Babies are monitored for wakefulness in terms of feeding. Most babies wake frequently for feeds. Babies born before full term do not always wake for all feeds, and this may also happen for babies who have been exposed to labour medication, so parents will be informed about when and how to wake a sleepy baby for a feed. This in itself would not always be considered a serious issue – it’s one that would be monitored by midwives and other staff members. If women have delayed lactation for any reason they are supported to express breast milk to stimulate milk supply, and so that expressed colostrum can be given to the baby. This is monitored by staff as well. Mothers with complicated medical histories, or those with previous breastfeeding issues, or those who have had complicated births, or caesarean sections, may also be seen by a hospital-based lactation consultant, as clinical lactation issues can sometimes be complex. If at any point, in the first 24-48 hours, the delay in lactation is an issue then there is a conversation with the mother about supplementation. The bottom line is always – feed the baby. Some women use donor breast milk and some use formula for supplements. If there is concern about a baby, baby blood sugar levels are monitored as well. Any mother and baby who have not initiated breastfeeding effectively before they go home, have a comprehensive feeding plan put into place. This could include expressing milk, continuing work on supporting the baby to breastfeed, and feeding the baby via bottles of donor milk from another woman, or infant formula. Babies’ weight gain is also monitored and feeds continue to be observed.