Breastfeeding your baby on discharge from the Neonatal Unit
How do I know breastfeeding is going well?
When your baby is approaching discharge, we will encourage you to come and stay with your baby
for a minimum of 48 hours. This will give you a valuable opportunity to ensure you are confident in
every aspect of caring for your baby. During this time you will become increasingly confident in the
signs your baby shows for hunger, tiredness and comfort.
In general terms, babies who are feeding well:
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Feed between 8 and 12 times in 24 hours, including at night. This may be more often than
your baby was being fed by tube when on NNU.
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Will be settled between feeds
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Will wake independently for most of these feeds. However, in some cases we may suggest
you wake your baby until they are reliable at waking frequently. Each baby will develop their
own feeding pattern over a period of time. If you have any concerns regarding the frequency
of feeding then contact your Health Visitor who can give you more guidance.
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Will pass at least 2 yellow, seedy stools in each 24 hours and will have at least 6-8 wet
nappies in the same period.
If you are not sure that your baby is displaying all of these signs, contact one of the nurses or your
health visitor for further advice.
How long should a feed last?
Babies will breast feed for different lengths of time at each feed. Sometimes they are hungry and will
want both breasts, and sometimes they are just thirsty and will have a quick feed from one breast.
The number of times in a 24 hour period that your baby feeds for, combined with the signs listed
above will indicate that feeding is going well.
How long should I breast feed for?
We strongly encourage mums of all premature babies to express or breastfeed their baby on the
unit because we know breast milk reduces the risk of serious infections, and helps improve feed
tolerance in vulnerable babies.
However, once your baby is discharged from the neonatal unit, there are still significant benefits to
continuing breastfeeding including:
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reducing the risk of your child developing infections, childhood diabetes, obesity and
allergies
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reducing the risk of mum developing breast or ovarian cancer, heart disease or osteoporosis
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breastfeeding is also free, easy and safe from contamination with bugs
Written by the Paediatric Dietitians at the Royal Devon & Exeter Hospital 01392 406063 December 2012
The Department of Health advises exclusive breast feeding for a minimum of 6 months with
breastfeeding continuing during the introduction of solid foods. Breastfeeding can continue for as
long as you and your baby wish.
Will my baby grow adequately on breast milk?
You are unlikely to be discharged from the Neonatal Unit until you and the neonatal team are happy
with the rate of growth of your baby. The health visitor or midwife will continue to monitor your
baby’s weight regularly once you are home. If your baby has been receiving breast milk fortifier, this
will be discontinued before you are discharged so that you can be confident your baby is growing
with exclusive breastfeeding. There is no need to add formula to your baby’s diet. If you have any
concerns you can also contact the Infant Feeding Coordinators for advice.
When should I stop expressing?
During your stay on the neonatal unit you will have built up your supply of breast milk. Often the
amount you express is more than your baby will take directly from the breast. To ensure that your
supply does not suddenly drop, we would encourage you to continue to express several times per
day until you are confident with feeding and your baby’s rate of growth. Once you are confident you
can reduce the number of times you express over 7 – 14 days. During this time monitor your baby’s
nappy contents and weight. Ultimately your breasts will respond to your baby’s demands.
If you have any concerns regarding your baby and their feeding then you can contact your health
visitor in the first instance. The Infant Feeding Coordinators are also available for advice over the
telephone.
Does my baby need vitamin and mineral supplements?
On the Neonatal Unit
Babies born early need extra nutrition to help them thrive, including vitamins and minerals such as
vitamin D for strong bones, and iron for healthy blood. If your baby was born before 34 weeks, they
will have been prescribed extra vitamins (Abidec drops) and iron (Sytron) during their stay on the
Neonatal Unit. Babies who were given breast milk fortifier will not have needed Abidec while on
fortifier, because the fortifier contains a range of vitamins.
After discharge until age of 1 year corrected
Breast fed babies who were born before 34 weeks will need a prescription of Abidec and Sytron
from your GP, to be taken until your baby is one year old
After the age of 1
The Department of Health recommend all children aged 1-5 take vitamin drops containing vitamins
A and D, because they don’t get enough from their food. These should be bought in shops or from
NHS clinics e.g NHS Healthy Start Children’s vitamin drops, and will not be prescribed by your doctor.
A fact sheet on children’s vitamins can be downloaded from www.bda.uk.com/foodfacts
Written by the Paediatric Dietitians at the Royal Devon & Exeter Hospital 01392 406063 December 2012
Weaning onto solids
Weaning is the process of introducing your infant to solid foods. Weaning helps babies take in more
nutrition to grow, develops their eating skills, and exposes them to lots of different tastes. This will
help them eat a wide variety of foods as they get older. For babies not born early, we recommend
solids are introduced at around 6 months of age. However, there are special guidelines for babies
born early.
When should I start?
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for babies born prematurely, weaning should start when they are between 5 and 8 months
old (this is the age they are from their birth date, not from their corrected age, which we
often talk about in hospital)
In addition to being between 5 and 8 months old, you should also look for signs that your
baby is ready to start weaning such as showing interest in what others are eating, or bringing
hands/toys to their mouth, and being able to be easily supported in a sitting position.
You do not need to wait until your baby reaches a certain weight, or has teeth
Early or late weaning – why not?
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Premature babies’ digestive systems are not developed enough to manage solids before 5
months of age. Weaning before this age may also replace milk with less nutritious solids.
Waiting until after 8 months age to wean means your baby misses the best time to develop
eating skills and accept new flavours, which may affect the types and variety of foods they
will accept later on.
Where can I get more information?
General advice about weaning, including suitable foods to give your baby, is available in a leaflet
called ‘Weaning: starting solid food’. This is available to download from the Department of Health
website, as well as through your health visitor.
More specific advice for premature babies is available from Bliss charity, in a leaflet called ‘Weaning
your premature baby’. This can be downloaded from www.bliss.org.uk
Further sources of help and advice
Your health visitor and consultant can help you with any general queries. If you need further
assistance, you can ask to be referred to:

Infant Feeding Coordinators at the RD&E, for advice about breastfeeding 01392 406663

Paediatric Dietitian at the RD&E, for advice regarding growth and weaning 01392 406063
Written by the Paediatric Dietitians at the Royal Devon & Exeter Hospital 01392 406063 December 2012