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Common feeding problems

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Real mums' tips

"I breastfed for five months, but it's less tiring now my husband can share the feeding. It helps him to feel involved too. But I wish I'd kept one breastfeed a day – I loved the closeness."

Melanie Phelps, 28, mum to Cormack, eight months

"For us, mixed feeding is the best of both worlds. It gives me a little more freedom, but Jen-Mei is still getting the health benefits of breastfeeding."

Irene Smith, 36, mum to 10-week-old Jen-Mei

"Bottle-feeding suits us. It"s reassuring to know how much milk Erin is taking, and I'm less stressed about returning to work."

Avril Taylor, 28, mum to Erin, five months

Whether you're choosing breast, formula or a combination, we have answers to your questions.

How often should I feed my newborn?

Approximately every two to four hours. At the beginning, a feed may take up to an hour, but once you and your baby get into a routine, it can take five to 10 minutes. Just relax and be patient – it can take up to six weeks to master breastfeeding. If you're bottle-feeding, keep offering milk until your baby decides he's had enough – amounts will vary and he'll pull away when he's full.

How can I avoid sore nipples?

Always wait until your baby's mouth is wide open before latching on. At the end of the feed, try this simple trick: gently place one or two fingers in the corner of his mouth before withdrawing to "break the seal". Nipples heal more quickly when exposed to the air, so if they're sore, go bra-less at home and change wet breast pads frequently.

Why have I got swollen, tender breasts?

If you delay a feed, or even if your bra is too tight, you can get what is known as engorged breasts. Once breastfeeding is established (at around six weeks) it's less usual, but if it happens, soak in a hot bath and stroke your breast down towards the nipple to encourage milk flow - and get measured for a new bra!

Is this mastitis?

Engorgement can develop into mastitis, an infection causing flu-like symptoms and red, inflamed patches on the breast. It may seem odd but keep feeding on the sore side as this will help unblock the duct, and see your doctor as soon as possible as you'll need antibiotics. Lining your bra with a cabbage leaf at the first signs of tenderness - savoy is meant to be the best - won't prevent or cure mastitis but may help to relieve the soreness.

Will expressing help?

You'll need a breast pump – a manual pump is good for occasional use, while an electric pump is best for regular use. Expressing at the same time each day may help prevent engorged breasts – try in the morning, when you'll get most milk. Then your partner can help with feeding and give you a break. But don't worry if you can't express at first – it takes practice. A warm bath may help milk flow or try expressing from one breast while your baby feeds on the other side.

What kind of water is best for formula?

Use boiled tap water that's at least 70°C (to kill any harmful bacteria) when making up formula in a sterilised bottle – don't use mineral water or softened water as these contain too much salt. Let the feed cool to body temperature  – test the temperature of the formula on your wrist, it should feel warm or cool but not hot – before giving it to your baby. Find out more about making up infant formula at NHS Choices.

What can I do if my baby is constipated?

Formula-fed babies are more prone to constipation, so if your baby is straining, offer 30-60ml of cooled, boiled tap water between feeds.

Should I worry about allergies?

If you have a strong family history of eczema, asthma or food allergies, your baby might need a hypoallergenic or non-dairy formula. Your health visitor will be able to advise you (you should avoid soya formulas for the first six months). More information about soya based formula can be found at the NHS Choices.

Why does teat size matter?

Too small and you'll have a frustrated, exhausted baby; too big and the milk will gush out of his mouth. Have a chat with your health visitor if you're not sure.

How can I help my sicky baby?

Most babies bring up a little milk after a feed, but some seem to regurgitate a lot (known as reflux) and are immediately hungry again. If your baby is growing and healthy, this is nothing to worry about. However, if your baby's not putting on weight, ask your health visitor or GP about treatments for reflux.

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