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Why this lactation consultant told a new mom to stop breastfeeding

stop breastfeeding

I Walked up the snow-covered steps of a quaint bungalow, excited to meet a two-month-old little boy and his mama. She had sent me an email a few days prior; all it said was, “I need help with my baby, he’s crying all the time. Can you do anything?” This is common story in my inbox. I replied I could be there Wednesday.

I knocked on her door, and a beautiful thirty-something woman answered, bouncing a bundle. We sat down on her couch and started to chat. She said he’d been born on his due date, a beautiful delivery, and she was back at home 24 hours later. Breastfeeding hurt in the hospital, but she was told that was “normal” and it would get better. A week later, still trying to “push through”, she couldn’t take it any longer, and went to her local breastfeeding clinic. Her little man had a tongue tie, they said, a common reason for breastfeeding pain. The physician clipped the tongue tie in the office and sent her home with instructions on how to move forward. She continued “pushing on” and did feel some relief, but continued to struggle with supply and latch issues. She was back and forth between clinics and private consultants, as she was desperate to breastfeed. She had dreamed of nursing her baby, like many moms, and the journey had consumed their household. She could not get a comfortable latch no matter what she tried or whose help she enlisted. She was consumed with trying and not giving up. I watched this woman become more teary and shaky as her story progressed. She told me he was gaining weight, but was very fussy and cried at the breast and throughout most of the day and night. Her husband had taken the day off work to be home for our appointment and he sat quietly with his arm around his wife and babe.

I first told her she was doing a beautiful job with her son. I told her the best part of my morning so far was getting to witness the way she looked at him and that I could hear the efforts she had been putting in to try to establish pain-free breastfeeding and an ample supply. I acknowledged that her path sounded full of challenges and I asked her simply, “How are you feeling?”

She broke down. Sobbing in her living room, she told me that breastfeeding was a number one priority for her, and she had read all the books and had sought out so much help and support, but that she just couldn’t do it anymore. She went on to tell me that the stress of nursing had taken all the joy out of becoming parents and it was all both her and her husband could think about. I could see that this woman was full of anxiety and had some real red flags of depression. She shared that she cried alongside her baby throughout most of the day, and was starting to wonder how she was going to keep going. She wasn’t leaving the house and spent all day feeding and pumping.

“Do you want to keep breastfeeding?” I asked her. Both her and her husband looked at me in silence. I realized in this moment what this woman needed from me, a registered nurse and lactation consultant. She needed permission. I told her that the most important thing was that her baby felt loved and that as a mom she had the ability to nurture and care for her baby. I told her flat out, “It is okay to stop and give him a bottle of formula.”

She and her husband hugged and both started to cry. Minutes later, they said, “Thank you, we needed to hear that.”

This is such a controversial topic. #Fedisbest is flooding the internet, and there are so many varying opinions. As a lactation consultant, I am an advocate for breastfeeding, and will go the distance with any family to ensure it happens. But it is not up to anyone but that mother to decide when she has reached her limit. A mama’s mental health trumps breastfeeding. Every time. Breastmilk does not care for, nurture and bond with the baby. A mother does. I am not arguing the health benefits of breastfeeding. Those are known facts. I am talking about the part that just isn’t talked about enough: a mom’s mental health.

Last year, for a few days anyway, the whole country was talking about it. Suffering from postpartum depression, Vancouver mother Florence Leung ended her life two months after her baby was born. On her memorial Facebook page, her husband recently wrote the following:

“To all the new moms experiencing low mood or anxiety, please seek help and talk about your feelings. You are not alone. You are not a bad mother. Do not EVER feel bad or guilty about not being able to exclusively breastfeed.”

As you can guess, despite being an advocate for breastfeeding, I agree completely. Somewhere along the way, our well intentioned, health-benefit focused campaigns on breastfeeding have fueled the message of guilt, shame and pressure on moms that are struggling and it is time for that to change.

I recently received a card and photo in the mail from the mom who gave up breastfeeding after our visit. It was her guy’s one-year birthday. In the picture, I saw a healthy, thriving family. The note said that the day I gave her permission to stop breastfeeding was the day she felt a shift. The tears stopped. She started enjoying the little moments with her boy and their bond grew. She said she still has moments when she feels sad that she and her son missed out on the nursing experience, but she knows that stopping is what her family needed.

We need to stop arguing about what is better. Breastfeeding, formula, bottles, pumping. It isn’t something that is up to “us.” It is not social media’s business, your neighbour’s, your mother’s, or the business of that mom group you belong to. It is yours exclusively.

As much as I like #fedisbest, I think it should evolve into new movement: #momsmentalhealthmatters. A healthy mom is necessary for a healthy, thriving baby—and that is what matters.

Carrie Bruno is a registered nurse, lactation consultant and sleep coach who runs The Mama Coach in Calgary, Alberta. Some details of this story have been changed to protect the family’s privacy.

 Credit: today parent
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Relactating: Restarting Breastfeeding

relactating

Relactation – Restarting breastfeeding after a gap / After Adopting a new child

What is relactation?

Relactation is how a woman can re-establish breastfeeding after a period of very little or no breastfeeding. She may have not breastfed for several days, weeks, months or years. Or even a new mummy who has just adopted a new baby and has never breastfed before called induced lactation. This is to induce lactation artificially typically for adoption.

Who would do it?

Mummies who have stopped breastfeeding earlier than they wanted or changed their minds.

Your baby might have been weaned from the breast, but since developed an intolerance to formula.

Mummies who might have been separated from your baby or your baby might have been ill.

Mummies who may have adopted a baby and want to re-start your milk supply to breastfeed him/her.  A woman could also breastfeed an adopted baby if she has never breastfed previously or has never been pregnant – this is called ‘induced lactation’.

You may want to help a sick friend or relative by breastfeeding her baby.

How likely is the mummy to succeed?

There isn’t a lot of research on relactation, but the studies that have been done suggest that, with proper support, most mothers can partially or fully relactate.

Some mummies were very fortunate. They can go from expressing a couple of drops of breast milk to a full supply AND get their baby back to the breast. It can range from a month to 4 months for some, but with lots of determination and effort, it is well worth it.

How is it possible?

Nature is a very clever thing. Breast stimulation alone sends important hormonal signals to switch milk production back on. It is a common misconception that once a woman’s milk has ‘dried up’, she can no longer breastfeed. However, this isn’t the case! Grandmothers have been known to relactate to feed their grandchildren!

How do mummies do it?

Learning the basics of breastfeeding is a great place to start. Breastfeeding works on a supply and demand basis, so the more the baby feeds and the breast is stimulated, the more milk the mother produces.

Learn how to recognise if your baby is getting enough milk. Is he producing six wet nappies in 24 hours and if under five weeks, is he pooping three or more times a day? Is he gaining weight?

If the baby will latch onto the breast:

Try to put the baby to the breast as often as possible (every 2-3 hours at least). Even before any milk is being produced, nipple stimulation will release the hormone prolactin which encourages the growth of breast tissue.

Learn how to recognise a good latch. A baby that latches on effectively will stimulate your supply in a way that a baby latching on poorly won’t. Has the baby got a nice wide-open mouth? Is it pain-free? If breastfeeding feels uncomfortable, do get support.

Ways of stimulating your milk supply whether or not the baby will latch on:

  1. Skin to skin time: Even if the baby isn’t feeding, have skin-to-skin time. Keep the baby on or close to your body as much as possible. This will stimulate the release of hormones needed for milk production and encourage the baby to feed. You could try wearing the baby in a sling. You can bottle-feed skin-to-skin and near the breast
  2. Good Grade Pump: Use a pump or hand express for 10-15 minutes on each breast several times a day. Ideally, at least eight times in 24 hours. Don’t worry about how much (or little!) milk you can express. The nipple stimulation itself will be stimulating your body to produce more milk for the future. Some mums choose to hire hospital-grade double electric breast pumps but this may not be necessary. If you are pumping frequently, remember that you don’t need to wash and sterilise the pump each time. You can store the pump in the fridge in a plastic bag between sessions and just wash it thoroughly once a day.
  3.  Supply and demand: You may get milk immediately, but if you don’t … don’t give up! The volume of milk will increase when the baby starts to feed directly from the breast and as time goes by. It may only take some women a few days to develop their supply. Others pump for several weeks before they see a significant increase in their supply. Everyone responds differently to the process of relactation so it’s very difficult to give a definite timeframe. If a baby will latch, you could also express directly after and /or between feedings. Expressing when the breast is emptier sends particularly valuable signals to the breasts to produce more milk. You may be able to find some time in the day when you ‘cluster pump’ and pump for ten minutes, break for 5, pump for another ten and repeat that a few times. Pumping should be pain-free. If your baby is happy to latch on and stay on the breast, it may not be necessary for you to pump at all. Power pumping is a good way to increase milk supply.
  4. Hydrate: Don’t forget to drink lots of water and have enough rest. A good well-rested machine then can produce a good product right?
  5.  Lactation Supplements: Take cookies, muffins, herbs or even medication (called ‘galactagogues’) to stimulate the hormones that govern their milk supply. Eat food that boosts milk will help too. By finding your milk booster, you will need to trial and error as the different body reacts differently to different food.

Continuing to feed other kinds of milk

It is likely that while you are building up your milk supply and getting the baby used to feed at the breast, you will also be feeding the baby formula. If you are using a bottle, you may want to consider using a technique called ‘baby-led bottle feeding’ (sometimes known as ‘paced bottle feeding’) which may help your baby transition to the breast. This slows the flow down and requires your baby to work a little harder.

Helping the baby to accept the breast

The baby may become frustrated by feeding from an empty breast at first, so you could try hand expressing enough (or pumping just for a moment) to trigger milk flow before putting the baby to the breast.

You want the baby to associate pleasure with being at the breast, so anything you can do to avoid making breastfeeding a battleground will be useful. It’s better not to ‘force’ the baby into a breastfeeding position but to gently enjoy time skin-to-skin and present opportunities. You could hand express some drips of milk or trickle milk into the baby’s mouth.

A baby may prefer to breastfeed when they are not desperately hungry or at certain times of the day. Especially when your baby is younger, spending time holding the baby tummy-down on your semi-reclined body will trigger innate feeding behaviour.

You could consider the use of a nursing supplement. This delivers milk from a bottle through a fine plastic tube that enters the baby’s mouth along with your nipple. This may help stop any frustration the baby might show at the breast and ensure that your breasts are stimulated to produce milk further.

A baby that is very accustomed to the bottle may accept the breast using a nipple shield but this is best done with the support of a breastfeeding counsellor or lactation consultant.

Things to consider:

Why did you stop breastfeeding in the first place? You might want to consider talking with a breastfeeding counsellor, lactation consultant or peer supporter before embarking on your journey to give it another go.

There may be changes in your body. There may be a change in your menstrual pattern as the baby nursing will affect your ovulation. Your breast may physically change in appearance too, the areola may be darker or the breast may be tender or feel full. Due to the hormone changes, you may feel emotionally different. Support is a great help if you are feeling any of these feelings but it is normally a sign that your body is starting to produce milk again.

Remember that if your baby will latch but you are not able to return to a full milk supply, they will still receive important benefits. And if you work hard to increase your supply but your baby is reluctant to latch, they can receive this expressed milk. That is still a valuable achievement.

Relactation may be difficult and time-consuming at times, but it IS possible. With the right support, information and dedication, relactation works for women every day and produces happy and valuable results. Confidence and self-belief will help you on your journey.

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Tips on breastfeeding twins

breastfeeding twins

You know that breastfeeding your infant provides an opportunity for bonding while providing health benefits for your child. However, it can be daunting to find out that you’ll have to breastfeed two infants at the same time! Just take a deep breath, because it is possible to breastfeed twins, without either baby suffering from sharing their mother’s milk. Here are some tips that can help you to breastfeed your twins!

  1. Set Up One or More Comfortable Nursing Stations – Twins often require more time to feed than a single child. Therefore it is essential to sit up one or more comfortable areas where you can sit or lie comfortably when breastfeeding your infants.
  2. Breast Feed on Cue Not on Schedule- When feeding twins you shouldn’t rush to get them on a feeding schedule. Instead, you need to feed your babies on demand or cue. Keep in mind that twins are often born prematurely and therefore eat smaller amounts, but need to eat more often than most full-term infants. In addition, twins, even identical twins, are individuals and therefore may not want or need to eat at the same time. By feeding your baby as they demand food you can better meet their individual needs.
  3. Start Nursing Only One Baby at a Time- It often takes time for an infant to learn to latch onto the breast properly. Therefore it is essential that you only feed one infant at a time until you are sure that one infant is latching onto the breast properly before trying to breastfeed both infants at once. If possible, have someone to offer support during the first three or four months that can offer to hold the other twin and comfort them while you feed the other infant. This will allow you to concentrate on each individual infant while feeding your child.
  4. Breast Feed or Pump to Encourage More Milk Production- If you are having difficulty producing enough milk to breastfeed exclusively, you still need to breastfeed or pump 8 times during a twenty-four hour period. Make sure that pump or breastfeed during the night to help keep up your milk supply and encourage more milk to flow.
  5. If Supplemental Feedings are Needed Alternate Between Infants- If you find that you need to supplement feedings to supply both babies with enough milk to stay healthy then alternate those supplemental feeding between infants, breastfeeding one infant one time and the other twin the next so that both babies get the benefits only breast milk can supply.
  6. Get Additional Support For the First Few Weeks or Months- Raising twins especially during the first few weeks or months can be physically and mentally draining. Having additional help and support during the first few weeks or months can result in your getting more rest and feeling more relaxed. The more relaxed you are, the easier it will be for you to care for your baby and the easier it will be when feeding time comes. The support you get can be help with housework or someone to watch the babies while you get short naps. They may simply be someone who sits with you when you are feeding and encourages you while keeping you company.

Should I follow a rigid or flexible nursing schedule?
For the first few weeks, infants need to breastfeed eight to 12 times per day. That breaks down to about once every two to three hours, day and night. Each session should last about 20 to 30 minutes—but wait for each baby to signal he or she’s done before calling it quits (the suck-swallow pattern will slow down to about four sucks to one swallow). A flexible schedule is best, and feeding your babies at the same time is the most economical use of your precious time. However, babies are individuals, so one twin may want to nurse every three hours, and the other, every two hours. Some mothers find that letting the hungrier baby dictate the time of the next feed for both works best. Some mothers nurse on demand during the day and follow a schedule at night.

How can I hold two babies to nurse at the same time?
Use rolled-up towels or a nursing pillow to support your babies. You can buy nursing pillows designed specifically for breastfeeding twins.

With the help of a pillow, you can vary your nursing positions. For example, you can rotate from the cradle hold (across your chest) to the football hold (along your side), or you can use a combination of the two. It’s a good idea to alternate breasts with every feeding, especially if one twin is a stronger feeder. If it’s hard to keep track of who was on each breast last, try alternating breasts every 24 hours instead of after each feed. Switching back and forth regularly helps produce equal amounts of milk in both breasts and lessens the chance of blocked milk ducts. Alternating breasts also helps your babies’ eyes get equal exercise and stimulation.

 

twinbreastfeedingpositions

If you have preemies, and one has to stay in the hospital longer than the other, you can simultaneously breastfeed on one side and pump on the other to keep up your milk supply.

Can I produce enough milk to nourish more than one baby?
The law of supply and demand applies to nursing mothers of twins and multiples. If you breastfeed when your babies want to eat, you can trust your body to supply enough milk. A low milk supply can almost always be corrected by nursing more often. If your babies aren’t emptying your breasts, you may need to pump.

Keep lots of water nearby, have a Lactation cookie and Muffin. The oxytocin your body releases when you nurse can make you very thirsty while lactation muffin and lactation cookies will help boost your milk supply.

What if I bond with one baby more than the other?
This can happen, especially if one of your babies has to stay in the hospital longer than the other. You’ve had more time to get to know the at-home baby, and you’ve developed a stronger attachment to that twin. Or, if you have one sickly baby, you may find you’re giving that baby more attention. The important thing is to be aware of your feelings and work to give your babies equal love and attention. Happily, breastfeeding brings you in close contact with both babies and can help speed up the attachment process.

Do I ever get a break?
You don’t have to be on the job at all times. In fact, you shouldn’t be. Sleep when the babies sleep if you can. Call in your support teams when you’re feeling frazzled, beginning with your mate. Let him take over while you take off, even if it’s for only 15 or 20 minutes. Get out of the hearing range of the babies by going for a walk, taking a hot bath, or reading a magazine in another room. Once your feeding routine is well established, enjoy a night out with your partner or a friend. Remember, you had a life before you became a parent. It’s time to continue where you left off.

Following these tips and those from your doctor or lactation specialist can make breastfeeding your twins more successful and enjoyable for both you and your twin infants.

 

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Simple Goal For Breastfeeding

simple goal for breastfeeding

I’ll never forget how I struggled as a first-time breastfeeding mom–especially during the early days! My milk did not arrive until day 5, and I clearly remember taking a bath and looking at my breasts with tears streaming down my face.

“Milk! Come in! Come in!”

It had been my dream to breastfeed, and in my postpartum emotional daze, I thought my milk would never arrive.

I started looking thru the internet and asking family and friends.

I look thru the web and thought about what gave me what I believe to be the very BEST breastfeeding advice. I believe it was this wisdom that gave me the push I needed to persevere through those challenges and other breastfeeding challenges that have come over the course of my now 19-month breastfeeding journey:

Give it two weeks

That’s it? Yes, that’s it! It’s so simple yet profound.

Instead of feeling like you have to conquer this whole breastfeeding thing from your first days postpartum, just take it one day at a time, and resolve that, no matter what, you will continue to breastfeed for at least two weeks.

Once those two weeks are up, go ahead and add two more. Next, commit to breastfeeding for a month. Then make it two.

Before you know it, you will have breastfed for an entire year. That’s how it worked for me!

Those two weeks turned into:
9 months with Baby Girl #1
19 months and with Baby Girl #2

Just give it two weeks. I know you can do it!

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Back To Work Pumping Tips

back to work pumping

Back To Work Pumping Tips

Many mothers breastfeed their infants when they are born and then change them over to formula when their maternity leaves end and they need to go back to work. However, not only are babies healthier when breastfed as long as possible and working mothers can continue to supply breast milk for their infants and still work a full-time job. Here’s how to pump while at work and some tips for breastfeeding mothers when they return to work.

Before you return

Decide to pump breast milk before or right after the baby is born

By planning, you can get the breast pump and all of the accessories you need before your baby is born. Now, you don’t find yourself rushing around a day or two before work to get everything you need.

Prepare Your Milk Bag in Advance

Your milk/Pump bag should contain a pump, tubing, 2 or 3 sets of accessories (flanges, attachments, and membranes), milk storage bags, labels and felt pen to date the milk you pump. Burp cloth, Breast wipes to clean your breast after pumping, photo of baby, and if there is no place to store milk at work (a refrigerator you can use) then you will need a cooler and several ice packs. But bear in mind the storage guideline and try to work around the schedule and the resources you have.

Start Saving up Milk Before Returning to Work

Once your infant is two or three months of age, you should begin pumping one extra time during the day and storing the milk in the freezer so that you begin to build up a supply of milk. Our wide range of lactation bakes can help you boost your milk supply along with the food list you can follow to find your magic booster.

Talk to Your Employer about what you need to pump at work

At a minimum, you need a private room to use about 3 times a day with good lighting and electricity and a comfortable chair and a table to sit the pump on. If your office doesn’t provide a nursing room, look around for any available nursing rooms around your vicinity.

Have a Practice Work Day

Before you return to work you should have a practice day to make sure you are prepared for pumping at work. Try and practice doing what you would do once you return to work including taking your baby to daycare, feeding them before taking them and after the workday, in the evening, and before bed and then pumping on scheduled breaks during the day.

Pumping as close to your baby drinking timing

Your pumping schedule should follow your babies normal eating schedule as close as possible. Keeping your schedule close to your infants normal eating schedule will help slow leaking and help to ensure a steady supply of milk and more comfort when pumping.

You need to maintain your milk supply 

You need to do everything you can to maintain to supply your milk supply including nursing your infant whenever you can. Getting in as many breastfeedings as possible since the baby feeding will help you maintain your milk supply. It is also important that you maintain your pumping schedule even if you only have a few minutes to pump because this will help to keep the milk flowing as well. Try your very best not to skip a pumping session. Do some power pumping if you have time.

Enlist help

To ease the transition, have another person (husband or partner, babysitter, grandparent) offer your expressed milk to your baby. Ideally, you should introduce the bottle or nipple no sooner than four weeks of age to ensure your supply is established, or at least two weeks before you return to work.

Once You Have Returned

Timing is everything

Know when to pump and when to breastfeed. Feeding your baby at the breast is ideal to keep up your supply and nurture them – so plan for that precious time. And remember to pump when you are away from your baby so your body gets the regular stimulation it needs to keep up your supply.

Plan when and where

Breastfeed just before you leave, when you return and before the baby’s bedtime. You may have to wake up earlier to get ready and still have time to nurse. You can nurse right when you return, depending on your schedule and when your caregiver has given the expressed milk. Feeding at the breast is the best way to drain your breasts and trigger more milk production so you may need to remind your caregiver not to feed your baby just before you return.

Take a deep breath

This will become second nature to you and your baby. We know that being a working, breastfeeding mom is not an easy task, but it’s well worth it.  We’re also here to support you, so check in with us if you need some extra guidance. We are not LC, but as a mom, we have our fair share of experiences (laughs)

Always Pack Your Milk/Pump bag the night before

Keep a checklist of what you need and refer to it when checking your bag. In addition, you might want to keep a spare set of accessories at work to use in an emergency in case you forget an attachment or flange. Wet hand wipes; Extra clothing, such as a top or sweater, to leave at work in case of leaks; Nursing pads;

Pumping mummies are hungry mummies

Snacks and lunch, including high protein healthy foods and drinks to keep you hydrated.

While providing your baby with breast milk once you return to work may pose a few logistical problems. However, they can be overcome by following these tips and now, who says going back to work is hard?

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My Baby is always hungry

my baby is always hungry

My baby is always hungry (or is she?)

One of the most common concerns I hear from parents is that they say their baby is always hungry. Often these parents question whether or not their baby is getting enough to eat, and breastfeeding moms may begin to question if they are making enough breastmilk. However, parents can be comforted to know that frequent feedings are often the way of it with babies- newborns in particular.

Little baby = little tummy = drinks small amount = Little tummies need filling more frequently.

Breastfed Newborns and Cluster Feeding

So, let’s start at the beginning. Cluster feeding, also known as bunch feeding, is when your little baby feeds several times over a period of a few hours. More often than not, cluster feedings appear in the evening hours. These bunched feedings serve the purpose of ramping up mom’s milk supply and also tanking up your baby on the nutrition that she needs. This is also why Power Pumping mimics cluster feedings and served as an important tool to increase milk supply.

What you need to realise is that

1) cluster feedings are completely normal,

2) they serve an important purpose in breastfeeding, and

3) thankfully, your baby will grow out of them (though they can reappear during periods of baby growth spurts.)

Bottle-fed Newborns and Spitting Up

Parents are often surprised to know that, generally speaking, newborns only need about 1 to 2 ounces of formula per feeding. Depending on the amount in the bottle, they may need to be fed anywhere from 8 to 12 times in 24 hours.

If you notice that your baby is spitting up excessively, then a sound suggestion is to decrease the amount of milk in the bottle but increase the number of bottles you offer in a day.

Understanding Baby Hunger Cues

Sometimes the problem is that parents are mistaking every fuss and whimper to be a sign that their baby is hungry.
Babies fuss for all sorts of reasons.

  1. They are tired.
  2. They are bored.
  3. They are overstimulated.
  4. They are uncomfortable.
  5. They pooped.
  6. They are having tummy ache
  7. They are too hot
  8. They are too cold
  9. They need comfort
  10. The list goes on and on.

Sometimes what parents need to do is be sure that something else is not causing the crying, and use different strategies to calm their fussy baby. All babies are different, and have different little ways of letting their parents know that they are hungry. Therefore as you and your baby gets to know one another, you will soon recognise your baby’s way of letting you know that that they are hungry.

However here are some of the typical hunger cues.

Common infant hunger cues include:

Early
  • Smacking or licking lips
  • Opening and closing mouth
  • Sucking on lips, tongue, hands, fingers, toes, toys, or clothing
  • Rapid eye movement while sleeping
Active
  • Rooting around on the chest of whoever is carrying him
  • Trying to position for nursing, either by lying back or pulling on your clothes
  • Fidgeting or squirming around a lot
  • Hitting you on the arm or chest repeatedly
  • Fussing or breathing fast
Late
  • Moving head frantically from side to side
  • Crying

Crying. Every baby is different so, a mother needs to learn to interpret her own baby’s cry ( you will know ). A hunger cry is usually short, low-pitched, and rises and falls. But crying is actually one of the later signs of hunger. By the time a hungry baby is wailing, she may be too stressed to start eating easily.

Waking up and acting restless. Before your baby launches into a full-throated hunger wail, she’ll wake up and move around in her crib. She may also move her mouth and raise her hands to her face.

Sucking on her fist, smacking her lips. If you feed a breast-fed baby when you see these signs, rather than waiting, she’ll latch on more easily.

Rooting. During your baby’s first weeks, when you stroke her cheek, her natural reflex will be to turn toward the bottle or breast and make sucking motions with her mouth. After 4 months of age, rooting becomes a voluntary action rather than a reflex.

Opening her mouth while feeding. Translation: “More, please!” A hungry baby may continue to show interest in sucking even after finishing the first breast or bottle.

Smiling during feeding. Babies older than 4 months will show their interest in continuing to eat by looking at you and smiling as they feed.

Signs That Your Baby Is Full

Closing lips. Just as a hungry baby suckles readily, a full baby zips her lips, as if to say, “No more, thanks.”

Turning her head away. A more forceful version of closing her lips is to move her entire head away from the food source. If your baby turns away from your breast or a bottle, you shouldn’t force her to eat.

Decreasing or stopping sucking. Some full babies will stay latched on to the nipple but not suck any more—at which point, it’s time to gently end the session.

Spitting out the nipple or falling asleep when full. After about 15 to 20 minutes of feeding, a full baby will often act drowsy and may even fall asleep.

Showing increasing interest in surroundings rather than eating. At around 4 months old many babies begin to get distracted during feedings, as their awareness of the world around them grows. A hungry baby will put this curiosity on hold long enough to feel sated. When she begins looking around more distractedly, it’s a sign she’s had plenty.

 

How Often Should Baby Be Fed?

Until your baby has regained her birthweight, the recommendation is to feed about every two hours. Keeping in mind that cluster feeding is normal, and breastfeeding more frequently than that is okay. Demand feeding which is the practice of feeding a baby when it cries to be fed rather than at set times is recommended as well.

Hungry Babies and Solid Foods

Once your baby is eating solid foods (sometime between 4 to 6 months), again you need to tune into her cues to determine if she is hungry or not. These cues can be subtle. Your baby will turn his head away, lean back in his high chair, may refuse to open his mouth, or has stopped making eye contact with you (or the spoon!).

Your baby’s appetite will vary from meal to meal and from day to day. Do not bank that your baby will eat a certain amount at every breakfast, lunch or dinner. Simply watch your baby’s signs and feed him accordingly.

The Importance of Wet Diaper Counts

A very important part of knowing whether your baby is getting enough breastmilk or formula is to keep track of her daily wet diapers. Depending on your baby’s age, she should have a certain number of wet diapers and soiled diapers each day. If that number drops below the expected amount, it could be a sign that she is not getting enough to eat.

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Storing breastmilk 101

Storing breastmilk 101

Yap, you are ready, you read about the benefits of breastfeeding your child, you are ready to latch, and you have prepared to pump 2-3 hourly. But how do you exactly know how to store your breastmilk? How long can you keep your breastmilk at room temperature? How long in the fridge? How long in the freezer etc. These are some of the questions that most mummies have and here I have compile some of the tips on storing breastmilk that I hope this might help you.

How do I store my breast milk?

How you store your breastmilk depends on how soon you want to use it. If you plan to use it within a few days, refrigerating is better than freezing. Freezing destroys some of the substances in your milk that fight infection. However, frozen breastmilk is still a healthier choice for your baby than formula, though.

The rule of thumb to follow while storing milk is

  • Always wash your hands before expressing and handling breastmilk for storage. Keeping everything as clean as possible will make it less likely that bacteria will grow in your stored milk.
  • Keep your breast pump clean. Wash the parts in hot, soapy water, and rinse them thoroughly before sterilising.
  • Use sterilised containers. Opt for plastic bottles or plastic breastmilk bags. Glass bottles may crack or chip.
  • If you’re pumping at work, you can store your milk in a travel cooler with ice packs or in a common space refrigerator.
  • If you need to combine freshly expressed milk with frozen milk, cool the expressed milk first. Don’t add more than there is of the frozen, since you want to avoid the frozen milk thawing.
  • Label and date your bottles and bags, and use up the oldest ones first. If you combine milk from several pumping sessions, label it with the date of the oldest milk.

If you plan to feed baby in the next 24hours, place the milk bag/bottle at the highest deck of the fridge. If you plan to feed baby 24 hours later, you can put the milk bag/bottle in an isolated compartment of your freezer.

It’s helpful to label each container with the date when the milk was pumped (and your baby’s name if the milk is going to childcare providers).

Can I top up fresh cooled milk to frozen/chilled milk?

Frozen Milk

You can add fresh cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have 40ml of frozen milk, then you can add up to 40ml of cooled milk.

Chilled Milk

You can add freshly expressed milk to breastmilk that’s already in the fridge, provided it has been expressed on the same day. Bear in mind, though, that you can only keep it until the original milk is five days old.

How do I freeze my milk?

Freeze your milk as soon as you finished expressing your milk. Leave a gap on top of your bag or bottle as your milk expands during freezing.

When freezing, store milk in smaller portions such as 1-3 ounces in order to avoid waste.

How do Thaw my milk?

Defrost frozen milk in the chiller section of the fridge ideally 12 hours before usage.

Once you defrost your breast milk, do not re-freeze it.
Don’t be tempted to defrost or warm your breastmilk in a microwave.

If you need the milk in a hurry, defrost it under cool, then warm, running water, or place it in a bowl of warm water.

Dry the outside of the container before you open it, and use it straight away. Once your baby has started to drink from the bottle, you should use it within 1 hour.

What to look out for

  • Thaw your frozen milk in the chiller section of the refrigerator 12 hours or overnight if you plan to use your frozen milk.
  • Do not shake your bottle if the creamier portion has separated, instead gently swirl your bottle  as shaking will cause some proteins in the milk to break apart.
  • Always use the oldest milk from your supply first. Don’t worry if the oldest is weeks or months old. It is true that the composition of your milk changes over time to suit your growing baby’s needs. However, even older milk, as long as it has been properly stored and handled, is beneficial to your little one.

Some Little tricks

  • Store bags, tightly sealed, flat and stacked. This will speed up thawing time.
  • To have some more extra use from our pump accessories,  give them a quick rinse then throwing them in a large ziplock bag, and storing them in the refrigerator until the next pumping session.
  • Does your milk smell soapy? Most breast milk has a mild or slightly sweet scent, but mothers occasionally report that thawed milk smells soapy. This may be due to enzymes in the milk digesting some of the fat and is probably fine if your baby accepts the milk. If not, scalding (but not boiling) the milk and quickly cooling prior to freezing may solve this problem if baby is rejecting the milk, although this may lower the nutritive content and is not ideal.
  • you can still offer your milk to your baby if you and your baby are experiencing thrush while being treated. After the infection has cleared, however, discard the milk as neither cooling nor freezing kills the yeast.
  • Have some expired milk? Instead of tossing the milk, consider using it for diaper rash, baby eczema, cradle cap, or a good milk bath for your little one.

 

Source

  1. Smith, Linda J. (1998) “Don’t Shake the Milk“. Bright Future Lactation Resource Center Ltd.
  2. The Academy of Breastfeeding Medicine Protocol Committee (2010). “ABM Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants (Original Protocol March 2004; Revision #1 March 2010)“
  3. Kelly Mom, “My expressed breastmilk doesn’t smell fresh. What can I do?“. July 28, 2011.
  4. Le Leche League International. “What are the LLLI guidelines for storing my pumped milk?“.
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Sore Nipples

nipple pain after breastfeeding

Sore Nipples 101

Ouch! Breathe. It’s not that painful… but when the baby starts to latch, OUCH! Many mummies, including myself, have had the experience of having sore nipples while breastfeeding. It is a frequent complaint from mummies, and some assume it’s an inevitable part of the nursing experience. But lactation experts agree that pain is a sign that something isn’t right.

It is common to feel some discomfort when the baby first latches on, especially in the first days after birth before the milk has come in. This type of soreness will usually ease up after the first few sucks, especially after the milk lets down and flows freely.

Babies are born with a strong sucking reflex, but they have to learn the mechanics of breastfeeding. At the same time, you are learning the mechanics of positioning, supporting the breast, etc. While some babies seem to come into the world knowing just how to breastfeed correctly, more often it is a learning process for both of you.

Nipple soreness will usually begin during the first few days of nursing, will peak on the fourth or fifth day, and then ease off each day after that. Soreness should lessen greatly on days 7-10, and by the time the baby is 2 weeks old, nursing should be pain-free.

What are the causes of sore nipples?

Difficulty latching on

This is by far the most common cause of sore nipples. A good latch should feel like tugging and pulling but not painful.  A poor latch from a baby is when the baby has to pull or suck your nipple hard into her mouth.  Your nipple is then too far forward in the baby’s mouth and it pinches your nipple against her hard palate, causing pain.

For breastfeeding to be comfortable, your baby needs to have the entire nipple and part of the breast in his mouth. The nipple needs to be near the back of her mouth where the palate is soft. This good latch is more likely to happen if the baby latches on with his head tipped back so that her chin is pressed into the mother’s breast and her nose is away from the breast. Of course, every baby and every breast is a little different, so you may need to adjust the positioning to find what works best for both of you. If your baby doesn’t gape to take in your breast, don’t pull your nipple out. Instead, break the suction by gently inserting your finger into the corner of her mouth and above her tongue. Take her from your breast and start again.

 

Here’s a video from NHSChoices

Tongue-tie
If your baby has a tongue-tie, her tongue will be attached to the bottom of her mouth. If she can’t move her tongue much, she may not be able to draw full feeds from your breast. The signs will be that she can’t latch on well to your breast and keeps slipping off. She will be feeding often, but not putting on enough weight. See a doctor to check for treatment recommendations.

Adjust without unlatching
If your baby latches on, and it hurts, you’ll know something is wrong. Sometimes mothers are advised to stick a finger in the baby’s mouth, unlatch him, and start over. The problem with this approach is that it’s very frustrating for the baby: every time he starts nursing, he’s taken off the breast. Some get so frustrated they refuse to nurse or begin clamping down on the nipple. It also puts you at the risk of more nipple damage if the baby latches on incorrectly repeatedly.

What you can do is to adjust when the baby is latching,

  1. Wait for the baby to open its mouth by tickling the baby nose with your nipple.
  2. Count to 10 for the baby to readjust.
  3. If you still feel tight and the position is wrong, flange the baby’s upper and lower lips out and hold the baby’s jaw for about 10 sec.
  4. Holding down the jaw for about 10 seconds is to make sure the baby’s jaw is in the position and doesn’t go back up.

Feed as soon as you spot a hungry cue
A very hungry baby isn’t going to have much patience and may try to grab at your nipple, causing more pain. Feeding the baby as soon as he seems hungry will make it easier to work on getting a good latch every time.

Use your milk to heal cracked, bleeding or blistered nipples
Express a little milk onto the nipple and let it air-dry there.  Apply an ice pack just before you feed the baby to temporarily numb the nipple as you latch the baby on. One piece of good news: breastfeeding nipples generally heal very quickly once the cause of the damage (such as a latch problem) is resolved.

Thrush

If your nipples are sore after a spell of pain-free feeding, and you feel burning, shooting or stabbing pains in your breasts, you may have thrush on your nipples. Thrush is a fungal infection that sets in when organisms that naturally exist in your body spread out of control.

Your doctor can prescribe an antifungal treatment for you and your baby. If you have thrush on your nipples, it will also be in your baby’s mouth, whether or not you can see it. You’ll both need to be treated at the same time, so you don’t keep passing the infection between you.

Dermatitis or eczema

If your nipples are inflamed and itchy it may be a sign of dermatitis or eczema. This can be caused by creams, lotions or soaps that irritate your skin. Swimming in chlorinated swimming pool water can also sometimes cause sore, itchy nipples. Wash your breasts with plain water alone, and see your doctor if your symptoms don’t improve.

Teething
If your baby has tender gums due to teething, she may change the way she feeds. If her tongue isn’t down and forward enough to take in a big mouthful of breast, she may end up biting your nipple. Help your baby to gape and keep her tongue forward by touching her lips to your nipple and then moving her quickly onto your breast as she responds. Older babies sometimes keep their mouths open but pull their tongues back after they have gaped, so you’ll have to move fast.

Breastfeeding during pregnancy
Your nipples may be tender if you are breastfeeding and pregnant again. Your nipples may only feel tender in the early days of your pregnancy, or they may only feel sore towards the end of your third trimester. If your nipples get really sore, you can try using a purified lanolin ointment or cream to soothe them.

Soreness from your bra or breast pads
If your nursing bra is too tight, it will put pressure on your already sore nipples. Some breast pad traps air and often will cause your nipple’s condition to worsen. Choose breast pads from natural materials which will help your skin breathe.


How to make yourself feel better

Have a towel on standby

Once the baby is done nursing you will want to gently dry your breast of any leftover milk. Gently clean the nipple and dry it. Breast milk is a great healer but it’s best to keep it dry to keep any form of bacterial away.

Air your nipple

Bring down your bra flap, use a nipple shell or even using a hairdryer on a low setting after each feed.

Apply modified anhydrous lanolin

After nursing, apply lanolin cream to help ease off some of the soreness. Surface dampness can contribute to soreness and cracking if the nipple remains moist after nursing, the same way your chapped lips get worse if you lick them. Applying lanolin can help keep the skin soft and pliable, which helps breaks in the skin heal without forming a hard scab which will break open each time the baby-nurses.  Don’t use soap on your nipples as it can dry the skin. Bathing with clear water is all you need to keep your nipples clean.

Use Nipple Butter

Nipple butter helps keep your nipples soft and supple. It also helps to moisturise and heal your sore nipples.  It’s completely safe for the baby, so keep it with you at all times.

Breast Pads

Some breast pads and plastic linings in bras don’t let your skin breathe and they trap the moisture. Choose pads made from natural materials. I like to use disposable ones as I feel that they are cleaner and I can just change and feel fresh at any time of the day. Be sure to put a couple of sets of breast pads in your diaper bag and you can change your breast pads on the go!

Nursing bra

Getting a comfortable bra will help you improve your breastfeeding experience.  If your nursing bra is too tight, it will put pressure on your nipples and cause pain. Try wearing a bigger bra.

Gel Pads

Have one set in the fridge! So that after an intensive feeding, you can put them on for some cooling relief it brings!

Don’t Give Up

I promise it will get better! It’s about learning together with your baby. Before you know it, you will be feeding like a pro! It always makes me sad when mothers quit nursing because of soreness. The long-term benefits of breastfeeding far outweigh the short-term pain. It really is worth hanging in there – ask any nursing mother, and she’ll tell you she’s glad she didn’t give up when the going got rough.

 

Reference

Teresa Pitman Jul 8, 2011

BabyCentre Sore Nipples, February 2013

Breastfeeding Basics, Anne Smith, IBCLC September 2013

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Power Pumping

Power Pumping

Although mother nature had made it a point to have babies and breasts work on the principle of supply and demand, many breastfeeding moms still worry about their milk supply. Some mummies however despite their best efforts, experience issues with low supply. Period when babies is experiencing growth spurt will certainly add-on to the stress to most mummies worrying about their supply.

Pumping often does help with the increase of milk supply as they stimulate the brain to “produce more milk”  however, despite regular pumping session, many mummies make not see results as quickly as they had hoped.  There is another way of pumping that might help this group of mummies – Power Pumping.

What is Power Pumping

Power pumping is basically mimicking the frequent feeding of a baby experiencing a growth spurt.  The longer and more vigorous suckling motion during these times helps trigger the release of prolactin from the pituitary gland which will then translate it into “baby needs more milk, please produce more!” message to the brain. Power  pumping which are also sometimes called cluster pumping is a routine of  pumping in a series of 10 minute sessions – 10 minutes pumping, 10 minutes off – over the course of 1 hour, 1-3  sessions each day.

 

Power pumping

Using this routine alone or in combination with other measures to increase supply – latching/pumping more often, use of galactagogues etc may slowly build up milk supply over time.  Many mummies may find that the milk they collect at first to be very little during these sessions but their supply catches up with the baby’s demand after some time. So, how much milk you collect is not so much of an importance during such sessions.

You may not see much milk during the actual power pumping routine but that’s okay, it’s all about the supply and demand and this is stimulating your breasts to make more milk. This routine not meant to replace your normal pumping routine; rather, it’s designed to enhance your milk supply within an established routine. For example if your normal pumping routine is at 12 pm and 3pm, you can add a power pumping routine at around 1.30pm.

Not sure power pumping is the right thing for you?

Power pumping suits some situations and not others, and it is worth knowing which one you are in before committing weeks to it. Joanna Goy is an International Board Certified Lactation Consultant based in Singapore and can look at the whole picture with you, including latch, feeding pattern and how your sessions are set up. See how a consultation works, at home or online.

When can I see result

Some mummies see results as soon as the next 48 hours while others take as long as a week to see the increase in supply. Do not be dishearten if yours takes a little longer. Perseverance and determination is the key to a successful breastfeeding journey.

Tips on Power Pumping

Pumping milk can cause a lot of stress and boredom, but the good news is that you can perform Power Pumping at any time, such as when your baby is sleeping. I personally enjoy following this routine.By now all mummies who are pumping and latching will know that the main key to make the session better is to ensure that you are as comfortable as possible.

Here are some tips that could help you through these routines.

  • Using a breast pump – hand expressing / manual pump is a no go as this requires 1 hour of constant pumping. Do use an electric pump as they are generally more effective, especially where the pump is designed to mimic the suction of  a baby. if you can, buy a hands free pumping bra or bra clip it will really help too.
  • Keep a stopwatch / set alarm in your phone – to keep track of the time
  • Have a cup of water nearby – Key of producing milk is drinking water isn’t it?
  • Make yourself very comfortable – sit at your favourite sofa/ couch as you will be in the same position for quite some time
  • Set yourself up with some entertainment. – My favourite method is pumping when I’m watching korean drama. I pump when the show is on and rest when commercial is on. But a book or simply using your phone might do the trick too.
  • Latch one one side pump on the other – Research shows that the best way to boost supply is to nurse at the breast often.

Pumping During Night Feeds

Another frequent questions that mummies ask is if they should pump during the night feeds. 

As prolactin levels are at the highest during night and pumping routine at night-time will help push prolactin level up, pumping around the clock is certainly good if you can do it. But another key to higher milk production is getting enough rest. Getting adequate sleep is important to your overall health and well-being.  

So, the trick is to be flexible in balancing the two. Sleep at every opportunity in the daytime, and if it is time to pump but you have a chance to take a nap and really need it, choose the nap instead of pumping.

If possible, aim to include at least one pumping session during the night in your plan. If you didn’t plan for a night-time session but happen to wake up in the middle of the night, take advantage of the opportunity. Additionally, even if nothing else is accomplished, the calming effects of oxytocin released during pumping may help you fall back asleep after you’re done.