Gill Rapley, MSc

 Demand feeding  Cue-led feeding  Needs-led feeding

 Ensures customised milk production and respects baby’s innate appetite control  Prevents complications for the mother  Cuts out the guesswork BUT: the emphasis is still on the baby’s nutritional needs

 Demand feeding  Cue-led feeding  Needs-led feeding  Baby-led feeding  Responsive feeding

Breastfeeding works best when it’s: Frequent Effective Exclusive on Demand Skin to skin (in the early weeks)

 The first breastfeed  Positioning and attachment  Demand / cue / needs-led feeding  Baby-led weaning (solid foods)  Child-led weaning (off the breast)

Mothers don’t breastfeed – babies do! The mother provides the opportunity – the baby does the rest

They have innate reflexes and instincts to:  locate the breast  use their head, arms and legs to orientate themselves and adjust their body position  root, attach effectively, and suckle

... are triggered or enhanced by skin-to- skin contact and a laid-back maternal position They need the freedom to experiment and time to practise, to get it right

Mother and baby fine-tune the mechanics of breastfeeding between them – with the baby leading (Christina Smillie) Babies haven’t read the books – they are very adaptable when it comes to positions for feeding!

 Choosing to breastfeed  Initiating breastfeeding  Sustaining breastfeeding  Incorporating other foods  Deciding when to stop... provided they are given the opportunity

 “There are only a very few mothers who cannot breastfeed – but there are many who are not enabled to” (Belinda Phipps, CEO, NCT)  There are only a very few babies who cannot breastfeed – but there are many who are not enabled to

 Culture  Technology  Expectations

 Family  Friends and peers  Health professionals  Media – advertising  Media – impressions of ‘normal’

a pram/buggy a playpen

 A hospital birth? Skin contact? Nursery care?  Input from health professionals?  Advice from parenting ‘gurus’?  Concerns about spoiling the baby, or being used as a dummy?  A safety pin, to help her remember which breast to use first?  Formula and bottles?

 A full-time paid job  A multi-function car seat  A baby monitor / CCTV  A mobile phone – with apps  Facebook & Twitter  A BabyNes

 To breastfeed unaided soon after birth (before anything else happens)  To touch and smell their mothers, as well as hear and see them, 24/7  To feel warm and safe, day and night  To be able to feed easily, whenever and wherever they want  To be understood and responded to without having to cry

 Recognise babies’ innate abilities  Understand how to facilitate (and recognise) effective feeding  Get to know all our babies’ signals, not just the feeding cues  Focus on using breastfeeding to comfort and calm – nutrition will take care of itself  Have a ‘babymoon’

 Shut out the 21 st century; surround yourself with real supporters  Listen for your instincts – and follow them  Keep your baby close, day and night  Get to know his signals, and what he needs to do to breastfeed  Experiment with different ways to hold him  Take every opportunity to ‘sit down for a rest’ – with your baby, skin to skin

D AD

“Hospital routines should not be deemed as more important than parents for babies’ wellbeing; parents should only ever be denied access to their baby on occasions where it is judged to be in the baby’s best interest.” (UNICEF UK BFI guidance, 2012)

We can support mothers to:  have a babymoon  hold their baby whenever, and for as long as, they wish  keep their baby close – day and night  discover how to help their baby to feed himself at the breast  offer the breast for comfort (and food)

 Babies are vulnerable, but they aren’t incapable – or passive  They can be trusted to know what they need and how to get it  Being baby-led makes breastfeeding – and parenting – easier