Breastfeeding Tips for Success

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By: Rue Khosa, MSN, FNP-BC, IBCLC

We recently had a chance to chat with Rue Khosa, a Board-Certified Family Nurse Practitioner, Lactation Consultant, and new momma of baby #3. She shares her expert advice on preparing for your delivery, planning for the return to work, and why Spectra Baby USA breast pumps are her top pick.

Before Delivery
✔ Book a Prenatal Lactation Consult
I firmly believe every expectant couple should book a prenatal lactation consult. Getting a review of your medical history, a breast assessment, and help to select the right pump for you is vital. Knowing I was going back to work at just 6-weeks postpartum, I knew getting the perfect pump to establish my supply and build a frozen stash was critical to my successfully maintaining supply.
Find and book your prenatal consult with an IBCLC around 28-34 weeks.
✔ Order your Breast Pump
I was fortunate enough to receive the Spectra Synergy Gold pump to review! The Spectra Synergy Gold electric breast pump uses advanced technology with dual motors allowing you to adjust each side independently. Furthermore, it’s a hospital strength closed system making it effective and efficient to establish and maintain my supply despite my hectic schedule.

Before you deliver, you will want to order your pump, wash the pump parts, and get familiar with using it. There is nothing more stressful than trying to read a pump manual with a hangry newborn wailing next to you. Find out if your insurance covers a Spectra baby USA here.

After Delivery
✔ Establish your Supply
When it comes to breastfeeding, demand equals supply. The more you demand of your breasts by stimulating and emptying them frequently, the more milk you will make. Therefore, breastfeeding your newborn a minimum of 10-12 times a day or every 2hrs during the first couple of weeks is crucial. Equally important is making sure you are breastfeeding effectively. If your newborn is unable to latch and nurse effectively or at all, then you will need your breast pump to pick up the slack while you work with your IBCLC to assess and establish breastfeeding.
Prolactin, the hormone responsible for milk production, returns to pre-pregnancy levels in the first two weeks postpartum if there is inadequate breast stimulation. This makes it increasingly more challenging to restore and recover your milk supply the further postpartum you are.
✔ Build a Stash
The word stash can often sound intimidating, but it is essential to remember that the goal is to feed your baby, not the freezer. You want to store 2-4oz a day, helping build a 4-7 day reserve by the time you return to work at 12 weeks.
If you are not already pumping, you will want to start pumping around four weeks postpartum. This will allow you to take advantage of higher prolactin levels and corresponding higher milk supply in the immediate postpartum period. Pumping after the first and last feed of the day for 10-15mins is more than sufficient.
✔ Contact HR
Thanks to the Obama administration, not only do we have better lactation services insurance coverage, but employers have to provide pumping breaks and designated pumping rooms for new mothers. Contact your HR department 2-4 weeks before your expected return to make sure that they make appropriate accommodations for you.

On the Job
Now you are ready to go back to work. Know that most women are bound to experience a decrease in their supply as they return to the workforce. Many factors, including work stress, decreased hydration, decreased breast stimulation, as well as the natural regulation of your milk supply around the 12-week time frame, contribute to this decrease. If you have followed all of the above steps, you are less likely to experience a dramatic drop. Additionally, to maintain your supply, you will want to pump at least every 3hrs while at work. I recommend pumping right before you leave for work to give you time to settle in before you have to pump again. You also want to coordinate the last pump of the day and the baby’s first breastfeed when you get home. Ask whoever is caring for your little one to avoid bottle feeding 2hrs before you are due to return home and likewise avoid pumping during that same time frame. If schedules allow, this will save you a pump session and give you both a much-needed bonding experience after a long day apart.

To save time, Spectra has created the Simple Store Solution Kit, which allows you to pump, store and feed your baby all from the same bag.

Take Away
Only 12% of women have access to paid maternity leave, and up to 25% of women have to return to work just two weeks after giving birth. Whether you are returning to work at two weeks or 12 weeks, the stress and anxiety around the transition can have devastating effects on your breastmilk supply. In a perfect world, we would all have the option of staying home with our little ones for as long as we desire. However, by following the above steps, you will have the next best thing, the best shot at being able to exclusively feed your baby breastmilk through the first year and beyond.

Good luck, mama, you got this!

Rue Khosa is a Board-Certified Family Nurse Practitioner and Lactation Consultant. She has dedicated her career to being a women’s health advocate supporting new and expectant parents to thrive through the parenting journey. Believing it takes a village to raise a child, she has created a global village of women centered around mutual respect, trust, and unconditional support. Follow her on Instagram @rue_theboobboss for all things Bumps, Babies, and Boobs.

Breastfeeding after Giving Birth

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After giving birth, I’m sure you are soaking in every minute with your beautiful new baby. But it is normal to have questions about what comes next especially when it comes to feeding your baby. Breastfeeding is a natural and beautiful way to provide your newborn with the ideal nutrients to help them get off to the best start possible! The World Health Organization is actively promoting breastfeeding as the best source of nourishment for infants and young children and is working to increase the rate of exclusive breastfeeding for the first 6 months up to at least 50% by 2025. If you are pregnant or just gave birth and plan to breastfeed this is a great read for you! Here are some top post-birth questions with evidence-based feedback:

When will my milk come in?
It may be hard to believe, but your breasts will begin producing small amounts of nutrient-rich milk called colostrum during the first trimester of your pregnancy and for 2-5 days after giving birth. Colostrum, also known as, pre-milk has many benefits, including nutrients that boost a baby’s immune system and help fight infection (Richardson & Littleton, 2019). Colostrum may not always look the same. For some, colostrum is thick and yellowish. For others, it is thin and watery. In the last 3-5 days of making colostrum, your milk supply is expected to increase. Signs that your milk supply is increasing and changing from colostrum to more mature milk include firm breasts and changes in your breast milk’s color and texture. 

When should I begin breastfeeding? 
It is best to begin breastfeeding within the first hour after birth, known as the magic hour, or as soon as you and your baby are able. According to the World Health Organization, bonding through skin-to-skin contact along with suckling at the breast stimulates the mother’s production of breastmilk, including colostrum, also called the baby’s ‘first vaccine’, which is extremely rich in nutrients and antibodies. 

Did you know term infants have natural instincts to find the nipple and latch on? Skin-to-skin contact helps to regulate the baby’s body temperature and helps to release hormones in the mother that assist with breastfeeding. 

First, it is recommended to bring your baby to your chest for skin-to-skin contact and then try to initiate breastfeeding in a quiet and calm environment.

If you and the baby are having trouble, try hand expressing or pumping as soon as possible and feed the baby with a spoon or syringe. Avoid bottles and pacifiers until breastfeeding is going well, and use your pump to help bring in a milk supply if the baby is not latching. 

How can I tell when my baby is ready to nurse?
Start breastfeeding when your newborn shows signs of hunger. An infant may not always display obvious signs of hunger; because of this, it is best to look for early hunger cues (Richardson & Littleton, 2019). 

Feed your baby at early feeding cues. Examples of early hunger cues:

-Baby moves head from side to side

-Baby opens their mouth

-Baby sticks out tongue

-Baby sucks on their hands and fists

-Baby puckers their lips as if to suck

-Baby nuzzles against mom’s breasts

-Baby displays the rooting reflex, which is when a baby moves their mouth in the direction of something that’s stroking or touching their cheek

– REM (rapid eye movement) 

How do I know if my baby is full and/or getting enough milk?
What is important to understand is that the newborn belly is super tiny. The first few days after birth, the belly will only hold droplets of colostrum. Then as time goes on, the infant’s belly will grow. Infants will also want to nurse frequently! Your baby should have 6 wet diapers and 3 stools (size of a quarter of more) per day. At a minimum, your baby should nurse 8 to 12 times per day. Maybe even more. The World Health Organization recommends feeding your infant demand, meaning as often as the child wants, day or night!  So, if someone tells you your breast milk might not be filling up your newborn’s little belly or that you are feeding too often, help them understand that frequent feeding, on the baby’s schedule, is exactly what the doctor ordered. 

Do you need breastfeeding help? Spectra Baby USA is happy to help! Schedule a virtual consultation with one of our IBCLCs today and get the support you need to meet your breastfeeding goals successfully! We’re here for you, and we support you! 

Pumping 101

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Melissa Portunato MPH, IBCLC, RLC

The majority of breastfeeding mothers will express breastmilk during some part of their breastfeeding journey. Sometimes it can be when returning to work, taking a break while temporarily working on baby’s latch, or choosing to pump exclusively from the start. Breast pumping can be intimidating for new parents, but it doesn’t have to be that way! Establishing simple-to-follow pumping strategies can ease worry and maximize pumping sessions. With manageable planning guidelines and evidence-based education and support, families can continue to reach their breastfeeding goals. Choosing to express breastmilk will ensure your milk supply is protected, and your baby will continue to receive the magical nutrition only you can provide. 

When to Start Pumping
If your baby is growing well and has unlimited access to the breast, there is no need to start pumping right away. Waiting 6-8 weeks is best. You could start sooner if you are returning to work around 4 weeks after birth but keep in mind the very early weeks are for establishing your milk supply at the breast and bonding with plenty of skin to skin. There will always be instances where pumping will be necessary right from the start, like preterm infants or unexpected medical emergencies. 

If nursing is going well at the breast, start with a short pumping session about 5 to 7 minutes after the morning or evening nursing session. Once a day at first and then gradually increase sessions according to your breastfeeding goals. If you are exclusively pumping aim for 6-8 / 20 min pumping sessions per day for a daily total of 120 min. In general, it’s recommended to double breast pump for a total of 15-20 min or 5-7 minutes after that last drop. 

Normal Pumping Output 
The newborn belly is super tiny. Studies show exclusively breastfed babies from 1 to 6 months old will consume an average of 25 ounces per day. Depending on if you are pumping for a missed feeding or pumping in between feedings, you can expect to pump roughly 1.5 – 4 ounces. At first, when your production is ramping up, expect to pump less milk. It takes time and practice to get your body to respond to the pump, just like learning to nurse at the breast. 

Check Flange Sizing 
The Spectra Baby USA S1/2 and SG come with two sets of flanges – 24mm and 28mm.  Spectra Baby USA flanges come in 20, 24, 28, and 32 mm. Flanges are relatively inexpensive and completely worth the purchase to ensure you have the highest comfort level when pumping. 

Finding the proper size for a breast flange is based on the diameter of the nipple, not the areola (the softer pigmented skin around the nipple).  When your nipple is centered inside the flange tunnel, it should only have a few millimeters (3-5) of wiggle room around the nipple. The entire nipple should fit comfortably without much, if any, of the areola entering the tunnel before pumping. Nipple size can fluctuate and can vary from side to side. We recommend measuring before pumping or nursing then adding 3-5mm to the diameter. Here’s our helpful fitting flange guide. 

Cycles, Settings, and More 
Spectra’s Natural Nursing Technology utilizes customized vacuum and cycle patterns that closely mimic a baby nursing at the breast. This natural pumping experience provides productive, comfortable, successful pumping sessions and ultimately more milk in less time.

Try these Cycle Pumping Settings to get started with your Spectra breast pump:

Massage 70
Expression 54
Massage 70
Expression 38
*Vacuum should always be set to comfort, 5 min on each setting.

Research shows moms can yield about 30% more milk when stimulating their breasts while pumping? Using a hands-free bra will allow for easier “hands-on pumping.” Massaging and compressing your breasts while expressing will help you get the most out of your pumping session. 

Cleaning and Milk Storage 
The CDC recommends sterilizing all your pump parts for the very first time before initial use. There is no need to sterilize the tubing since it will never contact your milk or pump. Have a designated bin to wash your pump accessories after each use in warm soapy water and then air dry on a clean dish or paper towel. Using non-antibacterial soap is ideal to ensure you aren’t leaving any film on the flanges that can inhibit the natural secretion of your Montgomery Glands on your areola.

Keep your liquid gold safe for your baby by adhering to the CDC guidelines for storing and preparing expressed breast milk. 

Have more questions on getting started with pumping? Schedule a complimentary consultation with us here. 

Happy pumping!