Can I breastfeed if…?

Don’t worry, mums with breasts of all shapes and sizes can breastfeed. Your body will constantly make milk, so you will still be able to make plenty of milk for your baby.

Mums with breasts of all shapes and sizes can breastfeed. Sometimes mums with larger breasts are worried about being able to feed discretely. If this is a concern for you, check out ‘Can I breastfeed in it?’ blog and Facebook group for tips from other mums.

You can still breastfeed! Remember that it is called breastfeeding, not nipple feeding! Having plenty of skin to skin contact with your baby will give them time to investigate the shape and size of your nipples – and these are the only ones they will know. Your baby will learn how to feed from you. If you are worried then speak to your midwife, and make sure you get support in positioning and attachment early on if you need it.

Most mums can – yes! It depends on exactly what surgery you have had done, and what technique was used. There is a website dedicated to breastfeeding after breast surgery by two mums in the US who have had surgery themselves, and one is a lactation consultant. It gives information about different types of surgery and your options for breastfeeding.

You could also talk to your GP or the clinic who originally carried out your surgery, as well as getting support and information from someone like a breastfeeding peer supporter or Lactation Consultant antenatally to ensure breastfeeding gets off to the best start.

Breastfeeding after a c-section is perfectly possible, although it can add some extra challenges. You may need to experiment to find a comfortable feeding position. Feeding whilst lying on your side or in the rugby ball position may prove to be more comfortable than the traditional cradle hold.

Sometimes the pain relief medications can make a c-section baby sleepy, and they will need waking regularly to feed. But it’s certainly easier to sit and feed than to get up and wash and sterilise bottles or prepare formula.

If you are a smoker then stopping smoking is the best thing you can do to protect the health of you and your baby. Nicotine replacement patches are safe to use whilst breastfeeding. You can also visit the Smokefree website or call the NHS smoking helpline on 0300 123 1044.

Nicotine passes onto the baby in breastmilk, but if you choose to continue smoking it is still better to breastfeed than to formula feed. Breastfeeding will help to support your baby’s immune system and protect them from some of the health effects of passive smoking. Smoking after a breastfeed (instead of during / before a breastfeed) can reduce how much nicotine is passed on to your baby, and both washing hands after smoking and wearing a coat or jacket you take off before handling baby, can help reduced the amount of chemicals which transfer to baby from the smoke. Because these chemicals can continue to be excreted by the body for hours after a cigarette, it is important not to share a bed (or any other sleeping surface) with your baby if you or your partner smoke. You can also reduce the risk to your baby by making your home smoke free.

La Leche League and the Breastfeeding Network have helpful information about managing breastfeeding and smoking and reducing the risks to your baby.

Although advice about alcohol in pregnancy is very clear, the guidance for a breastfeeding mother is not so clear. Currently, the NHS website recommends that a breastfeeding mother consumes no more than 1 or 2 units of alcohol a day. A unit is 125ml (small) glass of wine or 25ml (1 shot) of spirit or half a pint of beer.

There is evidence that drinking more than this when breastfeeding could harm your baby’s development. Drinking a small amount with a meal just after a breastfeed will reduce the amount that is passed onto baby.

If you know you want to drink more than this it is useful to plan ahead and express milk for another caregiver to feed to your baby. You may also want to express milk while you are out to help maintain your comfort and milk supply. This milk should not be fed to your baby. It is also important to note that expressing milk will not help the alcohol leave your milk any faster.

It is recommended that you do not share a bed with your baby if you have drunk any amount of alcohol.

If you have had difficulty breastfeeding in the past and you were worried that your baby didn’t take enough milk, it might help to talk over your experiences with someone. This could be your midwife, or other mothers at a breastfeeding support group, or a breastfeeding supporter on the phone. See our ‘support’ section for more info. They can offer you non-judgemental advice and information about breastfeeding which might help you feel more confident about giving it a go again this time round. Also see our section on preparing to breastfeed, which gives lots of information about how milk supply works.

It is rare for there to be a physiological (physical) reason why a mother cannot produce enough milk. More commonly mothers experience this concern because they are unprepared for the ‘normal’ behaviour of a breastfed baby, who often feed frequently and do not follow a routine. If you would like to try breastfeeding again it might be helpful to discuss your concerns with a breastfeeding counsellor. You might want to call the National Infant Feeding helpline, or speak to a local infant feeding specialist for support. You can always raise your concerns with your midwife or health visitor too, or  specialist such as a breastfeeding peer supporter, local infant feeding lead or Lactation Consultant.

Current advice for mothers living in the UK with HIV is that you do not breastfeed. This is to reduce the risk of transmission of the virus to your baby. You may wish to view our information on bottle feeding for tips on how to make the most of the opportunity to bond with your baby, and how to bottle feed safely. The Terence Higgins trust website make some recommendations.

With advances in HIV treatment and research, the advice may be changing in the future. If you have HIV and feel strongly about breastfeeding you may wish to view the information on HIV and breastfeeding on the Lactation Consultants of Great Britain website.

There are some conditions which require medications that are incompatible with breastfeeding. However, in many cases there are suitable alternative medications such as antibiotics and anti-depressants.

The Breastfeeding Network offer lots of helpful factsheets about different medications and their use in breastfeeding mothers. You might find it helpful to direct your GP or other healthcare professional to this resource too, as they might not be used to advising about medications suitable for use with breastfeeding. There is also an email address for health professionals to contact for further advice.