Glossary

Terms that are frequently used in reference to breastfeeding:

Antenatal (or prenatal) - the period before the birth of the child.

Antepartum - the period of pregnancy before childbirth.

Anti-reflux formula (or "staydown" formula) - a thickened formula aimed to prevent reflux in babies which is suitable from birth but under medical supervision.

Baby Friendly Hospital Initiative (BFHI) - set up by the WHO & UNICEF to help develop standards & steps for hospitals to support breastfeeding initiation & duration with the central part being the 10 steps hospitals must complete to be awarded Baby Friendly Hospital status to ensure optimal conditions are present for breastfeeding.

Biopsychosocial model of breastfeeding - a model of viewing the different types of breastfeeding barriers identified thus encapsulating biological, psychological and social barriers (Asimaki et al., 2022).

Breast cancer - cancer found in breasts. It is the most common type of cancer in women. Anyone can get breast cancer. Symptoms include a lump in the breast area, a change of skin, a change in size/shape of breasts, nipple discharge, change in shape/size of nipples, and a pain in the breast that doesn’t go away.

Breast (or postnatal) engorgement - the painful swelling of breasts that occurs usually soon after giving birth, caused by the shift in stage 1 lactogenesis to stage 2 in which there is an increase in milk volume and increased blood and lymph circulation.

Breastfeeding – feeding an infant breast milk either directly from the breast or through bottle-feeding and pumping. Identified as being one of the most effective ways to ensure child health and survival as the milk is safe, clean and contains antibodies which protects against illnesses (WHO, 2024).

Breastfeeding Aversion Response (BAR) - the compulsion to unlatch in reaction to negative physical sensations while breastfeeding.

Breastfeeding gear model - coordination, goals and monitoring sit in the middle of this model. This is surrounded by advocacy, political will, legislation and policies, funding and resources, training and program delivery, promotion, and research and evaluation. It is used to understand and map the factors facilitating or hindering the scale up of national programmes and the corresponding improvement in breastfeeding practices.

Breastfeeding grief - the mourning/loss of the breastfeeding relationship which can occur as a result of stopping breastfeeding earlier than one wanted to.

Breastfeeding self-efficacy - a person's belief in their own ability to breastfeed.

Cleft Lip/Palate - congenital abnormalities of separations in the upper lip & mouth that occur while a foetus develops in utero, difficulty feeding will usually occur as they may be unable to breastfeed or feed from a normal bottle as they cannot form a good seal with their mouth.

Clogged Milk Ducts - blocked milk ducts which usually carry the milk to the nipple, stops the flow of milk.

Colostrum - the thick, yellowish-white milk produced in the 2-3 days after delivery, at first produced in small amounts which is all the infant needs containing antibodies, a high amount of protein, minerals and fat soluble vitamins, fewer carbohydrates and less fat than mature breast milk.

Comfort feeding - when an infant breastfeeds for reasons other than to be fed/nutrition

Comfort formula - suitable from birth but with advice from a health visitor. It contains cows’ milk proteins that have already been partly broken down which is supposed to make it easier to digest and help prevent digestive problems, but here is no evidence for this.

Complementary feed - child receives both breast milk and breast milk substitutes (e.g. formula, cow, goat or sheep milk) or semi-solid or solid food.

Cup feeding - suitable from birth using either expressed breastmilk or infant formula, involves feeding child via a cup which encourages them to use their tongue and lower jaw similarly to how they would breastfeeding, giving them more control over how quickly they drink.

Donor Human Milk (DHM) - breast milk donated by another mother which is often given to premature babies, low birth weight, sick infants where there is insufficient MOM (mother’s own milk)

Dysphoric milk ejection reflex - an abrupt emotional “drop” that occurs just before milk release & continues for a few minutes, maybe caused by a sudden drop in dopamine which occurs when milk release is triggered. These brief negative emotions range in severity from wistfulness to self-loathing.

Early feeding cues - baby is stirring, mouth opening and turning their head.

Exclusive Breastfeeding (EBF) - ‘an infant receives only breast milk, no other liquids or solids are given – not even water, with the exception of oral rehydration solution, or drops/syrups of vitamins, minerals or medicines’ (World Health Organization, 2016). Recommended up to 6 months.

Feedback Inhibitor of Lactation (FIL) - prevents too much milk being produced thus milk is made on a demand basis, this inhibitor will be removed once milk release is being stimulated.

First infant formula (first milk) - formula that is suitable from birth, and should always be the first formula fed to the baby. It contains the proteins ‘whey’ and ‘casein’ which are thought to be easier to digest, hence why it is in first formula.

Follow-on formula - suitable from 6 months but ask health visitor for advice. It should not be fed to babies under 6 months old. Switching to this has no benefits for the baby, and a baby can continue to have ‘first infant formula’ as their main drink until 1 years old.

Foremilk - the milk an infant consumes at the beginning of a feeding. This is mostly water containing other nutrients.

Formula Milk - made from cow’s milk that has been treated to be more suitable to infants. There are a wide range of formula milks a parent can buy. It can be bought as a dry powder that is mixed with water or a ready-to-feed liquid formula

Goats’ milk formula - suitable from birth, it is produced to the same nutritional standard’s as cow’s milk-based formula and is therefore not suitable for infants with a cows’ milk allergy.

Golden Hour of Birth - the time immediately following birth with skin-to-skin contact being essential for attachment and reducing stress for both the mother & baby.

Growing-up milk (toddler milk) - suitable from 1 year, but ask health visitor for advice. This is marketed as an alternative to whole cows’ milk for children, but there is no evidence that these products provide extra nutritional benefits.

Hindmilk - milk that appears later into a feeding. It is often filled with more fat, leading it to appear thicker and creamier than foremilk. It is believed to be richer and more calorie dense.

Hungrier baby formula (hungry milk) - suitable from birth but with advice from a health visitor. Contains more casein which is harder for babies to digest, often described as suitable for hungrier babies but there is no evidence of infants sleeping better with this formula.

Hyperlactation - the overproduction of milk that can be caused by an overactive milk ejection reflex (OMER) which can in turn cause issues with latching.

Hypoallergenic formula - suitable from birth under medical supervision. If the baby is diagnosed with an allergy to cows’ milk, a GP will prescribe an appropriate formula with fully broken down proteins.

Kangaroo mother care (KMC) - a method of care of preterm infants which involves infants being buried with skin-to-skin contact.

Lactation consultants - health professionals who specialise in breastfeeding helping those breastfeeding offering general support and education but also helping with a wide range of conditions such as latching difficulties

Lactogenesis - process of milk being produced. It begins midway pregnancy (stage 1) with colostrum being produced & breasts becoming enlarged then after the placenta is delivered (stage 2) there is a sudden drop in progesterone & oestrogen which removed the inhibition on milk production due to their being high levels of prolactin then milk production will occur then after the first few days a higher vol will start to be produced which is driven by the removal of milk (stage 3).

Lactose-free formula - suitable from birth but under medical supervision. Suitable for those who are lactose intolerant, although it is rare in babies.

Lactose intolerance - symptoms after eating food containing lactose, can be prevented by eating smaller portions or avoiding lactose products entirely. Symptoms include stomach pain, bloating, farting, diarrhoea or constipation, and feeling sick.

Latch - refers to how a baby’s mouth attaches to the nipple and areola when breastfeeding which is important to initiate breastfeeding however what looks like a good latch varies.

Latching Difficulties - infant struggles to breastfeed from the mother, there can be many reasons for this. The infant may be cueing too little or too much, repeatedly letting go of the breast and resisting, or producing few stools and appear gassy. The mother may have sore/bruised nipples or areolas; the nipples may often become red, scraped, cracked, misshapen and rarely notice breast fullness.

Late feeding cues - baby is crying, is agitated and is turning red.

Let down reflex - the result of oxytocin being released from the hypothalamus due to an infant sucking on the nipple. Some women can experience overactive/forceful or inhibited let down. Also known as “milk ejection reflex”.

Long-Chain Polyunsaturated Fatty Acids (LCPUFAs) - substance which is important for infant growth & development it is found in breastmilk and formula milk, however many LCPUFAs added to formula are not as well absorbed.

Mastitis - an infection caused by the blocking of milk ducts resulting in pain and soreness when breastfeeding.

Mid feeding cues - baby is stretching and is completing a lot of physical movement. They often may put their hand to their mouth.

Milk Blisters/Blebs - white dots or spots on the breast which occur with breastfeeding often caused by a blockage of milk and they can often be painful.

Mother’s Own Milk (MOM) - the milk produced by mothers that has been found to particularly benefit preterm infants.

Neonatal Hypernatremic Dehydration (NHD) - a rare condition where infants become dehydrated, occurs more often in breastfed babies due to a low intake of breastmilk (breastfeeding hypernatraemia). One of the biggest signs is a decrease in weight after birth of more than 10%.

Neonatal Intensive Care Unit (NICU) (level 3) - babies that need the highest level of support for more than 48 hours. This is necessary for babies with respiratory distress, and they need longer-term feeding support through an intravenous tube.

Nipple Blebs - a dot on your nipple which can cause shooting pains and make breastfeeding difficult they are associated with inflamed milk ducts which may be caused by hyperlactation or bacterial overgrowth.

Overactive Milk Ejection Reflex (OMER) - also known as a ‘fast let-down reflex’ or ‘forceful milk let-down’ in which milk is released in force which can cause issues with latching i.e. they may refuse to latch, gag or pull away

Oxytocin - the hormone that makes the muscle cells around the alveoli contract which becomes part of a conditioned response.

Postnatal depression - depression that 1/10 women experience within a year of giving birth. It is categorised by symptoms such as persistent sadness, lack of energy, difficulty caring for yourself and the infant, and frightening thoughts (NHS, 2022).

Postpartum (or breast) engorgement - the painful swelling of breasts that occurs soon after giving birth, caused by the shift in stage 1 lactogenesis to stage 2 in which there is an increase in milk volume and increased blood and lymph circulation.

Prenatal - the period before the birth of the child. Also known was “antenatal”.

Prolactin - the hormone which is necessary for the production of milk with high levels during pregnancy stimulate growth & development of mammary tissue but until delivery of the placenta progesterone & oestrogen prevent milk production when the baby suckles higher levels are produced with the most amount being produced at night.

Reflux - when a baby brings up milk or is sick during/shortly after feeding. This usually starts before a baby is 8 weeks old and gets better by the time they’re 1. Other symptoms can include coughing/ hiccuping when feeding, being unsettled, swallowing or gulping after feeding, and not gaining weight.

Responsive bottle feeding - this allows both parents to build a close and loving relationship with their baby. Feeding the baby when they show feeding cues and limiting who feeds helps to build the relationship. This should involve holding the baby close during feeds with lots of eye contact, gently letting the baby take the teat into their own mouth so they can control the pace, and not forcing the baby to finish the feed.

Responsive breastfeeding - mother responds to her baby’s cues alongside her own desire to breastfeed. A mother offers the breast if the baby has given feeding cues, is distressed, is unwell, or if they need to meet their own needs (e.g. full breasts).

Responsive feeding - feeding a baby when they show signs they are hungry, helping them to feel safe and secure. There are a range of feeding cues that signify how hungry an infant is.

Soya formula - suitable from 6 months but under medical supervision. It is made from soya beans and sometimes used as an alternative for those allergic to cows’ milk. Soya contains phytoestrogens which causes concerns that it could affect a baby’s reproductive development, especially if they have a low body weight. Additionally, soya formula is more likely to harm an infant’s teeth.

Sudden Infant Death Syndrome (SIDS) – sudden, unexpected and unexplained death of an apparently healthy baby (NHS, 2021) with most deaths happen during first 6 months of life.

Tongue-tie - a piece of skin connecting the tongue to the bottom of the mouth that’s shorter or tighter than usual, can lead to issues with breastfeeding as the infant may have difficulty latching.

Touched out - feeling overwhelmed and overstimulated by physical touch, often used in the context of breastfeeding or raising young children

Weaning - the process of gradually withdrawing the supply of breastmilk and introducing other forms of milk and food in which the introduction of solid foods are recommended (whilst still breastfeeding) at 6 months.

Wet Nurse - a woman employed to give her breast milk to another woman’s baby. Wet nurses became less popular when feeding formula was created.