Re-lactation: One Mother’s Journey

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By Jacquelyn Ordner BSN, RN, IBCLC, RLC

I had met my breastfeeding goals with three out of my four children, with the fourth still nursing once or twice a day.  Number four was about 2.5 years old and had decided he only needed “milkies” at naptime and bedtime.  I was comfortable with this, and we were moving through this transition happily.  But, when my husband and I decided we were going to adopt, my thoughts around weaning began to change. What if my next child needs my milk too?

As we completed the international adoption application process and began the home study process, we really began to think about the little person who would be joining our family.  We had told the agency that we’re open to parenting a child with significant medical needs. Our child could need a myriad of medical interventions, and I immediately began thinking that I needed to store breastmilk to help support him or her.  I’m an RN and IBCLC, so that’s just how my mind works. I KNOW that just 15 ounces of breastmilk can provide up to:

29% of a toddler’s energy requirements

43% of their protein requirements

36% of their calcium requirements

76% of their folate requirements

75% of their vitamin A requirements

94% of their vitamin B12 requirements

And 60% of their vitamin C requirements (Dewey 2001).

Breastmilk does not suddenly become non-nutritious or suddenly lose its bioactive and immune boosting components at a certain age! So, in the waiting and through the mountains and mountains of paperwork, I could be working toward making more milk to save for our fifth child! 

I began with the basics…..pumping! In an effort to store every ounce, I gently encouraged our current youngest to cut back to nursing just once a day.  This was easy at first, and he didn’t even seem to mind me pumping. I was double pumping with the Spectra S2 just 3-4 times a day to start. Let me tell you, this wasn’t very encouraging!  I was only yielding a total of 1-1.5 oz per DAY! That’s when I hit the first major setback….my toddler became jealous of my pump! He cried when he saw me pumping and asked for “milkies” multiple times per day.  I felt so conflicted at this point because my natural instinct was to scoop him up and provide that loving comfort as we had done thousands of times before. However, I also knew my goal was to collect and store as much milk as possible before we brought kiddo #5 home.  Knowing that an effectively nursing baby (or toddler in my case) was far more efficient at stimulating milk production than my pump, I allowed him to nurse up to three times per day while I continued to pump 3-4 times per day. 

We were hitting our stride, and my pumping output was SLOWLY increasing, when we had another setback.  My work schedule changed, and this put stress on the whole family. My little guy had to start a new daycare during at this time as well.  So, I took a break from pumping for a couple of weeks. I could kick myself for this now, but I can’t go back to change it. That two week break set me all the way back to the beginning. Still, once we found our new rhythm, I was determined to get my production up.  I began faithfully pumping 5-6 times per day and VERY SLOWLY started to see an increase! Over the course of 4 weeks, my pumping output went from 1-1.5 oz per day to 3 oz per day in addition to the milk I was providing to my nursing toddler. Though my output is small, I’m confident that I can continue to increase my supply with dedicated pumping. Re-lactation takes time!   If you are considering starting the re-lactation process, there are a few things to keep in mind:

  •  Milk supply is easier to influence in the first 4-6 weeks postpartum.
  • The amount of time and pumping needed to re-lactate depends on many factors such as how long you were nursing or pumping before stopping, how long it has been since you stopped nursing or pumping, and how much milk you were producing at the time you stopped.
  • Pumping alone can be an effective way to stimulate re-lactation.  The use of galactagogues should only be done so with the help of a knowledgeable practitioner.
  • An effectively nursing baby is the MOST efficient way to stimulate milk production.  If your baby will latch, this is very helpful to the re-lactation process. The use of an at-breast-supplementer can be significantly helpful as well.
  • The knowledge and expertise of an International Board Certified Lactation Consultant, who has experience with re-lactation, can be extremely beneficial for a mother who is pursuing this goal!

Dewey KG. Nutrition, Growth, and Complementary Feeding of the Breastfed Infant. Pediatric Clinics of North American. February 2001;48(1).

There Is No Such Thing as The Perfect Mom

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breast pumping at the park

By Jacque Ordner BSN, RN, IBCLC, RLC

Instagram, Facebook, Mom Groups, even TV commercials and our own circles of friends all seem to be telling us there is something we could be doing better…..especially when it comes to motherhood!  Be sure you avoid that epidural. Only use 100% organic cotton garments on your little bundle. GMO, BPA, DHA, Vit D, RDA, BMI, OPD, PPD, PPA…..aaahhhh!!!!. You sleep train? Gasp! You don’t? From swaddling to co-sleeping and purees to Baby Led Weaning, parenting is full of choices.  It’s no wonder that today’s mothers feel incredible pressure to always get it right. In the Information Age data, trends, and opinions are all at our fingertips, but so are the blindingly judgmental comments of millions of social media participants. Somehow, with the availability of so much information, has also come the unattainable expectation of perfectionism.  And, to make matters worse, no one can agree on which type of mother is actually perfect……because SHE DOESN’T EXIST!

The truth is even if you do all of the “right” things, there will still be something, or likely lots of things, you’re going to wish you had done differently.  There’s just no way around this, and that’s because life is messy. We’re not supposed to have all of the answers. We’re not supposed to be able to see, with perfect clarity, how to pick the perfect daycare provider, or when to let them have their first sleepover.  Some of that knowledge can only be gained by living those experiences. As a veteran mom of four, soon to be five, I can assure you there are so many things I thought were of the utmost importance when my older kids were babies, and now I realize they really didn’t matter much at all.  The brand of diapers, the jungle theme or sailboats, whether we introduced the orange vegetables before the green ones, do we do SPF 50 or SPF 65? As my kids have aged, I have come to realize that the #1 thing that matters is if I’m really there for them. Am I there when they fall down and get hurt?  Am I there when they’re scared? Am I there when they don’t fit in with the popular kids? Am I there when they get their first crush? Am I there when they have to own up to telling a lie? Am I there when a friend betrays them? This is what matters! These are the moments when great moms are made. 

So, when you’re in the trenches of the newborn phase, or you’re bogged down by the demands of toddlerhood, try not to overcomplicate it too much.  Be their person. Make sure they know you are the one they can count on even when they feel like there is nowhere else to turn. If you can do that, then I promise the other stuff won’t matter nearly as much, and maybe not at all. It’s ok if you’re not the perfect mom because none of the rest of us are either.  

Benefits of Baby Wearing

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newborn baby breastfeeding

Benefits of Baby Wearing

By: Melissa Portunato MPH, IBCLC, RLC

It doesn’t matter what Grandma Susie says you can’t spoil a baby. It’s biologically normal for babies to want to be held. All around the world mothers have worn their babies for centuries in specially designed fabric wraps, ring slings and carriers. In recent times, baby wearing has gained popularity in the US because it allows busy parents to cuddle their babies close while keeping them hands free!  

Read on to check out 5 pretty cool facts about baby wearing:

Great For Being On The Go

Whether it’s a short trip to the grocery store or an international travel trip, baby wearing is an excellent way to be on the move. Who loves dragging a bulky stroller around? Not me! When you are baby wearing on the go, babies are less likely to fuss or cry because they’re close to you. Less worry and more time to run around getting things done. 

Good For Baby’s Overall Health and Well Being  

Let’s start with the fact that momma’s chest is a baby’s natural environment. Did you know that on a mother’s bare chest, a baby’s temperature and heart rate regulate? Pretty neat. If you have a baby with reflux, or colic you’ve likely been told to keep baby upright as much as possible because this position can lessen symptoms. Baby wearing does that! Baby wearing can also prevent flat head syndrome and improve cognitive development. By wearing your baby, you’re allowing them to be at your level exploring the world around them. This can encourage speech, social interaction, and independence. Bonus: People are less likely to touch a baby held tightly at your chest versus when a baby is in a stroller. Less exposure to nasty germs and less sicky – poo hands all over baby! 

Benefits For Mama Bear

We know skin to skin has a ton of benefits. Skin to skin promotes breastfeeding, bonding and oxytocin (the feel good hormone) which can lower rates of postpartum depression. Baby wearing makes it easier for mom to go out in public and socialize. Walking the mall with a friend or going to a church service doesn’t seem to be such a grueling task anymore. Getting mom out instead of keeping her all couped up at home – isolated, can help her transition easier into motherhood! 

You Can Nurse Or Pump In It! 

Structured carriers with a top hood are great to nurse in and YES, even pump! Throw the Spectra 9Plus in your pocket and you’ll pump your liquid gold without missing out on any fun going on. I recommend pumping one breast at a time if you are wearing baby. But hey! Why not use the carrier as a nursing cover?! Make your pumping sessions even more discreet and interchange your carrier for a breastfeeding cover. And YES mamas! Pumping is breastfeeding! 

Other People Can Bond With Baby 

Nothing warms my heart more than seeing an older sibling or daddy wearing the baby. Sometimes the rest of the family can feel a little left out since baby spends so much time with mama, especially during the first 6-8 weeks. Baby wearing can promote bonding with others and will let you get some much needed rest. 

Now, to choose which carrier type is best for you? Wrap, ring sling, structured carrier? You definitely want to consider the baby’s age/weight, your height, as well as where you will be wearing the baby. For instance: short trips, a formal event, or if you’re hitting the theme parks may call for different types of carrier styles and designs. Choosing the best type of carrier is a personal decision. Joining a local baby wearing group can help you decide. Click here to find one! Many have meetups and carriers to try on before purchasing. We love baby wearing because of the functionality and benefits for both mommy and baby. Like a mom boss, keep your baby close, get stuff done…baby wearing for the win!

Little Known Milk Supply Enemies

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breast pump and tea

By Jacquelyn Ordner BSN, RN, IBCLC, RLC

A breath mint, candy cane, or peppermint patty all seem pretty harmless, right?  Did you know that peppermint is often the sneaky culprit of reduced milk supply? Most moms don’t!  So, to make it easier for nursing moms, we’ve compiled a list of some little known milk supply enemies.

The following are usually harmless to  milk production in typical quantities used for cooking (as long as they’re aren’t consumed in large amounts or very frequently.

–Parsley

-Oregano

-Caffeine

-Thyme

-Vitamin B6 – Watch out for large amounts in common breakfast cereals! (stay well below the 100mg daily limit and you should be fine)

These foods/products/behaviors should be AVOIDED if you are a breastfeeding woman who wants to keep her supply up:

-Peppermint: Peppermint Essential Oil is often used when a mother wants to dry up her milk supply!  It is effective at doing so and should be avoided. Most people don’t realize that peppermint oil is in mint flavored candies, gums, and even menthol cough drops!  A cup of peppermint tea here or there will likely be fine, but that’s the limit. 

-Sage: Sage Tea is another remedy often used when a woman wants to wean or dry up her milk supply.  Sage is powerful and even too much in a turkey and dressing recipe can have negative effects. 

-Smoking: Studies tell us that mothers who smoke produce less breastmilk and their infants typically weigh less.  Studies also reveal that breastfed infants of mothers who smoke sleep less. Coupled with the increased risk of SIDs, it’s clear that quitting is best. Still, smoking and breastfeeding has far more benefits than formula feeding and breastfeeding!

-Dehydration:  You’ve probably seen one of those posts in a social media breastfeeding group where someone swears by red Gatorade, Body Armour, or drinking 200 oz of water a day.  The truth is that you need to be adequately hydrated to make milk, but you don’t need special drinks or excessive amounts of water. In fact, excessive fluids can actually have a negative impact on your supply! So, shoot for your 8 glasses of water a day, plus drinking to thirst, and that’s all you need.

-Dieting:  Don’t get me wrong, eating a healthy and balanced diet is fantastic!  However, heavily restricting your calories can definitely reduce your milk production.  Talk with your doctor about a healthy calorie range for you. Make sure they know you’re breastfeeding, and keep in mind that some women are more sensitive to calorie restrictions than others.

-Decongestants: Think Sudafed.  If it’s meant to dry up mucus, it can also dry up breastmilk.

-Many forms of Birth Control:  The biggest culprits are birth controls that contain estrogen.  Beware, even birth controls that are supposed to be “ok for breastfeeding” can still cause major supply issues for sensitive women.  The best bet for your supply is a barrier method (like condoms). Next best choice is a non-hormonal method (like an IUD). Third choice would be something like the mini pill.  Just be aware that any birth control that contains or affects hormones CAN negatively impact your milk supply. Always talk with an IBCLC if you have questions about medications and breastfeeding.

-Stress: Yep, we know…..this one’s a doozy!  Stress is everywhere when you’re a mom!  Still, if there’s anything you can do to reduce stress, it will benefit your milk supply.  Incorporating light exercise, like walking can help reduce stress. Eating well, trying to incorporate more sleep, and even just getting 30 minutes of “alone” time can be huge for stress reduction. Are there little things you can do to help?  Maybe prepping a few meals on the weekends, or packing your pump bag and baby’s diaper bag the night before? Even seemingly small reductions in stress can have a big payoff!

BONUS:

-Alcohol:  Maybe you’ve heard you should “have a beer so you can relax and make more milk”.  Well, there’s more to it than that! While alcohol consumption isn’t prohibited for breastfeeding mothers, it can have a negative impact on their breastfeeding relationship and breastmilk production.  Alcohol can inhibit your Milk Ejection Reflex or MER. The MER is what causes your milk to let-down. If your milk won’t let down, or if it lets-down very slowly, baby won’t drink as much, or you won’t pump as much.  In the long run, this can lead to less milk being produced. 

Breastfeeding and Coronavirus

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breast pump on babies dresser

By: Mirine Richey, MPH, IBCLC

The Flu and Coronavirus:

Can your milk or pump be at risk?

You can’t avoid the stories and worries of influenza (flu) and now COVID-19 (coronavirus). If you are pregnant or providing milk for a baby, the worry can be even worse! Let’s take a brief look at both of these respiratory viruses since there is so much media attention and look at what you can do to protect yourself, your baby and your milk, especially while traveling or exposed to crowds of people.

Flu: the flu is a respiratory virus that is spread through coughing, sneezing, and droplets of saliva. Flu can live on surfaces, including plastic, but not for more than about a day or two.  Flu can be killed on surfaces by using common household disinfectant wipes and cleaners, and by wiping surfaces thoroughly including breast pumps. 

Hand washing, avoiding crowds and getting a flu shot are recommended. For pregnant women, if you get a flu shot in your last trimester, it can protect your baby for the first several months after baby is born. Breastfeeding can help your baby develop a strong immune system. 

Coronavirus or COVID-19:   This is a novel virus meaning it is new to humans and we do not have any immune-memory to fight it. There is also no treatment or vaccine. We have immune-memory to fight things such as the common cold and that is why we get over that in a few days with little complication.  Person-to-person spread is thought to occur mainly by respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory illnesses spread. In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk and is not thought to transmit to the baby this way.

What can parents do to avoid spreading these viruses to the infant?

Precautions, including washing hands before touching the infant and wearing a face mask, if mom has symptoms. Mom wears the mask, not the baby.

If expressing breast milk with a pump, the mother should wash her hands before touching any pump or bottle parts and follow strict guidelines for keeping the pump clean after each use. This includes wiping the outside of the pump with a disinfectant wipe as both of these viruses can live on plastic for a day or two. This is especially important for a mom who travels with her pump or uses her pump in a public place. Although most cases of flu and coronavirus are not spread by touching surfaces, taking these extra precautions can lower your risk of having a virus on the outside of your pump, then touching it and touching your eyes, nose, mouth or baby’s eyes, nose or mouth. 

If you have fever or respiratory symptoms and do not have a face mask,  consider having someone who’ll feed the expressed breast milk to the infant.

Preparation tips, for community illnesses and other disasters:

  • Find out what the sitter or center’s policy is on illness, fever, disinfecting.
  • Make a plan for care if your center has a temporary closing.
  • Make a plan with your employer to find out if you can work from home, and what that would look like. 
  • If you do not have a job that has remote flexibility, find out what the policy is at your work in the event that public health authorities recommend staying home. 
  • Always keep a supply on hand for baby extras, and if you are pumping keep extra pump parts on hand.

For more information and the latest updates visit:

https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-guidance-breastfeeding.html

 

Video tip on sterilizing breast pump parts

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