Ask an expert: Liz Costagliola

Ask an expert: Liz Costagliola

Liz is here to offer advice on a range of queries, from how to organise your night feeds, to tips and clothing suggestions for breastfeeding.

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I’m due to give birth in June and have read that bottle-feeding at night makes for a more contented sleep for your baby. Is it possible to combine breast and bottle like this?

It’s a myth that bottle-fed babies sleep better than those that are breastfed. Often it is down to the individual baby and has nothing to do with how they are fed. It is recommended that babies are exclusively breastfed, so it is worth just breastfeeding and not using a bottle if you are able to. If you decide that you want to do both, then this is fine, but you are best waiting until your baby is at least three weeks old. This gives you the chance to get the breastfeeding well established. Under this age, baby may get confused between the breast and bottle.

My baby is due in July and I’m dreading having to breastfeed in public, or while visiting friends and family. Do you have any tips and clothing suggestions for when the inevitable situation arises? To start with, you can feel vulnerable and exposed whilst breastfeeding in public, but as you get more experienced and used to it, you will feel more confident doing so. Once baby is latched on, it really does look like you are giving her a cuddle as you can’t see anything. Wear button-up tops, rather than jumpers and T-shirts, as these are more discreet. There are special breastfeeding covers which you can buy to cover yourself and baby while feeding in public, but, to be honest, muslin squares are just as good and much cheaper.

When I lay my baby down in his Moses basket he wakes up crying. We’ve tried leaving him to cry and then settle, but it’s not working. We’re exhausted – help! Newborns often feel insecure when put down. Remember, they’ve been snuggled up safely in your womb for months, so finding themselves in a cot or basket can make them feel vulnerable. If you’re holding your baby until he 
falls asleep and then putting him down, it’s likely he’s waking suddenly and finding himself not in mummy’s warm arms any more. Try putting him in the cot before he falls asleep. Another 
tip is to warm the bottom sheet of the basket or cot before you put baby down 
– use your body heat by putting your 
hands on the sheet for a few minutes.


My baby weighed 6lb 13oz at birth,
she is now nine weeks old and
 only weighs 9lbs. She was on the ninth centile and is now on the
 second centile should I be worried? Babies don’t necessarily stay on the centile they were born on. Some go up and some go down. It is difficult for me to say for definite as I can’t see the centile chart, but as long as she now stays on this centile and doesn’t continue to drop, and if she is feeding well, pooing and weeing regularly, then it is
unlikely to be a problem. If she does 
continue to drop down the chart, then this shows she is not putting on enough weight and it needs to be looked into. Speak to 
your family health visitor as she’ll be able to check the chart and can advise you further.  

Do I still need to sterilise my eight-month-old’s bottles? I’ve been
getting mixed information about this. It is advised that bottles are sterilised until your baby is one. All other equipment, such as cups and spoons, should be sterilised until your baby is six months old. There are now self-sterilising bottles available which can also help make life easier. You just
put some water in them and pop them in the microwave.


My four-month-old had been sleeping through the night until a few nights ago when he started waking up for feeds again. Should I start weaning him?
 It sounds like your baby is going through 
a growth spurt and therefore needs extra milk. Continue to feed baby on demand in the day 
and in a few days he should settle back down. Try to persevere with the milk feeding until baby is six months. Recently 
in the press there were reports suggesting that weaning could be introduced at four months. This conflicting advice caused a lot of confusion for many parents. However, according to the World Health Organization (WHO) under the age of six months a baby’s digestive system is not mature enough for solids, and weaning before this time can lead to health problems. The Department of Health is sticking by the WHO recommendation. If parents feel that their babies are very hungry and decide to wean their babies early, then their babies need to be at least four months old and only offer tiny amounts of very simple food, such as baby rice and puréed fruit and veg.

My baby has dry skin on his body and legs. What’s the best way to treat it? Dry skin is very common in babies and can be easily treated. First, you must stop using any perfumed products on his skin and in his bath, even if they are moisturising, as these can irritate the skin and make the problem worse. Instead, he needs an emollient cream (moisturiser) and a special bath additive to stop his skin drying out in the water. Your family health visitor will be able to prescribe all these for you. It is important to apply the emollient cream as often as possible to keep the skin moist and to prevent it from becoming red and angry. Once his skin has improved, continue to apply the cream and use the bath additive 
to prevent it from becoming dry again.    

My eight-week-old baby has not had 
a poo for three days. He is breastfed, is feeding perfectly normally and doesn’t appear to be in any pain. Should I be worried? In the first few weeks of life, breastfed 
babies poo very regularly. In fact, it seems 
as if every time they are fed, they poo as well. But after a few weeks the baby’s digestive system begins to mature and they can actually go several days without having 
a poo (some babies will only go once a week). The stool should still be very loose and yellow, and there should be a large quantity, but the change in regularity can worry first-time mums. Your baby shouldn’t be in any discomfort and should still be feeding normally. Bottle-fed babies’ poos are more formed 
and they should pass a stool more often.  

My daughter is ten months old and takes hardly any of her baby milk –about 1oz with each meal. Would it be ok to try her on cow’s milk so she gets some goodness rather than nothing? First of all, try offering her water with meals and milk in between meals – so first thing in the morning, mid afternoon and again at bedtime. Often babies are too full to drink milk with their meals but will appreciate it later. You can also put formula on her cereal to try and get her to take more.  We don’t recommend cow’s milk as a drink for children under the age of one because it doesn’t contain enough vitamins and minerals for them. However, if your little one refuses to drink formula then 
yes, cow’s milk is better than nothing. 
Give her lots of diary products, too, such
as yoghurt and cheese. You could also give her vitamin drops 
(we recommend them for all babies from 
the age of six months). Vitamins A, C and 
D are the recommended ones and are available from most clinics. Some parents ask if it might be worth trying goat’s milk. However, goat’s milk isn’t recommended for children under the age of one either. Pasteurized goat’s milk can be given to older children but it contains even fewer vitamins than cow’s milk. If your child is allergic to or doesn’t tolerate cow’s milk, she is likely to have the same problems.

My tot is getting regular outbreaks 
of cradle cap and it looks so horrible that I’m actually beginning to feel a bit embarrassed about taking her out. Is there anything I can do to stop it recurring so often? The first thing to say is that no one should feel embarrassed about their baby having cradle cap, as it has nothing whatsoever to do with poor hygiene. It is simply caused 
by the overproduction of sebum from the skin’s oil-producing glands, which in turn causes the build-up of a thick, yellow layer of dry skin. It may not look nice but it doesn’t cause the baby any distress and 
can easily be treated at home.
Simply apply a layer of a natural oil (such as olive oil) to your daughter’s scalp about 
15 minutes before bathing her, and then wash it off with a mild shampoo. You can then use a soft-bristled brush or a fine-toothed comb to gently lift the scales from her head and brush them away. Continue with this regime even after all signs of cradle cap have gone, to help prevent the condition recurring. 


My seven-month-old has started to get upset most evenings. Mum says he’s just colicky, but he can cry for ages and is definitely in pain – he arches his back. Nothing I do seems 
to help. Do you have any advice? Colic usually appears a few weeks after birth and carries on for about three to four months. Babies may scream for several hours three, four or more times a week but it has no long-term effects and babies with colic will feed and gain weight normally.
However, it does usually stop being a problem at three or four months old and, as your baby is now seven months, it’s unlikely to be colic (although in some babies it does carry on for longer). I feel you should take 
your baby to your GP, as unexplained pain should always be investigated.

I’m due to give birth in June and have read that bottle-feeding at night makes for a more contented sleep
for your baby. Is it possible to combine breast and bottle like this? It’s a myth that bottle-fed babies sleep better than those that are breastfed. Often it is down to the individual baby and has nothing to do with how they are fed. It is recommended that babies are exclusively breastfed, so it is worth just breastfeeding and not using a bottle if you are able to.
If you decide that you want to do both, then this is fine, but you are best waiting until your baby is at least three weeks old. This gives you the chance to get the breastfeeding well established. Under this age, baby may get confused between the breast and bottle. 


I gave up smoking during my pregnancy, but now I’m back to work, everything feels a bit stressful and I’m starting to take sneaky cigarette breaks. I’m so disappointed in myself. How can I expect to give it up when I feel so stressed at home and work? Congratulations on what you have 
achieved so far! Quitting smoking is never easy and you have done well, so don’t feel disappointed. Work stress is a common trigger and finding another method of relieving it instead of cigarettes is the ideal answer. You will need to consider what works for you as everybody is different. While at work, try to surround yourself with the ex or non-smokers who can encourage you and be supportive when 
you are struggling. Talk with them about what you need and how you are dealing 
with your cravings. Remember to be patient 
with yourself and give yourself healthy rewards for not smoking. There are organisations that can help too. Go to smokefree.gov for advice and useful tips 
on how to stay nicotine-free.

Is it better to have our newborn baby in a nursery or in a cot in our room? 
Is there a recommended environment that will benefit mum, dad and baby 
in the long-term? The guidelines to reduce the risk of cot deaths advise that babies from birth to six months old should sleep in a crib in the same room as their parents. There is evidence to say that babies who sleep in the same room as their parents have reduced risk of cot deaths. Once babies are six months old they can be moved into a room of their own. Some parents keep their babies in with them for longer than this, but this 
is just a personal choice and up to the individual parent as there is no right or wrong way of doing it.  Some parents do 
say that as their babies get bigger and more aware, they are disturbing them at night and find that once they are in their own room, they settle sooner and sleep better.  

My childminder tends to let me down about once a month. How do I broach the subject with her as it’s getting very stressful when I have to take time off work at the last minute? It is always beneficial to make time for regular chats with your childminder to ensure that you are both happy with your arrangement. As a childcare professional
she is bound by a contract that you will 
have both agreed at the beginning of your arrangement. It might be useful to clarify with her what is in the contract and, if 
she is in breach of it, discuss with her 
how the issue can be resolved. If it is a regular problem that cannot be sorted out, then maybe you will have to look at alternative childcare arrangements. Check out ncma.org.uk for more advice on working with your childminder.

I had really bad morning sickness 
with my first child and because of 
this I’m scared of trying for a second. 
I felt wretched and so miserable with it. Is there anything I can do to help overcome this fear and ease the symptoms if they occur again? Each pregnancy is different, so morning sickness won’t necessarily be as bad in future pregnancies. But if you do suffer, there are things you can do to ease the symptoms. Keep plain, dry crackers or ginger biscuits by your bed and eat one as soon as you wake, then rest for 20 to 30 minutes before getting out of bed. Eat little and often, every two to three hours, even if you’re not hungry, and drink plenty of fluids, but avoid caffeine and alcohol. Try ginger tea or ginger tablets, as ginger is renowned for soothing morning sickness. If none of the natural remedies works, speak to your midwife or GP.

I’ve been breastfeeding for six months and now plan to move on to formula. But I’m worried it may not be a good enough substitute. Which of the leading brands would you recommend, and is there an impartial website where I can compare brands? You’ve given your baby the best start in life and have done really well to breastfeed for six months. I can’t recommend makes of milk, but do recommend that you stick to the well-known brands as these companies are always conducting research to ensure that their formula milk is as good as possible. Now that you’re starting to wean your baby, and he will be gradually drinking less of your milk, it is worth introducing the formula slowly so that your breasts don’t become engorged. Try increasing the formula feeds by one bottle every few days, and this will give your body the chance to adjust to producing  less milk.  

My mum couldn’t breastfeed me
as a baby, as she ‘couldn’t produce enough milk’. Now I’m seven months pregnant, I’m worried this problem might be heredity. Could it be? And are there any supplements I should be taking to help me produce more milk? Although your mum wasn’t able to breastfeed, there is no reason why you won’t be able to successfully breastfeed your baby. Breast milk is produced on a supply and demand basis. This means that the more baby feeds, the more milk you will produce, and it is very rare that not enough milk is made. In the early days, it’s very important that you feed baby as often as possible to help get your milk supply started. Try not to offer your child any other fluids as this will interfere with your milk supply and it can also confuse the baby by
using a different sucking mechanism. It is advised that all pregnant and breastfeeding women take 
the ‘healthy start vitamins’ which are vitamin C and folic acid.

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