlet:
Feeding and Nurturing
- Health Visitor led feeding support groups in the local area can be found on the Surrey Child and Family Health website:
Locations Archive - Surrey Child and Family
RSV and Infant Feeding
RSV / Bronchiolitis is predicted to increase dramatically this coming autumn and winter. Breastfeeding protects babies from infections and illness and mothers generate antibodies within 2 hours of exposure to a pathogen to protect their infant with every drop of breastmilk. Breastfeed your baby responsively and keep your baby close to help protect your baby. If your baby does get RSV / Bronchiolitis this leaflet provides feeding guidance until your baby feels better.
