Grandparents & Support for breastfeeding families

img_7819Congratulations! Becoming a grandparent for the first or subsequent time is exciting. This information has been written for grandparents like you who want to support your child or child’s partner to breastfeed.

Your own children may or may not have been breastfed, perhaps there wasn’t much support around and feeding a baby with a bottle was what most families did then. A great deal is known now about how important breastfeeding is and how it gives a child the best possible start in life and the number of women choosing to breastfeed is increasing.

Below you will find some questions which you may find helpful if you have any concerns or were wondering why breastfeeding is held up to be so good for mothers and babies.

Q Is breastfeeding really better than bottle feeding?

A Infant formula is cow’s milk which is modified (skimmed, the sodium level is lowered and the protein content is modified) to make it more digestible for human babies. Other ingredients are added as part of the manufacturing, it is made in a factory – not in a laboratory as the word ‘formula’ suggests. All brands of formula have to meet legal requirements of safety and nutrition. Formula is sold in dried form, where you add the water, and ready-to-feed liquid formula, in a carton.

Breastmilk is ‘human milk’ and is therefore ‘species-specific’, matching the needs of the baby for the first 6 months of their life when milk only is needed, and for many months and years beyond this, alongside solid foods . Breastmilk is like a medicine for babies because it has important nutrients, antibodies – which enhance the baby’s ability to fight illness – and hormones which can only be found in the mother’s own milk. Research clearly shows that breastfed babies are healthier than babies who are bottle-fed, even in developed Western societies with clean water supplies, need fewer visits to the doctor and hospital and have a lower risk of:

  • Ear, chest, stomach, kidney and urinary infections
  • Severe asthma and eczema
  • Childhood diabetes and obesity
  • Sudden infant death (cot death)

Mothers who breastfeed are at lower risk of:

  • Breast cancer
  • Ovarian cancer
  • Osteoporosis (brittle bones)

Q How will I know if the baby is getting enough milk?

A Look at the baby’s nappies! It can be surprising to see the variety of colour changes, particularly within the first week, but wet and dirty nappies are a really important guide!

You will probably help with changing your grandchild’s nappy – to see our guide as to what is normal and how this helps to reassure you that the baby is getting enough milk.

Most women are able to produce plenty of milk to fully breastfeed their baby. You don’t need to see exactly how much the baby is getting.

Q Why does my grandchild seem to be feeding all the time? Is this normal?

A Getting a good milk supply going involves breastfeeding when the baby shows the first signs of wanting to feed and allowing the baby to decide when they have had enough. This is called responsive feeding. Babies can’t tell the time so strict routines, for example four-hourly feeding schedules, are not helpful and will make establishing breastfeeding difficult for both mother and baby. It can be helpful to think about how often you have a drink or something to eat in a 24 hour period, and how you would feel if someone said you had to wait to eat or drink even if you were really hungry or thirsty!

A baby’s tummy is very small (see ‘what’s so special about breastmilk’ page in our Essential Guide for a guide to the size of babies’ tummies) and breastmilk is designed to be easily digested so babies need to be fed very often, particularly during the first few weeks and months.

The number of feeds in a 24 hour period can vary and each feed may have a different gap of time in between. Sometimes the baby will want to have lots of feeds close together and this is quite normal. Most babies will still need to feed at least once during the night and this is important in maintaining mum’s milk supply as the hormone needed to keep making milk (prolactin) rises overnight and is kept at a higher level if the baby feeds during that time.

Q I’m worried that breastfeeding seems to be painful for the mother of my grandchild – what can I do to help?

A Breastfeeding is a new skill which can sometimes take time to get right. Pain is usually a sign that the mother needs help to get the baby well positioned and attached for breastfeeding. You can encourage her to ask for some help from her midwife, health visitor, breastfeeding counsellor or peer support group. Many areas have peer support volunteers, these are mums who have breastfed their baby and have had training to help them support other mums to achieve their breastfeeding goals – sometimes they will have experienced difficulty in getting breastfeeding established themselves (see here for more information on what is a peer supporter).
As a grandparent you can be very important in reassuring and encouraging the mother of your grandchild to achieve her breastfeeding goal – don’t underestimate the importance of your role in this!

Q If I can’t give the baby a bottle how will I get to know my new grandchild?

A There are so many other things you can do to help you feel close to your grandchild; offering to change or perhaps bath the baby could give the parents a welcome break in those early days. You can cuddle and soothe the baby, particularly during those times when the baby seems to be unsettled, take the baby for a walk in a sling (see here for a link to sling leaflet) or pram and putting the baby skin-to skin (see our page on skin-to-skin) can calm a fractious baby – babies love skin-to-skin with the people closest to them including grandparents.

Q What else can I do to help?

A Supportive grandparents can make a real difference to a new breastfeeding mum. Practical help with preparing healthy meals, shopping and laundry will make such a difference, as will enabling the new mum to rest which, as you may remember yourself, is a big deal in those early days.

Being sensitive to the new mother’s feelings is important – new mothers can feel quite fragile and sensitive but listening to her concerns and encouraging her when she is tired and feeling down can make a real difference. Remind her that she is doing a great job breastfeeding your grandchild – you may be surprised how important this can be in encouraging her to continue.

Q What can I do to help her when we are out and about visiting or shopping?

A There are now many places to feed out and about and the 2010 Equalities Act protects a mother’s ability to receive services whilst breastfeeding. Getting out and about in the early days can be a challenge but Grandparents can help with this. Perhaps try:

  • packing the ‘nappy’ bag and
  • remembering to include something like a light scarf or cloth to drape over mum’s shoulder while feeding – this can help her to feel that feeding is discreet. Once she feels more confident she may not feel she needs this, but in the early days simple things like this can make a difference.
  • Suggesting loose clothing for mum – a drapey t-shirt or jumper are easy for breastfeeding.
  • Suggesting a visit to a local peer support group – these are brilliant as ‘halfway houses’ as mums can breastfeed within a supportive atmosphere – no-one will worry if baby needs some time to attach and feed well and they are often where friendships are formed.

Q Our grandchild has had to go onto the Neonatal Unit – what can we do to support?

A This can be a particularly worrying time for all family members and the wider family are often left wondering what they can do to support the parents during this time – whether it is a short or longer stay.

A very practical thing would be to act as a contact for other members of the family to be updated, as constant information requests from the wider family can put strain on already fragile parents. You could also signpost interested family members to helpful websites and information.

When babies are admitted to a Neonatal Unit (NNU) it can be due to being born too early or a health condition such as an infection or other difficulty that has become apparent during or shortly after the birth. The NNU staff will discuss treatment with the parent(s) but depending on this discussion one positive thing that you, as a grandparent, can do is to support and encourage the mum to express her breastmilk.

The earliest milk (colostrum) is already being produced by a mum during her pregnancy and the birth itself further stimulates the mum’s milk to start to be produced in larger quantity – ready for a baby to feed – as long as the mum is supported to express her milk as soon as she is able. This should ideally be within 6 hours of birth and she will be supported to hand express her milk at first (see our information on how to hand express here) as soon as she can. This is because breastmilk is so important for babies to receive as soon as they are able to feed, and starting to express will be important as it takes a little while for the mum to establish her milk supply.

If the baby is not well enough to take breastmilk immediately it is still important for mum to start expressing and build her milk supply as the milk can be frozen and given to the baby as soon as it is possible, perhaps via a nasogastric tube (click here to see our guide to n/g tube feeding).

Breastmilk protects the baby’s gut from harmful germs and starts the baby’s immune system working. It also provides the specific fats which support brain and eye development.

The milk a mother makes when her baby is born early is different to that which she would have produced if her baby was born at the end of her pregnancy – it is truly tailor-made for that baby. It is used by NNUs in a similar way to a medicine whenever it is possible as research has shown that incidence of Necrotising Entero-colitis or NEC for short (which is a very serious and sometimes deadly gut condition to which ill or premature babies are more prone) is much less likely to occur if a baby is given breastmilk.

It is thought that babies have a sense of smell although how far it has developed during a baby’s time in the womb is uncertain, however even premature babies seem to be comforted when a cloth which has been kept close to their mother’s skin is placed in their cot. To help the mother stimulate her milk when expressing, a cloth which has been kept close to the baby and has absorbed the baby’s scent can be smelled by the mum. These cloths can be swapped each time mum visits her baby. Scent/smell is a very powerful stimulant of the hormone (oxytocin) needed to release the milk from the milk-making tissue when expressing and which in turn then stimulates the milk-making hormone (prolactin) which makes more milk.

As a grandparent, encouraging, supporting and enabling the mum to express between 8 and 10 times in a 24 period including at least one expression overnight is one of the most positive things you can do for both mum and baby.

When a mum starts to use a pump (either electric or hand) there will be parts which will need to be sterilised – practical help with ensuring the pump parts are washed and sterilised so they are ready when needed is a practical way of supporting the mum to give her baby her all-important breastmilk.

When the baby is stable and well enough the baby may be able to have skin-to-skin with his or her parents – this is sometimes referred to as kangaroo care and research has shown how powerful this can be in shortening a baby’s stay in NNU.

Babies on Neonatal units can need time to grow, in the case of prematurity or, if ill, time and the treatment to get better or support a longer term condition. Knowing just how to help and support the parents while on the NNU can be difficult. Sometimes they may just need you to listen to them.

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