When someone else feeds the baby Having another caregiver give a bottle of expressed milk can be a really This is not because bottles are inherently a problem. Someone else might take responsibility for school runs, older children, shopping, cooking, laundry, cleaning Work, study, caring responsibilities, separation from a baby, neonatal care and individual medical or expressing, donor human milk and formula feeding can all be part of a responsive feeding plan, depending

comfort where relevant, milk transfer concerns, bottle-feeding mechanics, growth, supply, positioning A well-rounded course should also explore: the physiology of breastfeeding, chestfeeding and bottle feeding What happens when positioning, attachment or bottle-feeding pace is adjusted? Families may be breastfeeding, chestfeeding, expressing, combination feeding or bottle feeding. or bottle feeding has changed.

Did it include infant feeding? Did it include both breast and bottle feeding? Look for someone who understands breastfeeding and bottle feeding where relevant, and who can recognise issues such as positioning, attachment, milk transfer, milk supply, bottle-flow mismatch, feeding endurance Feeding difficulties can have multiple causes, and babies respond differently to intervention. Do you observe a breastfeed or bottle feed where appropriate?

, expressing breast milk, bottle feeding and combination feeding. Infant feeding support: breastfeeding, chestfeeding and bottle feeding Not every feeding journey follows Bottle feeding also involves more than choosing a bottle. feeding positions Choosing Bottles and Teats How to make up a formula bottle safely How to express breastmilk attachment, bottle feeding or other aspects of their infant's feeding journey.

A careful response starts with the infant’s feeding, comfort and tongue function, rather than appearance Continuing pain, clicking, lengthy feeds, milk transfer concerns or bottle-feeding difficulties may warrant prematurity, jaundice, neurological or muscular differences, reflux-like symptoms, flow preferences, bottle-feeding For bottle-fed babies, it may include seal, coordination, endurance, coughing or spluttering, and whether professional if feeding pain is persisting or worsening, feeds are increasingly stressful, there are

or bottle, feeding for long periods, clicking, dribbling milk, or a parent experiencing pain and worry , maternal or parent comfort, milk transfer concerns, bottle-feeding efficiency and the family’s own Evidence concerning bottle feeding is more limited. Families who bottle feed, combination feed, express milk or use donor milk deserve the same careful, A plan may include feeding support, review of positioning and attachment, paced bottle feeding where

Bottle feeding Tongue-tie is less extensively studied in bottle-fed and combination-fed infants than coordination and normal individual variation can all influence bottle feeding. The evidence for treating ankyloglossia specifically to improve bottle feeding remains limited. This does not mean that bottle-feeding difficulties should be dismissed when a tongue-tie is present. Research has investigated possible relationships with breastfeeding, bottle feeding, breathing, speech

Is it responsive to people's needs? Is it well-led? You may be experiencing difficulties with bottle feeding. Whether you choose breastfeeding, bottle feeding, combination feeding, expressed milk, conservative management Bottle-feeding families may need help understanding changes in feeding behaviour, pace, comfort or coordination CQC rated D-Restricted Ltd® Outstanding for Responsive care.

If you are moving from breastfeeding to bottles, paced bottle feeding can help keep the feeding experience responsive to your baby's cues. You can read more in my blogs [Alternative Feeding Methods for Babies] and [How to Pace Bottle Feeds] others remove daytime feeds while keeping a morning or bedtime feed reduce the frequency or duration of feeding.

If breastfeeding, continue to offer the breast responsively and allow your baby to feed according to For bottle-fed babies, smaller amounts taken more frequently may sometimes feel easier than trying to Follow your baby's usual feeding pattern as far as possible and avoid pressuring them to finish a bottle Others may prefer the breast, a bottle or another familiar method of soothing. A difficult feed tonight is not a prediction of how feeding will develop.

, milk supply, infant prematurity, neurological or medical factors, bottle teat flow, feeding frequency Learners need to understand that breastfeeding, chestfeeding, bottle feeding, combination feeding and For bottle-fed infants, it may include feeding pace, seal, milk loss, coughing, fatigue, comfort and whether the feeding pattern changes with responsive adjustments. That principle is equally relevant when supporting bottle-feeding families.

For bottle-fed babies, similar principles apply. Yet bottle-feeding challenges can also relate to teat flow, pacing, feeding position, volume, the baby Rapid feeding and overfeeding This can be particularly noticeable in bottle-fed infants. This can occur with both breast and bottle feeding, although the mechanics and flow characteristics are Note the duration of feeds, approximate volume if bottle feeding, how quickly the feed was taken, signs

dribble with bottles, or seem unsettled around feeds. Why a tongue-tie release may not resolve feeding difficulties Feeding is a learned, shared skill Feeding It is about ensuring that support is responsive to what is actually happening at a feed. illness, reflux-like symptoms, muscle tone, developmental variation, milk flow, breast or chest fullness, bottle Where bottle feeding is used, observing a typical feed can be equally informative.

If a partner gives a bottle instead of a breastfeed, the breastfeeding caregiver may still need to express Some people want enough for an occasional bottle, while others need to express most or all of their baby's feeds. Available from: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding/expressing-breast-milk Available from: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding/expressing-breast-milk

Feeding can also be affected by positioning, milk flow, breast or chest comfort, bottle teat choice and For bottle-feeding families, it may include dribbling, prolonged feeds, coughing, distress, fatigue, A responsible practitioner should be able to explain the risks in a calm and proportionate way, without It is not an automatic response to a frenulum, feeding discomfort or a referral label. may mean supporting a caregiver who wants to continue breastfeeding or chestfeeding, a family using bottles

or tire more quickly during feeds before feeding becomes easier and more efficient. or bottle dynamics, parental comfort and a baby's wider health. For bottle-feeding families, it may include assessing feeding pace, teat flow, positioning, coordination Some babies need time, some need changes to feeding support, and some feeding difficulties have causes Practical care while your baby heals Keep the focus on ordinary, responsive care.

When assessing a baby with feeding difficulties, the whole feeding picture needs to be considered. For bottle-fed babies, difficulties such as losing the seal, dribbling milk or taking a long time to Teat flow, feeding pace, bottle angle, positioning and other medical or developmental factors should be considered rather than assuming that a frenulum is responsible. In bottle feeding, it may involve observing coordination, seal, pacing, stress cues and the baby’s comfort

With bottle feeding, the assessment may consider the baby’s seal around the teat, tongue and jaw movements historically focused more heavily on breastfeeding outcomes, particularly maternal nipple pain, than on bottle-feeding Bottle feeding with a restriction Does my baby need a tongue-tie release? These bottles may have soft, squeezable reservoirs or other features designed for particular feeding These specialist bottles are used for particular feeding needs associated with cleft palate or palatal

For bottle-fed babies, factors such as feeding pace, teat flow, positioning, coordination and comfort It usually begins with your story: when feeding concerns started, what a typical feed looks and feels Breastfeeding, chest feeding, bottle feeding, expressing and combination feeding all deserve respectful It should never be presented as a guaranteed solution for pain, milk transfer, bottle feeding or unsettled Some babies feed differently straight away; others need time, practical feeding support or further review

Breastfeeding, chest/body feeding and bottle feeding can be influenced by positioning, attachment, milk bottle-feeding pace and family circumstances. For practitioners supporting bottle-feeding families, this breadth is equally relevant. Bottle-feeding challenges can involve feeding rhythm, teat flow, positioning, infant coordination, discomfort response.

Vitamin K is not a treatment for feeding difficulties or tongue-tie. Vitamin K and feeding Vitamin K is not a treatment for breastfeeding difficulties, bottle-feeding difficulties Feeding difficulties should therefore be assessed on their own merits. A baby who is struggling with breastfeeding, bottle feeding, expressing or combination feeding may have Decisions about tongue-tie should consider function, feeding history, observed feeding where appropriate

Observing a feed is often valuable. If a baby is not feeding effectively at the breast, a tailored feeding plan may be needed to protect , expressing, combination feeding or bottle feeding. feed. NICE guidance recommends practical, responsive postnatal breastfeeding support, including assessment

Similarly, I have seen very short, and thick posterior ties that cause every feeding problem known to A tool combined with a feeding assessment, tongue motility assessment and noting of adverse symptoms Dribbling milk Tiring during an active feed Not maintaining a seal/latch (teat or breast) Noisy feeding Crushing teat with gums Piston action on a dummy/bottle (like Maggie Simpson!) (The ATP are not regulators, so it remains within the caregiver's responsibility to check an individuals

Feeding assessment Feeding assessment considers how the infant functions during feeding, rather than Depending on whether the infant is breastfed, bottle-fed, combination-fed or receiving expressed milk responses and coordination. Restricted movement can influence how an infant uses the tongue during feeding, but feeding difficulties or if concerns arise about the infant's response.

The pain may feel burning, stabbing, throbbing or tingling, and it can occur during a feed, immediately afterwards or between feeds. The resulting vascular response can cause the nipple to blanch and become painful after the feed. the nipple is exposed to cold air after a feed the nipple is still wet after feeding when exposed to immediately after feeding covering the nipple as soon as the feed finishes adding an extra layer of clothing

or how feeding looks. much softer between feeds. NHS guidance identifies weight gain, wet nappies, swallowing during feeds and other aspects of feeding My article When feeding doesn't feel right: Looking beyond tongue-tie considers the wider feeding picture Available at: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/enough-milk

During bottle feeding, teat flow, teat fit, bottle angle and pacing can influence the coordination of For some infants, appropriate support may involve feeding positioning, pacing, addressing bottle flow An IBCLC can assess feeding function whether a baby is breastfed, bottle-fed or combination-fed, and An IBCLC can support families whether their baby feeds at the breast, from a bottle, or through a combination of feeding methods.

Or, if bottle fed; either down a bottle too quickly (so you think they're ravenous but its more that they are not in control of the flow and you over feed them) or feeds are so long they end up taking in The tongue-tie itself is not particular how you feed to 'decide' if it will affect your chosen feeding Or ones 'at the front' need doing-yet they have a long stretchy frenulum and are feeding fine. It is only considered restrictive in infancy if there are feeding implications hindering efficacy.

feeding is not going as hoped. feed at the breast, combination fed, or because this is the feeding relationship that works best for When feeding difficulties are more complex A pump can be valuable while feeding is being assessed or Latch, positioning, breast and nipple health, infant development, prematurity, bottle-feeding technique often they expect to use it, whether expression is comfortable, and what is happening at the breast or bottle

Others may be exclusively expressing, combination feeding, returning to work, expressing during separation Someone trying to maintain milk production while their baby temporarily feeds elsewhere has different If breastfeeding is also part of the feeding plan, it may be important to consider breast and nipple comfort, infant positioning and attachment, milk transfer and infant feeding function. World Health Organization (2009) Infant and young child feeding: Model Chapter for textbooks for medical

for feeding difficulties. outcomes or the response to frenulotomy. for effective feeding. For bottle feeding, the assessment may also consider the infant’s oral seal, sucking pattern, coordination , the concerns described by the feeding dyad and the response to appropriate feeding support.

to work, combination feeding, managing temporary separation, donating milk, or feeding directly at the areolar tissue drawn into the tunnel, skin colour changes, the seal against the breast and the person’s response responses involved in milk production and milk ejection. So, if pumping feels very different from feeding your baby at the breast, you're not imagining it. the pump, the flanges currently in use and any parts that affect fit, such as inserts or collection bottles

These responses are part of the body's wider immune activity, including responses to microbes encountered This response can occur more than once during a feed (Neville, 2001). Feeding patterns need to be considered in the context of the individual infant, including feeding effectiveness Understanding a baby's feeding cues can help families respond to their individual needs without trying of lactation to feed their baby.

Feeding is a coordinated activity, and a baby may be using several of them together during a single feed tongue to move forwards or sideways, supporting cupping or tongue elevation, encouraging an appropriate response Feeding tells us much more. Breast and bottle feeding also place slightly different demands on the feeding system, so the assessment feeding.

For example, infant feeding support, lactation support or professional education may not themselves be Responsive CQC considers whether services respond appropriately to people's needs and whether care is accessible, personalised and responsive. Who is legally responsible for the service? Can the provider explain who is responsible for follow-up and complaints?

Oral Anatomy: Structure, Function and Feeding. The position of your hand depends on the feeding position. observe a feed and help determine which factors may be contributing. Infant Skull Shape and Infant Feeding explores how positioning and the wider feeding mechanism may be Available at: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding/positioning-and-attachment

feeds. Side-lying can be comfortable for feeding, but it is important to distinguish feeding from sleep. their own feeding patterns. The best position for you may change from feed to feed, breast to breast, day to day and as your baby Available at: https://www.nhs.uk/baby/breastfeeding-and-bottle-feeding/breastfeeding/positioning-and-attachment

It is important to assess feeding and milk transfer rather than assuming that frequent feeding alone Follow your baby’s feeding cues and seek support if feeding is difficult or feeds are repeatedly missed feeding plan. Seek support early if your breasts remain very full, feeding is painful, or your baby is not feeding Management should be guided by the symptoms, the feeding situation and clinical advice where needed (

additional support with feeding a baby who may need care on a neonatal unit some situations where a If it is uncomfortable, stop and check your technique with your midwife or infant feeding team. If your baby is feeding effectively and does not need additional milk, you may not need to use the colostrum Your maternity team can advise you about how it can be given alongside responsive feeding and ongoing Having colostrum stored does not replace skin-to-skin contact, responsive feeding or support with positioning

This needs to be considered alongside a full feeding history and direct observation of a feed where possible Frequent feeding is normal for young babies, especially in the early weeks, but feeding that remains Parents are the experts in what feeding feels like at 2 am, how long feeds are taking, and whether pain when feeds remain difficult. Persistent feeding pain or worry can make the early weeks feel lonely, even when others say that feeding

from flange fit, suction settings, friction, swelling, nipple damage, breast fullness or an underlying feeding pumping, combination feeding or building a milk supply alongside direct feeding. If you are pumping after direct feeding difficulties, the pump is not necessarily the whole story. a replacement for a feed. For others, discomfort is a sign that a wider feeding or health issue needs attention.

additional breast stimulation may be relevant when considering the wider feeding picture. When the nipple changes shape after a feed The appearance of your nipple immediately after a feed can provide useful information about what is happening during feeding. The pain may be sharp, burning or shooting and can occur during or after a feed. The best approach will depend on your circumstances, your baby's age and feeding needs, your milk supply

from day of division where I will send you a weekly message to check-in with yourself and see how your feeding At the 6 week mark feeding should be well and truly on the road to being efficient and effective if it for a face-to-face follow up review where I may review feeding techniques and reassess tongue function care-planning working towards your individual goals-I am a Lactation Consultant (IBCLC) and infant feeding specialist so rest assured together we can set goals to get your little one feeding effectively (this

Thickening of the wound causing further restriction, bleeding, infection or pain causing a feeding aversion tongue-tie are just a few examples) all of which can all interfere with efficient, effective infant feeding have also had a body therapy to relax, have less wind/reflux, sleep better and improved efficiency in feeding-especially Please also see this link: Manual Therapy and Infant Feeding - Association of Tongue-tie Practitioners These are optional of course but will give your little one a 'head-start' to effective feeding.

Different breast shapes and tissue characteristics may respond differently to different funnel geometries What does a correctly fitted flange look and feel like? Equally, a flange that feels comfortable but results in poor milk removal may not be meeting the needs Milk production is influenced by the frequency and effectiveness of milk removal, the physiological response observation rather than a conclusion established by high-quality comparative research, and individual responses

to what the tongue is able to do during feeding. Tongue function during infant feeding Infant feeding involves coordinated patterns of sucking, swallowing anatomy, sensory-motor organisation and the mechanics of the feeding method, making a functional feeding A functional feeding assessment remains important because feeding difficulties can have multiple contributing within the wider assessment of oral feeding rather than as an explanation for feeding difficulty in itself

Assessment needs to consider the infant’s oral function, feeding difficulties, clinical history and whether It requires consideration of the infant’s feeding function, the expected benefit of intervention, the literature on complications following infant tongue-tie release describes concerns including bleeding, feeding A functional assessment helps establish whether tongue movement is affecting feeding and whether division A Guide to Understanding Your Baby’s Oral Function and Infant Oral Anatomy: Structure, Function and Feeding

To know this, there would be adverse feeding symptoms, which would indicate the need for further assessment Infant feeding is one of the hardest things the tongue will need to do in a lifetime, so please ensure that your chosen provider is a registered infant feeding specialist, who also provides some form of is very much an umbrella term and one of a few things can happen: Following frenulotomy procedure, feeding This is usually resolved with time, changes in feeding positions and bodytherapies (such as @Baby-Myo

It would be wise to source a reputable Infant Feeding Specialist. This may be a member of your local NHS infant feeding team, or a Lactation Consultant (IBCLC) who, even if you are no longer/did not choose to breast/chest feed or provide human milk, still possess the gold standard qualification in infant feeding. Yes-they can support you however you choose to feed your babies including the use of formula milks.

WHAT IS A LIP-TIE AND DOES IT NEED TREATMENT? Sometimes a lip tie can affect the ‘vacuum draw’ of getting breast into a correct breast feeding position