Bump, Birth and Baby Stuff Antenatal Classes

Hi there, my name is Karen and I work for Bedfordshire Community Health Services in the baby friendly team, which is part of the Health Visiting Service. 

Health Visitors are all nurses who have gone  onto do extra training for their role, and that involves supporting your on your journey for the first five years of your child’s life, ensuring that they get the best possible start to life.

Our Health Visitors in Bedfordshire have key contacts with you, and that includes getting to know you when you are pregnant,  and also a new birth contact when your baby is 10 – 21 days old.  If you haven’t heard from us by the time you are 32 weeks  pregnant please make contact with us on our Single Point of Access number  or as we call it our SPA number on 0300 555 0606.  This is also the number that you would ring at any point if you needed support or information about your parenting journey, or to get in contact with your named health visitor.

During these video’s our Bump, Birth and Baby stuff sessions  we are going to be talking about a range of things, so with me you will be talking about your baby’s brain development, we will be talking about skin to skin, about feeding your baby, and we will talk about both breast feeding and formula feeding, and we will be talking a little bit about your well-being as well. 

Later on you will have a midwife talking about labour and delivery, and then our children’s centre team will be talking about all that really useful practical stuff like changing nappies, bathing your baby, about car-seat safety, about safe sleep, and also about the importance of play for your child’s development.

So, it is a bit of jam packed session, and we do call it a bit of a basic session, but if it sparks any questions or concerns please do get in touch with us.

Enjoy the sessions.

In this section we’re going to talk about your baby’s feeding cues. Often when we talk to parents about what their baby might do to let them know that they’re ready for a feed, the thing that parents suggest is crying. Crying is a feeding cue but babies will do other things too.

If we think about early feeding cues, that’s things like your baby stirring, so they might still be asleep but they’re just starting to come to. They might be starting to open their mouth, and they might turn their head as if they’re looking for food. They’ll do that especially if something touches their cheek, this is called “rooting” and it’s an instinctive behaviour. So they’ll do that if mum is holding them at the breast and they’ll turn down towards the breast, but they’ll also do it on your shoulder or your arm, or even if your fingers are on their cheek they might turn to that rather than whatever you’re trying to put in their mouth, so make sure that when you’re holding your baby to feed them, your hands aren’t actually on their cheeks but further back, and you’re holding them across the top of the shoulders.

These early cues have no sound attached to them, so in order for you to be able to spot them you need to keep your baby close so you can see what’s going on. Keeping your baby close is one of the first principles of Responsive Feeding which we’ll be talking about later.

As time goes on your baby moves into the mid cues, so your baby is starting to stretch and increase their physical movement, they might start to circle their arms. Do you remember when we talked about babies during those nine stages or skin to skin when they’ll move up mum’s body and do that commando crawl, that’s the arm circling working, but they may also do that on their back. They’ll put their hands in their mouth and they’ll just to get a little bit more active and start to make little noises, and that’s them saying “hello, I’m a little bit peckish now, can you feed me please?”

These early to mid cues are a really good time to start to feed your baby, because the next thing that’s going to happen is they’re going to move into the late cues. Crying is on this list. Crying is a late sign of hunger, we often talk about it like crying is your baby saying “I’m starving, feed me now,” and if you’ve ever gone a few hours without food and then you’ve got home and gone to the cupboard, you’re probably not making logical food choices and you’re just grabbing whatever you can. If you think about your state of mind when you feel like that, that’s what babies feel like too, and they can get a bit frantic when they get to that crying stage. You can be trying to feed them and saying “food is here,” and then can be saying “where is it, I can’t see it?” So it can feel very stressful for you and very stressful for your baby, and we want to avoid that stress because we know that when babies are calm their brain development is at its absolute best.

The other thing that happens when a baby cries is that its tongue lifts up towards the roof of the mouth. We think that’s a protective mechanism that prevents anything getting sucked down their airways. If you think about it, the baby’s tongue is up when its crying, but it needs to be down when it’s feeding. The tongue needs to come out of the mouth, over the lower gum and scoop in the breast or the bottle, so if a baby is crying you’re going to find it very difficult to feed them. What you need to do is calm them down and then try to feed them to avoid that difficulty.

Hopefully you can see from this that those late cues are things to avoid if possible. We know it’s the real world – sometimes you might have seen your baby sleeping and gone for a shower and by the time you get back your baby has gone through those early cues, gone through the mid cues, and you’re at the late cues. We know that every now and then that might happen, but the vast majority of the time you can look for those early cues and the mid cues and start the feeding process then. It’s going to be a lot calmer for you and for your baby.

We’re going to talk about responsive feeding and what that means. The first thing is following the feeding cues like we’ve just talked about, and this goes for whether you’re breastfeeding or formula feeding. The only thing that your baby needs for the first six months is milk, whether that’s breast milk or a first stage infant milk. Then at six months of age you start to introduce solids. Then by a year of life they will predominantly be solid-fed, with some milk feeds continuing. If you’re breastfeeding you continue to do so through introducing those solids, and if you’re formula feeding you use the first stage infant milk through that process.

What does responsive feeding mean? If you’re breastfeeding, as well as following the feeding cues, it’s about knowing that you can feed your baby at any point. Babies get a lot from breastfeeding, not just nutrition. It’s about comfort for babies too, and that’s not a bad thing. It can be a really useful parenting tool that if your baby is upset, or in pain, or tired and they need a little bit of help to go to sleep, then actually you can breastfeed your baby and it will help them with that process. If your breasts feel full and uncomfortable then you can feed your baby to help you to feel a bit more comfortable. If you know that you’re going out for lunch then giving your baby a little feed before they were ready to feed might help you to get through to pudding before you need to feed your baby again. Responsive feeding works both ways, for mums to fit it in for them (perhaps before the school run for the older children) but also for babies, knowing that babies will breastfeed for reasons other than hunger and breastfeeding for comfort is fine. It’s always ok to offer the breast and you cannot overfeed a breastfed baby.

We’ll talk about what responsive bottle-feeding means in a little while, but we’re going to focus now on why you might breastfeed. As a health service we recommend and encourage you to breastfeed your baby, and the reason for this is that we know from the evidence that there are lots of benefits for you and your baby if you breastfeed.

If you don’t breastfeed, and decide that you don’t want to do it or you’re unable to breastfeed (we know that there’s a small proportion of women who because of medical conditions are not able to breastfeed) and of course there are babies with medical issues that stop them from breastfeeding too. We will make sure that you are supported and we will make sure that you get really good information about how to care for your baby. But if we think about the value of breastfeeding and the reasons why you might breastfeed, we know that if babies are breastfed they’re less likely to get gastroenteritis which is a stomach bug that can require hospitalisation. They’re less likely to get ear infections, they’re less likely to get upper respiratory tract infections, they’re less likely to get diabetes, they’re less likely to be overweight or obese in childhood, and breastfeeding also protects against Sudden Infant Death Syndrome. There’s a whole host of other benefits and you can see these on the Unicef Baby Friendly website. For mothers it also reduces your risk of breast cancer and ovarian cancer.

If we think about the practicalities, breastfeeding is free, it’s set up and ready to go, and there are estimates that say it can cost around £1000 a year to formula feed your baby, so that can be a big consideration for some families.

The other thing about breast milk is it’s there, on tap and is immediate. You don’t have to make up a feed or buy formula milk, you don’t have to sterilize bottles, it’s there and ready to feed your baby as soon as they’re ready.

In the first few weeks of breastfeeding it’s definitely a steep learning curve and you might feel that you’re spending more time feeding your baby than a friend who is formula feeding. But actually as time goes on breastfeeding can become really quick and convenient that you can just lift up your top, put the baby on, they feed and you’re done, with no need for any extra equipment. So there’s lots of reasons to breastfeed and even if you’re not sure about it, you don’t have to make a decision until your baby is born. You might find than when you do skin to skin you think: “well I might just let them do this first feed,” and what your baby will get from those first feeds is colostrum which is this amazing first milk that’s power-packed with antibodies.

Antibodies are disease-fighting substances, so when you’re poorly you produce antibodies to help you get better and to protect you in the future. Breast milk passes those antibodies out to your baby so your baby will get antibodies you already have, so if you’ve had chickenpox you’ll pass those chickenpox antibodies on to your baby, so they either won’t get chickenpox at all or they’ll get a much milder dose.

Breast milk is also really responsive to the environment you’re in, so if you pick up an illness your body will make antibodies against that illness and very quickly it will pass out through your breast milk to your baby to help to protect them. It’s really important for your baby, when their immune system isn’t fully developed, that breast feeding can actually support this. So even if you do the first feed or the first few feeds before moving onto formula feeding, that has value. It’s worth you doing it. Sometimes mums aren’t sure about it but do end up enjoying it and end up feeding when they didn’t think that they would do that. We work on the premise that any breast milk is better than no breast milk, so if you’re doing one breast feed a day, if you’re giving your baby one bottle of express breast milk a day, or you are exclusively breastfeeding, it’s all worth it. So whatever you can do, we’re here to support you so that you can do that.

In this section we’re going to talk about how to position your baby at the breast, and we follow the acronym CHINS. What this means is it spells out the key factors that you need to consider when you’re going to position your baby.

The first one of those is Close. So the “C” of “CHINS” is “holding your baby Close”. It’s really important that your baby can get close enough to the breast so it can get a deep mouthful of the breast. Things that can get in the way of this are your baby’s arms – remember those arm circling feeding cues that your baby does? Well they make it really difficult to feed your baby when you’re trying to bring them to the breast, so the temptation is to wedge the baby’s lower arm in and hold the baby against them so they only have to deal with one arm waving about. But if I turn sideways, can you see how much distance there is between the breast and the baby? This can make it very difficult for a baby to actually attach to the breast. Look what happens when I slip that arm out of the way, how instantly that baby can get closer to the breast. That’s really important because what your baby needs to do is to get a nice big mouthful of breast.

If I demonstrate with my knitted breast, when a baby attaches to the breast what it should do is take a wide mouthful of breast and go onto the breast like this. Imagine my thumb is the baby’s tongue and it does this kind of wave-like motion to draw milk out of the breast while oxytocin is contracting the milk cells and pushing the milk out of the breast. Imagine my fingers are the top of the baby’s mouth, so their hard palette and then going into their soft palette. You can see that if a baby is well attached it actually isn’t touching the nipple at all, the nipple is right in the back of the mouth right up against the hard palette and milk is just going down the baby’s throat.

But if a baby is poorly attached and it can’t get close enough to the breast then what happens is it will still attach but it will just go onto the end of the nipple. Look what happens to the nipple now when the baby is drawing the milk out of the breast using its tongue. You can see that that nipple is being pinched against the roof of the mouth, it’s being rubbed so there’s lots of friction going on, and this is how women end up with cracked nipples which shouldn’t ever happen when you’re breastfeeding. But that skin can get rubbed away and you can see that that nipple is really being compressed and that can be very uncomfortable for mums. You can also probably see that the nipple looks a bit squashed, and sometimes mums will report to us when they’re having pains during feeds that their nipple looks pinched, almost like the end of a new lipstick, after a feed. What your nipple should look like after a feed is a little bit longer but it should be a nice rounded shape, it shouldn’t be squashed or pinched in any way, and breastfeeding should be comfortable. You shouldn’t be sitting there crying, you shouldn’t be dreading every single feed because it hurts so much. If you’re in that situation please get help, please ring us on our SPA number.  

It can be quite common in the first couple of weeks of breastfeeding for it to feel like a really strong sensation when a baby first attaches to the breast, because what a baby does when it attaches to the breast is it does these quick sucks when it first goes to the breast, and that sends a message up to the brain to release the oxytocin to release the milk out to the breast to the baby. But those quick sucks are also stretching the breast tissue into a teat for the baby. So those first 20 or so seconds of a feed can feel like a really strong sensation while that stretching is happening. After a couple of weeks generally your breast tissue gets used to it and you don’t feel that strong sensation anymore.

But what should happen regardless even in those early weeks is after those first few quick sucks the baby’s sucking changes to long deep sucks and swallows, you’ll see your baby’s chin bounce down and pause as it swallows and when your baby is doing that it should feel comfortable for you. It’s not sensation-free because there’s a baby at your breast, but it should feel completely comfortable. As the feed goes on your baby’s sucking might change, they might have another surge of milk letting down and so they might do these quick sucks to stimulate that and then they might go back to these long deep sucks and then as the feed ends they might go do some little fluttery sucks, not always but sometimes they do, so it’s important to let your baby finish that first side and not cut off a feed after a certain amount of time. This means that they’re going to be accessing all of the milk that they need and they’re able to regulate exactly what they need.

When your baby’s finished on that first side it will either come off the breast, or they might fall asleep at the breast, in which case if you need to take them off you can get your little finger and slip it into the corner of your baby’s mouth to break the seal and then lift your baby off the breast. At which point they might go: “ooh I wasn’t quite finished yet,” so then you can offer the second side. We call this “main course” and “pudding”. Some babies will always want pudding, some will never want pudding, and some will just see how they go, so it’s about finishing the first breast and then offering the second breast. If your baby does have a bit of a feed on the second breast, the next feed you would start on the side that they just had their pudding, just to even out the supply. Remember your milk supply works on supply and demand, the more you feed your baby the more milk they’re removing from the breast, or if they’re not able to feed then the more that you express your milk, the more milk that you’re going to make. In the early weeks of breastfeeding this is really important because you’re setting up those messages of how much milk you need to make for your baby. Try to avoid introducing bottles, avoid stretching out that time between feeds, and being responsive to your baby’s feeding cues is the best way to make sure that you make a full milk supply for your baby.

After Close the next thing we need to think about is that our baby’s head is free to tilt back. Often we’re told when we’re holding babies to support the head, but what’s going to happen if you hold your baby’s head is that you push your baby down towards the breast, and if you put your chin on your chest now and try to swallow you can see that that’s actually really difficult. So we want your baby’s head to be free to tilt back. The way that you hold your baby is you put your hand across the top of their shoulders and the bottom of their neck, not even on the neck, because if I put my hand behind my neck that restricts my movement and I can’t tip my head back as much as I need to, whereas if I take it away I can move my head much more freely.

Hold your baby across the top of the shoulders and then make sure that their head, spine and legs, are all facing in the same direction. What we don’t want is for your baby to be turned towards the breast like this, because that’s like us trying to put our chin over our shoulder and trying to swallow, which is really difficult and we can’t do it. So we need to make sure that our baby is nicely in line, and that’s our next element.

We’ve got our baby nice and close with their arms out of the way, we’ve got the head free to tilt back, we’re holding our baby across the top of the shoulders, we’ve got our baby nice and in line. If your breasts are larger your baby might be a bit flat on its back but it’s still in line.

Then what we’re going to do is line our baby up “nose to nipple”. That’s the “n” in our “CHINS” acronym. You’re going to make sure that your nipple is pointing up towards the baby’s nose, so it’s not on the nose but just pointing up. What this means is that as your baby tilts its head back then it can end up in the right position.

If you started your baby off mouth to nipple, which would make logical sense, but what happens when a baby tilts its head back, you can see that that nipple ends up too low. It will go into the baby’s mouth but it will end up where the hard gums are and where the tongue is, all that hard friction and compression. So if we start a baby off with their nose opposite the nipple, then actually once that baby tilts its head back you can see that the nipple just slips under the lip. As the baby’s chin bounces against the breast it will trigger your baby to open their mouth wide and at that stage you need to hug your baby on and bring them to the breast.

Remember in this upright feeding position your baby is not being supported by gravity, gravity wants to take your baby away, so you do need to hug your baby in to bring them to the breast. When a baby is well attached you’ll see something like this where their nose is clear of the breast, their chin is indenting the breast so it’s really dug in, and their cheeks are so close to the breast they’re making contact, so there’s no gaps there. You can see much more of the areola which is the dark bit around the nipple on the nose side of the baby rather than on the chin side. These are signs of good attachment.  

What that looks like when you’re holding your baby, is you’re making sure they’re nice and close, tucking them under the opposite breast so they’re almost in a diagonal position, their head is free to tilt back so you’re ensuring that you’re not holding them on the head, that they’re nicely in line. Then you’re going to line them up nose to nipple and bring them nice and close to the breast, and as their chin bounces against the breast they will open their mouth and you go: “on you go baby,” and you hug your baby in.

Once your baby is on in this position, you won’t be able to hold them for the average feed of 5-40 minutes, so you can bring your other arm round, slip the other one out of the way so that you can have your drink or your phone, and then you can snuggle back and be nice and comfortable. If you want to put a cushion under your arm to support its weight then you can. We don’t recommend feeding pillows generally because they tend to make babies either too low and mum’s bending down to get to their baby, or they make them too high and mum’s are feeling like they need to lift their breast to get to the baby’s mouth. The problem with lifting your breast into your baby’s mouth is that as soon as you let go the weight of your breast will put out of your breast and they won’t be able to stay on the breast.

These are our principles: we’ve got the baby close, with their head free to tilt back, we’ve got them in line so their head, their spine and their legs are all in the right position and then we’re lining the baby up nose to nipple, we bring the baby on, and then we make sure it’s sustainable, that we’re comfortable and can sit there and enjoy that feed for as long as it needs to take.

You might find during your breastfeeding journey that you might want to express some milk for your baby, and in this section I’m going to talk about how to hand express milk for your baby. You may also want to do this if you decide not to breastfeed, your body doesn’t realise in the early days that you’re not going to breastfeed and what happens is that your breasts become very full at the end of day 3 and beginning of day 4, and that’s called your milk “coming in.” If you’re not breastfeeding and you are very uncomfortable then you could hand express a tiny bit off just for your comfort, but remember the more milk you remove the more milk you’re going to make, so you really want to minimize that if you can if you’re not going to breastfeed. If you decide not to breastfeed, by the end of the first week generally you’re body’s got the idea that you’re not going to breastfeed the baby and you’ll stop making milk.

If you do need to hand express your milk this is how you do it. The first thing that you want to do is do a little bit of breast massage, and what this does is skin to skin so it helps to raise those oxytocin levels, and remember oxytocin helps to move that milk through the breast. So we’re just waking up the breast and telling it that there’s work to be done. Any of the ways that I’ve demonstrated here will work, just for 30 seconds to a minute just to wake up the breast.

The next thing you’re going to do is make a C shape with your thumb and your index finger. What we often suggest mums do is that they start at the nipple. This may feel a bit tough and fibrous, and then if you move back a bit further it will feel a little bit empty like a bit of cushion that’s lost its padding. Move back a little bit further and you’ll notice a change of texture. It might feel a bit more solid or lumpy or bumpy, but it’s the change of texture that you’re looking for and that’s usually around 2-3 centimetres back from the nipple. Once you’re on that spot you’re just going to compress and release repeatedly. You’re going to avoid dragging your fingers along the breast because that can cause trauma and make you sore, so keep on this spot and after 30 seconds or so you should start to get some drops of milk. If it’s colostrum that’s all you’ll get, little drops, but if your milk is already in you may well get sprays of milk and you’ll need to collect that in a sterilized container.

Once that milk is flowing then you stay on that spot compressing and then you get that flow of milk so holding it on while the milk is flowing and then compressing and releasing repeatedly. Once it’s stopped flowing or slowed down you rotate your fingers around the breast to access another lot of milk-making cells. Then you repeat that process. If milk’s not flowing at all you might need to move your fingers forward or back a bit. Once you’ve finished expressing from one breast you can then move on to the other breast if you’re doing it to collect lots of milk. If you’re just doing it to soften the areola around the nipple, which makes it easier for the baby to attach, you might do this in the early days if you’re really full, or if you’re doing it to clear a blocked duct, then you can just stay on that one side. That’s how you hand express.

In this next section we’re going to talk about how to hold your baby when you’re bottle feeding your baby. You might have expressed breastmilk in this bottle or you might have a First Stage Infant Formula in this bottle. What you’ve probably seen when a baby is being bottle fed is they’re being held nice and close and the person that’s feeding them is making lots of eye contact with their baby and that’s a really good thing, that’s really important for their brain development. Probably the bottle is being held like I’m demonstrating and actually this can be quite difficult for a baby, because you can see from this that this bottle is quite upright and if this was full of milk gravity would be acting on the flow of that milk and making it come out quite quickly. Where the baby’s head is wedged against my arm, it can’t move its head back to say “I’ve had enough, it’s coming too quickly,” so babies can feel quite overwhelmed and they have to just keep on sucking and swallowing because that milk is flowing out.

What we encourage you to do if you’re bottle feeding your baby is to sit them more upright. Have them more upright and still hold them close and make eye contact, it’s such an important part of your relationship with your baby. Before you put the bottle in, you’re going to stroke the teat to the top lip. Just like when you’re breastfeeding and line up nipple to nose. Then your baby will open its mouth making sure it’s ready rather than that bottle coming in from nowhere. Once the baby opens its mouth you’re going to gently put that bottle into the baby’s mouth. You can see the position of this bottle is much more horizontal. There will still be milk in the end of the teat so the baby’s not taking in air, but this baby now has much more control. It’s much easier because their head isn’t wedged back by gravity for them to turn away if they’ve had enough.

So you hold your baby like this and let them feed, but what we want to do is to pace the feed every few minutes. What that means is actually taking the bottle away or tilting the bottle down so your baby can work out if they’ve had enough or if they want more. They will let you know if they want more, and then you repeat that process, so stroke the teat to the top lip, baby opens their mouth wide and you put the bottle in. As the bottle of milk gets emptier you may need to tilt your baby down a little bit so that they can get all of the milk that’s in that bottle, but because gravity won’t be acting on the larger volume of milk it won’t be as overwhelming for your baby.

When we think about how much milk your baby should take, use the instructions on the tins of formula milk as a guide but they are a guide. There are 700,000 babies born in the UK every year and the instructions and volumes on those tins don’t match all babies. Use it as a guide of how much milk you should make up but never force your baby to finish a bottle. Their appetites vary throughout the day just like yours does, so sometimes they might want the whole bottle but sometimes they might only want half of it. Please don’t make them finish their bottle and force those final bits in when your baby is showing signs that they’ve had enough.

So what might they do? Feeding cues at the beginning of a feed are just like we discussed in another video, when they’re telling you that they’re ready for a feed and you follow those, but you also need to think about cues for if they’ve had enough, and what a baby will do is turn their head to the side, stop sucking, spit the teat out, or they may even push away with their hands. Milk might start to spill out of their mouth because they’re no longer swallowing it. Look for those signs that your baby is telling you they don’t want to feed anymore and then stop that feed.

What else is really important is to limit who feeds your baby. Often bottle feeding is thought of as a time where anyone can feed the baby, but actually for your baby that’s quite stressful. People hold the bottle different, they move the bottle around, they smell different, or they might wind them differently, so for your baby it’s not necessarily a pleasant experience. They just want you. So we encourage you to limit the feeds to mum and then partner. If you had someone in your family that was going to have a strong close relationship with your baby and see them frequently then that’s ok but really it should be mum doing the majority of the feeds. We want your baby’s brain to be in a nice calm state and for them to feel safe and secure because that’s the best environment for their brain to develop. Please limit who feeds your baby so they can get the most out of that feed.

In this section we’re going to talk about how to make up feeds safely and also a bit about sterilising feeding equipment. I direct you to the Guide To Bottle Feeding leaflet which you can access on the Unicef Baby Friendly UK website, and you can also get information about how to make up feeds safely on the NHS Choices website. We’ll just go over a summary here.

It’s really important that you know that the only milk your baby needs for the first 12 months if you are formula feeding is a First Stage Infant Formula. There is no need for your baby to move on to follow-on milk when they hit 6 months old, First Stage Infant Formula is fine for 12 months and then you go on to full fat cow’s milk. Again there’s no need for these growing up milks or toddler milks, cow’s milk is fine once they reach 12 months. In terms of brands of formula milk we don’t recommend any special brand. By EU law they have to comply with a certain level of nutrients, fat, carbs, protein, vitamins and minerals in them, so all formula milks will have those in them whether you choose a budget brand or the most expensive brand.

Think about what you can manage in your budget, think about what’s available in your local shop, and if you need to change brands because the one you usually use isn’t available that’s ok because they’re all within the same range of ingredients and made up the same way.

When you are bottle feeding you need to sterilise all feeding equipment. What you do when your baby has finished its bottle is tip away any milk they haven’t drunk, you can’t save that, and then you’re going to take the bottle apart. Then you’re going to wash all of those in hot soapy water and rinse the bubbles off. You need to make sure that you use a bottle brush to get into all of those nooks and crannies where milk residue can gather, because that’s a really good breeding ground for bacteria. Once you have washed it thoroughly and rinsed it, it then goes in your steriliser. There are different sorts of sterilisers, you can use cold water sterilisation methods with chemical tablets, or you can use steam sterilisers, you can use microwave sterilisers, just follow the manufacturer’s instructions according to how you would do that.

When you’re ready to make up a feed it’s really important that you know that you need to make up each feed as you go along. The reason for this is because it’s been discovered that there could be harmful bacteria in powdered formula milk and so by making up each feed as you go along you are minimising the risk of that bacteria being able to grow and multiply within that bottle of milk.

The way you make up each feed is that the first thing you need to do is boil the kettle. You need to put about a litre of water fresh from the tap, not bottled water as the mineral content is too high, so just cold water from the tap. Once it’s boiled you have about 30 minutes to make up that feed because what’s really important is that the water is above 70 degrees Celsius in order to kill the majority of the bacteria that might be in the formula milk so you have to add the formula to the water while that water is still hot.

Put the water into the bottle according to how big a feed you want to make up. Always put the water in first, if you put the powder in first you can make the feed too thick and concentrated and that’s not good for your baby’s tummy. So you put the water in first and then add the scoops of milk from your tin of formula milk. Scoop up the formula, level it off with a flat knife so you’re not packing it down or giving an extra heaped scoop, you’re going to make sure that that’s level. Always use the scoop that came with that tin of formula milk because there’s a possibility that it might change sizes so use what’s come with that tin. However many scoops it says in accordance with the size of the feed that you’re making.

Then you’re going to put all of the bottle components back together. Obviously you will have washed your hands before this and you can also get tongs to pull the teat through, but fingers are fine. Screw the lid back on and gently mix that bottle so the powdered milk dissolves. You have a bottle of made up formula milk but it’s 70 degrees Celsius, it’s way too hot to give to your baby. What you need to do now is cool down the bottle of milk. Run the bottle under the cold tap making sure the lid is still on or put it in a jug of cold water to cool it down. Test the temperature by dotting some milk onto your wrist – if it feels hot then it’s still too hot and you need to cool it down a bit more. If it feels your body temperature then it’s perfect to give to the baby. If it feels a bit cold and you’ve gone a bit too far with the cooling process it’s still safe to give to your baby, never reheat milk in a microwave as it’s very unsafe, it can develop hot spots that can scald your baby. If it’s a little bit cold then don’t worry, it is safe, you can go ahead with that feeding process.

The guide to bottle feeding leaflet that you can get from the Baby Friendly UK website has also got information about how to cope with feeding your baby when you’re out and about and what the best thing to do is in those situations so please do look at that for a written guide and for further information.

How are you going to tell if your baby is getting enough milk? This is true whether you’re breastfeeding or formula feeding. We look at how our baby’s behaving – are they happy after a feed? Are they contented? Are they growing and putting on weight, filling out their baby-grows? The other really good sign of how much milk your baby’s getting in those early weeks is your baby’s nappies. This knitted nappy shows the colours of poo that your baby will go through when it’s born.

When they’re born it will pass this lovely black tarry poo called meconium. That lines their gut in the third trimester so it’s there and ready to come out. As food and milk gets into their system the poo goes through these different colour changes, so by the time your baby gets to day 4 or 5 it’s changed to this lovely mustard-coloured poo. We expect by day 4 or 5 for your baby to be doing at least 2 £2 coin sized poos a day and at least 6 heavy wet nappies a day and that reassures us that they’re getting enough milk. If they’re doing more than 2 poos a day then the more poo the better, we like that very much.

You can find more information about this if you look on the Unicef Baby Friendly website and look for the “off to the best start” leaflet which will have lots of information about nappies and what they should look like and this information is also on the NHS Choices website.

My name’s Alison, I’m a family support worker with the Children’s Centre team here in central Bedfordshire. I’m going to talk about nappies, how to change a baby, caring for your baby, we’re going to go on to do some safe sleep and some car seat safety (please see other videos for these).

First of all we’re going to talk about nappies and the contents of your baby’s nappies. You will get asked quite a lot from your midwife and health visitor how many wet and dirty nappies your baby is having every day. You should be expecting to change your baby up to around 10 times a day in the first few weeks. The contents will vary greatly, for the first 2 or 3 days your baby will produce a black sticky substance called meconium which will look a bit like this, it can be a bit oily, thick and dark. Then after the first few days when all the meconium has passed through it will start to look a bit like this. It will be more green, there might be a few bits of black strain in, it might look a bit like spinach. Then once all of that’s out the way eventually it will start to look a nice bright yellow colour a bit like mustard or korma. It shouldn’t smell until about day 10 once the colour of the nappy has changed, and then depending on how you feed will determine what the colour of the poo is.

If you’re breastfeeding your nappies will still stay a nice yellow colour, if you’re formula feeding it will start to take on and resemble poo as we know it to look like and it will be more brown and it will certainly be smellier. Breastfed babies’ poo tends to smell quite sweet, I think it smells like toffee yoghurt, but it will still be a nice bright yellow colour. You might get seeds like a seeded mustard in the yellow poo but that’s just the bits of fat that haven’t broken down and is all perfectly normal.

If you see blood, you may see a few spots of blood, that’s when you need to speak to your health visitor or your midwife. Keep the nappy and take a picture of it and just show them if you’re not sure, and they can tell you whether that’s normal or not.

If you have had a baby girl you might also see a bit of vaginal discharge or bleeding, if it’s only a few spots this is absolutely normal, but if it’s more than a few spots you do need to raise that with your health professional.

When we change our babies what we want to do is keep them as safe as possible. The safest place to change a baby is on the floor with a changing mat and a towel. The reason we say that is because the baby can’t fall off. However if you can’t get on the floor and do it on a table that’s waist height, this is the perfect height for you to not bend over too much, but do make sure that you keep an eye on your baby at all times. If you turn your back or walk away babies can still move their feet and wiggle and this can cause the mat to slide off. So if you need to do it on the table please make sure that you watch your baby at all times.

We want to start off by undressing the baby. We want to change baby as soon as they have a dirty or wet nappy. They have very sensitive skin and it gets sore very easily. It doesn’t matter what type of nappy you buy, they’re all very similar these days, whether you buy the premium brand or the supermarket brand, they’re all made up of the same thing. The reason this line is down right around the nappy that indicates when they have a wet nappy. They have a gel lining with crystals down the middle of the nappy to absorb the urine, so as soon as the baby’s had a wee the indicator line will change colour but the gel crystals draw the urine away from the baby’s skin and it stops them being wet. If we then add any type of barrier cream or nappy cream it will stop the nappy from working so we would suggest that babies don’t need nappy cream unless they’ve got nappy rash. All it will do is prevent the crystals from doing their job and therefore not draw the urine away from baby’s skin. It will sit on their skin and cause nappy rash. You will know when your baby has nappy rash – it’s very red and sore and the best thing for that is fresh air. When you’re changing baby, take their nappy off and clean them up, if you let them have a bit of a wriggle around then that way their nappy rash will clear up. You can add a little nappy cream if you want but a very thin layer and only when they’ve got nappy rash.

When changing a baby, what you should do is hold their toes or ankles, lift up most of the waist and then get rid of the dirty nappy. This is a top and tail dish for two sets of water – one side is for the face and the other is for the bottom. We also suggest using cotton wool rather than baby wipes, wipes can be quite harsh on baby’s skin and if you use them frequently throughout the day it will dry the baby’s skin out and cause irritation. Plain water and any type of cotton wool balls or pads will be more than adequate for cleaning your baby and a lot gentler on the skin.

When cleaning your baby, take a little bit of water and always wipe front to back so that you don’t spread any type of infection, making sure that you get in the creases here, and at the back babies have a little dimple above their bottom and waste can collect in there, so make sure that you clear out that dimple. With boys you need to lift the testicles up and clean around them, but don’t pull back the foreskin on the penis because that can cause infection, and with girls don’t wipe inside the vagina just wipe from front to back so that you don’t cause any infections.

Once they’re all clean you can put on a new nappy. A lot of the nappies will have a little dip, they’re made like that, some don’t, but that’s to sit under the cord. If there isn’t a dip on the nappy just turn the nappy down so it’s not pushing the cord into the nappy, it’s just sat outside of the nappy. That’s also the same with little boys, make sure that the penis is not upwards and that it is down otherwise it will be uncomfortable.

Once the nappy is on and you lift baby up it should be tight enough so that the nappy doesn’t fall down, but not so tight that you can’t fit your fingers down the waistband meaning that babies can move and aren’t restricted.

When they’ve got the nappy on you can dress them again.  Baby grows are the easiest type of clothing when you have a young baby, with the poppers, that way you can lay it down onto your changing mat and you can lift your baby onto it and dress them. Or if you have these little vests you can see at the top they have what we call “envelope” sleeves – these are designed so that you can pull them down over the baby. If they’ve had an explosion out of the nappy we don’t want to be lifting up over baby’s head in case they get mess into their mouth or on their face. Always bring their clothes downwards or open with the poppers.

When buying clothes, if you take them out of the packaging to wash them, turn them inside-out and just check to make sure there’s no loose threads in the seams. Sometimes you can get a long hanging thread, especially on things that have little toes just in case it gets wrapped around a finger or toe and cuts off the circulation. Just make sure that you do that with all of your clothing before you put them on your baby.

Normally if you’re just changing a nappy then you would be all done here, but if you’re doing top and tail, which you only need to do this a couple of times a day, we suggest that you do it first thing in the morning when baby wakes up and you take them out of their nightclothes and put them into their day clothes, and then again at the end of the day when you do the reverse.

Same thing again, we’re going to change which side of the water we’re using, one side for face and one side for bottom. Take some clean cotton wool, clean their eyes from inside to outside and then get rid of that piece of cotton wool. Then do the same on the other side from inside to outside, and get rid of that piece of cotton wool. So if they do have something in their eye we’re not transferring the infection from eye to eye. With another fresh piece of cotton wool we’re going to wash baby’s face all around. Take care that you clean behind the ears, because babies feed lying down the milk can dribble and collect behind the ear and go crusty, so make sure that you get behind the ear and do the same underneath their chin. Babies tend to have lots of layers beneath the chin and their milk can dribble, so just make sure to get right underneath the chin.

Once their face is nice and clean you can lay them down on the towel and pat them dry. Do the same with their hands; just make sure that you wash in between their fingers and toes. That’s all they need a couple of times a day.

When you’re bathing baby, we only suggest you bath them a couple of times a week, wait until the nappy cord has come off. It’s usually off by about day 10. If you bath while they’ve still got their cord on chances are that you might cause an infection, so what you want to do is wait until the cord has gone completely, then you can start bathing them.

It might be a little bit scary for the first time that you do it. It doesn’t need to be a proper baby bath like I have here, it can be anything that holds water, but you want the water to be around body temperature. You don’t need it completely full, it can be around half full, just enough for the baby to be able to splash about. Again, make sure that your baby isn’t tired or hungry or feeling grouchy, you want them to be nice and relaxed, and you need to be relaxed. If you’re nervous about bathing then make sure someone else is in the house with you so you have someone who can help you. You want to pick a time where you’re free so that you’re not rushing and we’re going to do the exact same as when you’re top and tailing.

Do the face first, leave the nappy on while you wrap baby up in the towel. Have a good hold on them underneath your arm so that you have a really good position and wash their hair. Use either a sponge or some cotton wool in the water. The water needs to be around body temperature and the best way to test this is to dip your elbow. If it’s too hot and you can feel it on your elbow then it’s too hot for the baby. You can get a thermometer as well but it needs to be around 37 degrees.

Just put a little bit of water on their head – you don’t need to use shampoo and don’t need baby bath soaps. Just put their hood up, you don’t want to rub their head because it will just cause friction, just pat them dry. If they have lots of hair and they’ve not been bathed since birth, and they have a lot of blood and matter in there, you can put a little drop of shampoo on just to get that out. But generally speaking don’t use any shampoo. If they have lots of hair then just use a soft baby brush to brush them over. Some babies will also have something called “cradle cap” which is a thickening of the scalp. Don’t be tempted to pick it, don’t try and brush it out, you can buy cradle cap oil that you can add to it and rub a little bit on the top of the scalp just to soften it, but it’s best just to leave it alone.

Once baby has had their hair washed and they’re all dry then you can take off their nappy. Be prepared, especially if you have a boy, that this is where they will wee. If you hold either the towel or the nappy in front for them to wee into, they won’t get you. If they’re dirty just give them a quick clean with some cotton wool before you put them in the bath.

If you’re moving downstairs with baby and holding them in the crook of your arm, make sure to have a hold on their limb, with one hand holding on to the rail as you come downstairs, that way if you do drop baby then at least you’ve got a good hold on them if you stumble or feel feint or anything like that. It’s a safer way of carrying them.

As you put them into the bath just gently pop them in, smile, relax, and give them a splash. You can you a sponge or your hand or some cotton wool to splash them. You don’t want them in there very long in case they get too cold. If you’re confident, you can turn your baby over and wash their back as well. Make sure that all the time you’re talking to them, you tell them what you’re doing, and you’re relaxed and smiling. The first couple of times you just need to get them nice and clean and then get them out onto the towel, cover their head in the towel, and the best way to dry them is to pick them up and give them a cuddle.

Just pat them dry, don’t rub their skin, as they can be very sensitive, and give them a nice pat all over. Make sure that you dry in between their knees and elbows and in all their little creases so that they don’t get sore. Once they’re nice and dry you might be tempted to give them some moisturiser or body lotion or talcum powder – we would suggest not to. At this point babies don’t need it. If you squeeze a talcum powder bottle you can get a cloud of dust that can go into the baby’s lungs, and all it does is clog their pores up. If they have really dry skin and the midwife says it’s healthy then they might need a bit of moisturiser, just apply it very thinly. Generally speaking babies don’t need anything on their skin.

You might be given lots of products when you’re in hospital like free gifts or tester pots, and that’s fine, just take them home and use them on yourself, or keep them until your baby’s a little bit older. At this point as a new-born they don’t need anything.

Then what you want to do is put a clean nappy onto your baby, and then you can get them dressed into their night or day clothes.

When buying nappies don’t be tempted to go out and buy lots and lots of nappies. This is a new born nappy and this is the next size up, they go from new born to the next one very quickly. Just buy as you need them, one pack at a time. If you don’t want to use disposables, disposable nappies can take around 500 years to break down, you may want to go down the real nappy route and this is what a real nappy looks like. You can get them in different colours and patterns. They can be disposable liners or washable liners. There’s lots of information on our central Bedfordshire website – central Bedfordshire will give you a £25 grant as a start up to get you your first pack. If that’s the route you want to go down have a look into it and do your research, there’s plenty of real nappy libraries around and if you do need more information there’s advice on our website.

Unless baby has a bit of nappy rash, in which case this is when you would let them have an air and a kick about, they’re now nice and clean and ready for their day.

So now we’re going to talk about safe sleep and something called Sudden Infant Death Syndrome. We will refer to it as SIDS. It used to be called Cot Death but it was renamed a few years ago simply because a lot of deaths of babies don’t occur in the cot, they can be on sofas or chairs, so it’s now referred to as SIDS. We’re going to talk about the risks, but what I’d like to say first is that SIDS is very very rare and doesn’t happen often, and if you practise safe sleep then hopefully you can avoid it. If you research the stats on SIDS they can be very hit and miss, some websites will tell you different things, but it’s a very low percentage.

We have a picture here, and there are 8 risks on this picture that would increase the chances of SIDS. Ignore the carpet and wires which are trip hazards, as we’re looking only at safe sleep in this video.

As baby is asleep, the safest space for them to sleep is in their own space with a flat, firm mattress. Whatever you’re using, whether it’s a Moses basket or a baby box or anything that a baby can sleep in, make sure the mattress is firm and flat and that it has a nice fitted sheet rather than loose sheets.

The 8 things on this picture – the first thing to notice is that baby is sleeping next to a radiator. This can cause baby to get too hot and if the cot is pushed up against a radiator the baby can lean against the radiator and therefore burn their skin, so we want them away from the radiator. We also want them away from a window, they can cause drafts in the winter but more so in the summer when you get direct sunlight coming in – if you’ve ever been in a car on a hot sunny day you’ll realise how hot that can get. The best place for the cot in the room is on a wall away from direct sunlight. If the hot room gets too hot, especially in the summer, you can put a fan in the room to keep the temperature down. The temperature should be around 18 degrees, so to cool it down you can put a fan in there, but we do suggest it’s not aimed directly at the baby and circulates the air rather than making baby cold.

Next thing is blankets. The picture is showing lots and lots of blankets and loose blankets. The best blankets to use are something like this, this is called a cellular blanket and they have lots of little holes in so that the air can circulate. The holes are also small enough that baby can’t get their fingers trapped. One blanket is fine, if you fold your blanket and use it as two layers that now becomes two blankets, so bare that in mind. If you are using blankets you want to put them underneath the mattress and not underneath the baby. This is simply because, if baby is moving around, if the blankets are loose they can creep up and go over the baby’s face and suffocate them. So we want blankets that are tucked underneath the mattress.

The next thing to notice on the picture is to notice that baby is wearing a hat. We’re going to take baby’s hat off. They don’t need a hat, we don’t wear a hat indoors so babies don’t need one, especially when they’re sleeping. Some hospitals may put a hat on your baby when they’re born, that’s just to regulate their temperature but once they’re home they don’t need a hat indoors.

The next thing on your picture that you might have noticed would be that baby is sleeping on their side and at the top of their cot. The safest place for a baby to be sleeping is on their back. As they get older and they start rolling over by themselves and positioning themselves onto their tummy that’s absolutely fine and you can leave them to do that because if they’re capable of getting onto their tummy they can then safely get back. But when they’re new born for the first few months they need to be on their back, it’s the safest place for them to be. They need to be at the bottom of the cot, so feet to footboard, that way they’ve got nowhere to go. If they’re high in the cot and they have blankets they could wiggle down and get trapped. So we want them at the bottom of the cot, and that’s whether they’re in a Moses basket or in a full sized cot, they should always be at the bottom.

Also on the picture you’ll see that baby is sleeping with a pillow. Babies don’t need a pillow – they have a natural pillow on the back of their head for when they’re sleeping flat and their head will be in the perfect position. If you put something underneath like a cushion or a pillow it pushes the baby’s chin onto their chest and can restrict their breathing. We want to have those airways open with nothing underneath the head. If you have a pillow and baby turns their head they can get caught up in the soft furnishings and that can cause suffocation.

You can also see they have some nice bumpers. Lots of companies still market bumpers – they were introduced to stop babies putting their arms through the bars in the cot and they look pretty, but they are a soft furnishing and again they can cause suffocation. Some of the ties that they have can get wrapped around the baby and cause their circulation to stop in their fingers, so again we suggest that you don’t have them in the cot. They don’t need them and even if babies get their arms through the bars of the cot, we’ve never heard of a baby being injured or getting trapped.

What’s not obvious on the picture is soft toys, we don’t recommend that these go into your cot with your baby because they can be a suffocation risk. Make sure that they are out of the cot, same thing with anything that makes a white noise. These are fine to use but make sure that they are out of the cot, on a shelf away so that they can’t fall into the cot. If you’re using nice blankets that someone has bought don’t drape them over the side of the cot so baby could pull them in. Make sure that it’s only baby in the cot.

You may want to use something called a sleep bag. These are a really good alternative to blankets and duvets. These come in different togs – there is lots of different advice on the internet so make sure that you research and find the correct tog for the time of year. If you’re having a spring or summer baby make sure that you’re using a lighter tog and not an autumn or winter tog. Make sure that you fit your baby correctly – some old stock in shops, or second hand items, go by the age of the baby but we all know that one baby could be 5 pounds at birth and another baby could be 10 pounds at birth. They have changed them now and it goes by your baby’s weight, so just make sure that if you do buy one that it is the correct weight size for your baby. Where the arms go through they should fit snugly, not tight, around the baby. If it’s a big gap and baby can get their arms into the sleep bag and move down then they can be trapped in the bottom, so make sure that they do fit correctly if you are going to use them. They are a good alternative to blankets.

A rule of thumb when you’re putting your baby to sleep is that they wear one layer more than what you do, so if you are wearing a t-shirt and a cardigan your baby would wear a vest, a t-shirt and a cardigan. If they’re in bed in their sleep bag then their arms should be covered, if it’s a bit chilly you can put a long-sleeved vest on them, but they don’t need blankets with the bags as well.

That’s it for safe sleeping. If you want to co-sleep, a lot of people used to say don’t co-sleep at all, but now we know that people do, make sure that you do it safely. There’s lots of information on The Lullaby Trust, and we have a clip. Make sure that you have a watch of that so that you do it safely and that you don’t put baby in between you and your partner, that you’ve got the correct position, and that baby has got their own blankets. Just make sure to do your research so that you do it safely!

So now we are going to talk about car seat safety.  You can buy any car seat as long as it fits your car correctly, make sure you go to an independent retailer and take some advice.  Make sure that you practice before you go to the hospital to collect baby, some hospitals won’t allow you to leave until they make sure it is correctly fitted, and that you have got a safe way of taking your baby home from hospital.

The best time to practice getting your baby in and out of the car is before it is born, so make sure you do all that before baby comes along.  Once baby is in the car seat recommendations are that you don’t have baby in the car seat for more than two hours absolute maximum.  Bear in mind if you are going shopping that you are driving to a shopping centre, baby is in the car seat and then you would lift your car seat out to a frame if you have got a three in one buggy system, then you do your shopping, then the baby would be transported from the system back into the car, you get home, baby is still asleep, it is very very tempting to pop them out onto the floor while you put your shopping away, and then they are still sleeping so you might want to have a cup of tea as well.   So just bear in mind that all of that time adds up and baby is sitting in a car seat quite thrust up with their chin down onto their chest.  So what we would want you to do is suggest that baby is in the car seat as absolutely as little as possible.  If you are going shopping, once you get to the shopping centre have a bit of a break, take baby out, give them a bit of a stretch, hold so that they can get their chin of their chest, give them a cuddle, lay them down on your lap, go and have a coffee, or just walk around with them for 5-10 minutes, just to give them a bit of a break before you go back in.

If you’re going off on long car journeys make sure that you drink lots and lots of water, this will force you to stop to go to the toilet, so that then baby can get out of the car seat, and give them a good 15-20 minutes out of the car seat before you pop them back in and go and do another 2 hours driving.  This just allows baby to get their chin of their chest and take in some air and just stretch their back.  It is really difficult, traffic is horrendous nowadays, and if you just want to go from one of the town to the next then bear that in mind as to how long they are sitting in their car seat.

So the safest space for the car seat to be in the car is behind the passenger side.  This is because research shows that most accidents happen on the driver’s side of the car, so the safest place for your baby is behind the passenger seat. 

Make sure that you don’t overdress your baby when you are popping them into the car seat as well, they just need their day clothes on.  If you pop a big thick coat on we will adjust the straps accordingly and therefore may not hold the baby should the car crash.  If baby has got a big thick coat on in the car they may overheat, they may get too hot with the sun coming through the windows, so the best thing to do is just have their day clothes on and then have a blanket, therefore the blanket can be unwrapped whether they are in the car or out shopping, going into a warm shopping centre you could then just take the blanket off them and they will be a lot more comfortable than what they would be if they had a great big thick coat or a snow suit on.

So that’s it for car seats. Just do your research and make sure your car seat fits your car and that you use the correct car seat for the age of your baby, it does go by weight.  The first size seat that you need, their legs will dangle over the side, it doesn’t matter, as soon as the top of their head gets to the top of the car seat that is when you need to be thinking about buying the next size up. So – go to an independent retailer, do your research, and make sure that you have got the correct one for your baby.

So where can you get support?  Don’t forget you can ring us on our Single Point of Access number, and that is 0300 555 0606 to speak to the health visiting service about any aspect of your parenting journey.  We also have Parentline, which is a text number that you can see (07507 331456), and if you have just got a quick query and you want to ask something, just text that number, and it is covered by our staff and they will respond to you by text. So you can get support there as well.

We have already talked about Bedfordshire Well-Being service and you can self-refer via their website, and crisis is a charity that was set up by parents who experienced babies that cried a lot, so they know what it can feel like, and you can access their support via their website.

Family lives is a really good parenting charity, with lots of good information on their about all aspects of parenting, so you can look at that too. 

With have a wonderful partnership with the Breastfeeding Hub app, and there is lots of information on here about breastfeeding, video’s about positioning and attachment, hand expressing, all sorts of information and it’s free to download either on Apple or android, so please do have a look at that.  It also has got a review system where you can go to a café, and if you have had really good support whilst you were breastfeeding there, the staff were nice, you can rate that place, and so it is a bit like trip adviser for breastfeeding.  So please do have a look at the Breastfeeding Hub app.

We also support mums to feel confident to breast feed when they are out and about, and that’s our FreeToFeed campaign, so if you look up FreeToFeed Bedfordshire then you will see all our details on our website and also on our facebook page.   Our facebook page is @bedscyp, so please do follow our facebook page because we put all sorts of information on there. 

If you have got any health concerns you can contact your GP, you can contact 111 if you are not sure if you should be going to your GP or should you be going to the hospital, and that is also available out of hours, and obviously you have got the NHS Choices website as well, and if there is an emergency with you or your baby you can also ring 999.

All of our Bump, Birth and Baby sessions are done in conjunction with the children’s centres, so in Beds Borough that is the Early Childhood partnership, and in Central Bedfordshire that is managed directly by Central Bedfordshire Council, so we are all here to support you, and please do get in touch with us if you need any help or information.

Thanks for watching.