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Optimal practice review: recommendation reminders detail

Recommendation reminder 1: Formula milk should not be given to breastfed babies in hospital unless medically indicated.

Guidance:Postnatal care
Date issued:July 2006

Postnatal care refers to the care of women and their babies in the first 6–8 weeks after birth. Because each woman and baby has different needs, the postnatal care they receive will vary.

For most women and babies the postnatal period is uncomplicated and postnatal care is primarily about providing a supportive environment in which a woman, her baby and the wider family can begin their new life together. Postnatal care is also about ensuring that the mother and baby are recovering normally after the birth and being able to quickly identify and deal with any problems that might occur.

The majority of postnatal care takes place in the woman’s home and is likely to include routine clinical examination and observation of the woman and her baby, routine infant screening to detect potential disorders, support for infant feeding and ongoing provision of information and support.

Breastfeeding provides many short- and long-term health advantages for a woman and her baby. Within the first hour of giving birth women should be offered support to help them start breastfeeding, and the benefits of breastfeeding and colostrum should be explained to them. Colostrum is the first milk. It is rich in fats and protein and also helps protect babies against infection.

Formula milk or artificial milk is modified cow’s milk or modified soy liquid. There may be circumstances where infants may need formula milk as a replacement for or supplement to breast milk, for example, if they are born underweight or prematurely, if they are affected by certain rare diseases, or if their mother is diabetic or taking certain medications. However, NICE has recommended that all health services caring for women and their babies ensure they implement a programme that encourages breastfeeding. This programme should be approved by an external organisation.

The Baby Friendly Initiative is a global programme set up by UNICEF and the World Health Organization. Its aim is to improve practice so that parents get the help they need to make informed choices about how they feed and care for their babies. The evidence-based standards set by this initiative should be part of the health service’s breastfeeding programme. These standards include ‘Ten Steps to Successful Breastfeeding’, one of which is to ‘give newborn infants no food or drink other than breast milk, unless medically indicated’.

The evidence reviewed by the NICE Guideline Development Group indicated that institutional changes in hospital practices to promote breastfeeding, either as part of or independent of the Baby Friendly Hospital Initiative, can be effective at increasing both the initiation and duration of breastfeeding.

Therefore in line with the Baby Friendly Initiative, NICE recommends that formula milk should not be given to breast fed babies in hospital unless medically indicated.

This page was last updated: 15 October 2009

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.