Cathy Sage Baby Feeding Specialist in London

I am thrilled to announce that the paperback version of my book Breast, Bottle or Both: How to Feed Your Baby Your Way is about to come out on Apple, Kindle and Google Play Books.

This beautiful, full colour guide would make a wonderful present for any expectant or new parent. I answer common baby feeding questions with honesty, empathy and humour. The tone is kind, practical and judgement free. 🥰

Supporting your baby's weight with a pillow can help to relieve sore arms and wrists and give you both hands free for something else!

Make sure the pillow is firm and flat, and tucked in close to your body so there's no gap. The breast rests on the pillow. Your baby lies on their side, tummy to tummy with you so they can easily reach the ni**le without you moving it. You might need to experiment a bit to find the right pillow(s) that fits your body so you can relax your shoulders and enjoy the feed.

If you'd like more information about comfortable breastfeeding please see my articles at www.cathysage.com or buy my book Breast, Bottle or Both on Kindle.

Celebrating Pride in London with my fabulous kids, friends and brilliant colleagues from St George’s❤🧡💛💚💙💜

London

It was so lovely to catch up with Emily, Cam and baby Reggie this week.

Relaxed, laid back breastfeeding is such a natural and baby-led way to feed. Full term healthy babies know how to do this! Just put them tummy to tummy with mummy in a place where they can use their instincts and find the ni**le.

For more details about laid back breastfeeding and what a good latch looks like, pop to my articles on www.cathysage.com or buy my book Breast, Bottle or Both on Kindle 🤍💜💙

I loved chatting to Netflix stars Emily and Cam about feeding their little one on their hit podcast Now We're Talking Baby ✨️🤍

Listen now 😁
https://open.spotify.com/episode/2ngtsTyMwC3BlGnbx4eyRh?si=K0qx81qGTt-kFS2QJt93rg&context=spotify%3Ashow%3A6YqrxVQQI90aGELUQaB5Rm&t=1321

Lovely to meet Netflix stars Emily and Cam on their hit podcast Now We're Talking Baby. We chatted about breast and bottle feeding their little one when he's born, and discussed the truths and myths around baby feeding. Catch the new podcast tomorrow on your favourite platform or watch us on YouTube.

Why is your baby refusing a bottle?
There are so many possible reasons, including:

🍼 They haven't got the skills
🍼 Their oral anatomy is working against them
🍼 The bottle teat is a difficult shape for them
🍼 The flow rate is not suitable for them
🍼 They don't feel securely supported
🍼 They are being forced to drink when they are not hungry
🍼 Their caregiver has unrealistic expectations about how much they should drink, and how often
🍼 Their caregiver is stressed

There is so much we can do to help. Please read the full article on my website www.cathysage.com and reach out for some help from an IBCLC with bottle feeding skills.

What worked for you and your baby?

There are so many formula milks on the market. It can be tempting to pick one that offers special attributes like comfort, anti-reflux, lactose free, or to be for hungrier babies. None of these are recommended unless prescribed by a doctor.

Most babies thrive on a standard infant milk labelled 1, which means it is suitable from birth to one year. After one year, healthy babies can move onto whole cows' milk. There is never any need for follow on formula or toddler milks. Formula composition is tightly regulated, and any brand will do. Expensive number 1 formula is not proven to be better for babies.

I highly recommend the organisation First Steps Nutrition for well written, evidence based research about formula and nutrition for babies and children.

I work with lots of parents of babies who are struggling to take a bottle. Reach out for a free ten minute chat, or a bottle consultation in person or online. The link is in my bio. Here’s how to start.
1. Find a time when your baby is willing to eat, but not hangry.
2. Choose a teat size and shape that is appropriate for the age and mouth shape of your little one. Have one or two different styles and flow rates to hand.
3. Your baby will learn this new skill better if they are relaxed with someone that loves them.
4. Hold your baby securely, with lots of eye contact and reassurance. Skin to skin feeding is gorgeous.
5. If you can, dip the bottle teat in expressed milk or formula first.
6. Some babies prefer the milk in the bottle to be warm.
7. Rub the teat on their top lip to ask them to open their mouth. Put the bottle into their open mouth facing up towards their palate so that they can make a seal and suck on the empty teat for a few seconds.
8. When they are sucking on the teat, raise the bottle so that they can access the milk. Keep the bottle teat full of milk, but bottle angled just off horizontal so that baby controls the flow of the milk.
9. Look for baby swallowing happily. If they are stressed, stop for now, and calm them.
10. Watch your baby and give them a break if you feel they need it.

🤍 I offer a FREE ten minute consultation - link in the bio to book online

💜 I often get asked what to expect during a consultation. First, I know it might seem odd to invite a stranger into your home with your new baby, or even worse to get your breasts out online! Rest assured that I will not judge you or be embarrassed in any way, and I aim to keep you really comfortable.

💙 We will start with a chat about what is going on for you and your baby, and I will need to ask you about how the birth went and any relevant medical history. Everything we discuss remains confidential between us.

🤍 Breastfeeding consultations generally involve me observing a feed for start to finish. Depending on your concerns, we can look at finding comfortable ways to feed your little one, talk about how we know that supply is OK or what to do about it, discuss feeding times and patterns, colic or reflux...whatever you need.

💜 If breastfeeding is not going so well, or is not your preferred option, we can work together on using ni**le shields, expressing, bottles, teats and formula. Sometimes these can be necessary to get you both over a temporary glitch, or they can form part of your ongoing baby feeding solution.

🍼 I am fully trained in bottle feeding and can help you to do this comfortably and safely.

🤍 Many of my consultations are around bottle feeding, including how to achieve responsive or paced feeding, determine appropriate milk volumes, select a suitable bottle, teat and flow rate for your baby’s unique situation, and help reluctant bottle feeders to take milk this way.

After our visit I will send you a Care Plan detailing what we discussed.

For more information, a free 10 min chat or to book a visit, follow the link in my bio.👆

**leshields

Breastfeeding is a brilliant way to calm your baby.

Babies will want to feed if they are tired, distressed, need to connect with you, are feeling unwell... Breasts are the best mothering tool. I promise that you cannot spoil a baby by feeding them in these situations.

How do you know whether your little one is actually feeding or just sucking?

Look for baby’s jaw movements. When baby first comes to the breast their sucks will be rapid and fluttery, this is your baby asking for the milk to let down. After a few seconds your baby may settle into more rhythmic sucks, but with some pauses. When baby is swallowing their jaw will move down lower and there will be a tiny pause, you might also hear a gulp or a little “huff” from baby’s nose.

Sometimes your baby might do fluttery rapid sucks later in a feed, to stimulate further let downs. If your baby has stopped swallowing, try compressing the breast slowly with your fingers. This can send more milk down and get baby interested in sucking.

If you are worried that your baby is not taking sufficient milk, please consult your healthcare professionals or give me a call to chat it through.

Family members often love feeding your baby. They get those super snuggly times together, lots of lovely cuddles and interactions, and know that they are allowing you some time to rest or do other things. It can feel like a gift to all involved.

Some women feel guilty about not wanting to be the only one to feed the baby. I get masses of enquiries each week about how to encourage baby to take a bottle so that mum can do something else. The mums apologise. They say things like "I know it is selfish but I really need some sleep/want to get a haircut/need some time out/want to get some exercise." This is NOT selfish, this is self care.

Many mothers need or want their baby to be bottle fed. That is fine too. Babies just need to be fed and loved. Sharing the feeding process can be amazing for everyone.

I bet you have been told to "sleep when your baby sleeps." It sounds like a cruel joke. You can spend ages trying to get your baby down for a nap, and might even crawl into bed or onto the sofa, only to have them wail again in five minutes. So what can you do about your sleep and theirs?

After years of working with new families, I suggest:

💜 Don't stress about routines or wake windows. Trust that your baby will sleep when they need to. It is just biology.

💙 Little babies sleep best in contact with an adult, so it is fine to let them sleep on anyone who is willing to sit and hold them! I promise this is not setting up bad habits.

💛 If you are awake, or want to get on, or want to get out, use a carrier. There are loads of good ones to rent or buy. Strap baby to you and get on with your day. It can do you the world of good to get outside.

💚 If you are hoping to sleep too, consider safely sharing a nap in your bed with your baby. Follow safe sleep guidelines (in my articles or look up the Safe Sleep Seven).

Which techniques work for you?

🍼 Most parents feel pretty overwhelmed by the choice of bottles on the market. Each claims to be natural, closer to breastfeeding, and to fix all your baby's problems like colic, gas, spit up or reflux.

🍼 Sadly, there is no independent oversight of these claims, and bottle manufacturers can write whatever they like!

🍼 There is also no consistency in what slow/medium/fast flow means between brands.

🍼 Common sense suggests that you buy one or two bottles at first, and see which one your baby prefers. The bottom line is that most babies are able to cope with most bottles.

🍼 Your baby needs to be able to grasp the teat deeply with an extended tongue, and be able to maintain a good seal with relaxed lips. If your baby is squirming, readjusting, sliding up and down or leaking milk, you might need an alternative teat.

🍼 While a wide teat base helps some babies to keep a wide open mouth, tiny babies and those with suck problems might need a narrower base.

🍼 Teats vary in firmness and texture. Babies with tight mouths or those who collapse teats while feeding will need a firmer brand.

🍼 Bottle feeding should be relaxed, a whole bottle taking 10-20 minutes rather than 1-2 mins!

🍼 Some teats are variflow or only offer milk when your baby sucks well on them – great for some babies but hopeless for babies with a compromised or weak suck.

If you'd like more tailored support for you and your baby, please get in touch or book a free ten minute consultation, see my bio 👆

Most babies spit up or reflux milk, often many times a day.

Their digestive system is immature, and it is easy for them to spill milk. It often happens when:
😮 baby is coping with a fast or big feed from breast or bottle
😮 you move baby around a lot after feeds, such as with vigorous winding or nappy changing
😮 baby is lying down in a cot or pram

The good news is that most babies grow out of this in time. The bad news is, you do a lot of washing! Provided that baby is well, putting on weight, thriving and doing an appropriate number of wet and dirty nappies, please try not to worry about it too much.

We can help by choosing feeding positions (like laid back and side lying) that work well for fast flowing breasts, or selecting a bottle with a slower flow rate. Many experts think that babies don't need quite as much burping as we might think. Many babies do best when cuddled upright or carried in a sling during the day.

If feeding is a nightmare and baby is dropping centiles on the growth charts, baby needs to be assessed by a GP or paediatrician. A lactation consultant can help you detect and manage feeding issues. A newborn baby projectile vomiting every feed needs urgent medical assessment.

Babies writhing in pain may be offered Gaviscon or medications to reduce stomach acid. However, this is controversial and there is limited evidence that they work. As babies are regularly fed milk, their vomit is not particularly acidic. Investigations into most reflux babies rarely shows inflammation or damage to the oesophagus. The medications prescribed for reflux can have quite significant side effects, not least uncomfortable spikes in stomach acid production as we take our babies off the drugs. They should be used with caution.

It is so important that we look after parents’ mental health while baby is having such a hard time.

Please share your experiences of how you coped with reflux below.

Here’s how to start.

1. Find a time when your baby is willing to eat, but not hangry. This could be when waking from a nap, or when a little sleepy. Probably avoid late afternoon or evening when everyone is frazzled.

2. Choose a teat size and shape that is appropriate for the age and mouth shape of your little one. You might like to have one or two different styles and flow rates to hand.

3. Your baby will learn this new skill better if they are relaxed with someone that loves them. Mummy does not need to leave the building!

4. Hold your baby securely, with lots of eye contact and reassurance. Skin to skin feeding is gorgeous.

5. If you can, dip the bottle teat in expressed milk or formula first.

6. Some babies prefer the milk in the bottle to be warm.

7. Rub the teat on their top lip to ask them to open their mouth.Put the bottle into their open mouth facing up towards their palate so that they can make a seal and suck on the empty teat for a few seconds. Don’t worry, they are not swallowing air.

8. When they are sucking on the teat, raise the bottle so that they can access the milk. Keep the bottle teat full of milk, but bottle angled just off horizontal so that baby controls the flow of the milk.

9. Look for baby swallowing happily. If they dribble, cough, gag, splutter, hit the bottle, pull away, flail around, make fists or splay their fingers, they are stressed. Stop for now, and calm them. If this happens a few times, investigate a different bottle and teat. We don’t try to bottle feed a baby that is crying.

10. Watch your baby and give them a break if you feel they need it. Some babies like to be offered the chance to burp if they look red and squirmy, and after a feed if they are awake. No need to burp a baby that is happily sound asleep after their feed.

If you are worried about your baby’s bottle feeding, please reach out to me for skilled support. Some babies take time to learn this new skill, and some seem to forget how to do it when they used to bottle feed just fine! I work with lots of parents to help babies that are struggling to take milk from a bottle. You can book a consultation with me through following the link in my bio. #

If you'd like more tailored support for you and your baby, please get in touch or book a free ten minute consultation, see my bio 👆

**leshields

There are several milk collection devices on the market - one of the best known is the Haakaa. What does it do?

These silicone devices aren't pumps, there are no working parts. Instead, the mother uses them while feeding or expressing on the other breast. She squeezes some air out of the device and then applies it to the centre of her ni**le. This generates suction, encouraging milk to drip out and be collected.

The suction should be comfortable! I have seen mothers with red and swollen areolas from having too much pressure.

These devices are commonly used during morning feed or pump sessions, when there is more milk around to collect.

The milk could then put in the fridge for use within a few days, or poured into a suitable storage container to be put in the freezer.

What is your experience of using these systems? I would be so interested to read your comments below.

**leshields

Feeding lying down can be incredibly relaxing and help you both to get more rest.

Simply lie on your side, one arm up, legs bent, making a C shape around your baby. This is often called the cuddle curl.

Baby lies on their side, tummy to tummy with you, where they can easily reach the ni**le (on the breast that is resting on the mattress).

Babies can drink and digest just fine on their side, and it can be a great position when mum has a generous supply and/or fast let down. Just put a muslin on the bed first!

Worried about falling asleep? Provided that you set up the environment safely, that is rarely a problem. In fact, it is much safer than accidentally falling asleep while feeding on a sofa.

For more on how to feed on your side, and how to bedshare safely, see my article at https://buff.ly/3LRyO4s or follow the link in my bio 👆

New parents deserve empathetic, judgement free support to work through their baby feeding issues. It was gorgeous to work twice with this new mother, seeing her confidence build.

**leshields

🤍 I work with lots of bottle feeding families, in person and online. Some are exclusively using bottles, others want to introduce some bottles to their breastfed baby.

🍼 You can expect lots empathy, I aim to make our consultation as comfortable as possible. We will start with a chat about what is going on for you and your baby, and then discuss your bottle feeding goals.

🤍 We look for a time when baby is willing to eat but not hangry!

🍼 Please have your bottle feeding kit and some milk ready to go, and I will probably also bring some sterilised bottles of my own to try if you would like.

🤍 If you are comfortable, I may ask to put on some hospital gloves and examine your baby's mouth, tongue and how they suck. This really helps us all to understand what is going on for your baby and which teats and flow rates might be appropriate.

🍼 We might try some bottle teats, first without milk. If baby will suck, we will offer some milk.

🤍 We can discuss all your bottle questions about kit, volumes, frequency, flow rate, expressing, storing milk, type of formula, whatever you need.

🍼 Afterwards I will send you a Care Plan detailing what we talked about, any exercises and next steps.

🤍 I look forward to working with you. Book a consultation or schedule a free ten minute chat from my website https://buff.ly/3LRyO4s or follow the link in my bio 👆

**leshields

💗 Over the last 18 years, I have seen A LOT of ni**les! New mums often worry that their ni**les might not be right for breastfeeding. The good news is that, with support, most women can feed their baby regardless of what is going on with their ni**les.

💗 Ni***es that stick out can be easier for a baby to latch onto, as the suck reflex kicks in when they feel the ni**le touch their palate.

💗 Flatter ni**les will often come out when baby massages with their hands or starts to suckle. Mothers can make this happen themselves by gently tugging or lightly pinching the ni**le just before the start of the feed.

💗 Some ni**les don't stick out though, even when stimulated, and mothers might need to help by squishing the ni**le as baby latches to assist them to get a big mouthful.

💗 Inverted ni**les, that point into mother's body, can be a little challenging for baby and uncomfortable for some women.

💗 When ni**les are difficult for feeding, some women use ni**le shields either temporarily or for all feeds. These are flexible silicone, shaped like a teat and worn at the breast during feeds.

💗 I have occasionally met women whose ni**les are too large for their newborn. While they will be able to feed when baby has grown a bit, these mums need to express milk at feed times (8x a day) to keep their milk supply and bottle feed their baby in the interim.

👆 Feel free to contact me for more help in your unique situation.

**leshields **lesize **leshape

It is so important to nurture and nourish the whole family. I love to involved partners, grandparents and other trusted adults in baby feeding consultations.

How much milk should we put in baby's bottle? I wish there was a straightforward answer. Obviously, it depends on the age and size of the baby, how frequently they feed, and what their appetite is at that time. We feed babies responsively, based on whether they're asking for food, and we use the appropriate flow rate teat for the baby.

It might help you to know a couple of rough guidelines. From the end of the first week, milk intake in 24 hours is approximately baby's weight in kilos multiplied by 150 mls. So a 3 kilo baby would have 3 x 150 = 450 mls in 24 hours. Then divide by the number of feeds eg 8 feeds is 450/8 = about 56 mls per feed. From 1-6 months old an average baby takes 750 mls in 24 hours.

Formula packets tend to suggest fewer, bigger feeds, but lots of babies prefer smaller more frequent feeds.

If you'd like more specific information for your baby, please reach out for specialist support. For more information on bottle feeding, click the link in my bio.

Parenting a baby is really stressful. Doing so while facing some of life's other major challenges can be pretty overwhelming. Many new parents are also dealing with stressors such as illness, a house move, job loss, financial insecurity, relationship problems, bereavement... the list goes on. So does a baby pick up on parental stress?

As you would imagine, it's complicated. Most of the time, parental love and care shields the little one from the negative effects of stress.

Babies are designed to pick up on their parents' responses to what's going on. They are impacted by parents' expressions, tone of voice and heart rate. As babies get older, they might be more affected by stress that is severe, long term and toxic. We know that babies react, for example, to shouting, rough handling, and big changes in the way they're parented.

Some babies are very sensitive and cause stressed out parents!

If you're impacted by severe stress or depression, please reach out for some support. We need to care for you as well as your little one.

Follow the link in the bio for more articles on this and other feeding and parenting issues.