Paced Bottle Feeding

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Jacque Ordner BSN, RN, IBCLC, RLC 

Are you worried your precious little one will grow to prefer the bottle over your breasts?  Are you concerned you might not be able to keep up once baby begins taking bottles regularly while you’re away? Are you exclusively pumping and looking for tips on bottle feeding?  We’ve got you covered with our full guide on Paced Bottle Feeding.  

Research indicates that infants will take more from a bottle than they would when nursing.  This can result in overfeeding, mom losing confidence in her milk supply, and can even contribute to later obesity.  One large study compared formula fed infants (via bottle) and breastfed infants (via direct nursing) and found that the bottle-fed infants consumed 49% more milk at 1 month, 57% more at 3 months, and 71% more at 5 months. In comparison, we know that directly breastfed infants do not increase the volume of breastmilk intake from one to six months of age.  The average daily intake for a breastfed infant from one to six months remains about 25 ounces per day.  

 Why do bottle-fed infants tend to consume more?  

  • The flow from a bottle can often be initiated by gravity alone, triggering innate sucking reflexes present in babies under 4 months old.  In other words, baby will often continue to suck and swallow milk from a bottle long after they’ve reached “fullness”.  In contrast, the flow of milk from the breast requires a coordinated suckle and does not flow consistently.  An infant can pause, breathe, relax, and reassess before initiating additional flow from the breast.  This puts the baby in greater control of the feeding.  
  • Formula fed infants regularly consume more than their breastfed counterparts because more formula is required to meet their nutritional needs.  Formula also does not contain hormones such as leptin and adiponectin which regulate hunger and metabolism.  It’s especially important to keep this in mind if your baby receives breastmilk and formula or if you are tempted to compare your breastmilk fed baby’s intake with that of a formula fed infant.  

 What are the benefits of Paced Bottle Feeding? 

  • Paced Bottle Feeding allows infants to develop and practice their innate feeding cues and skills rather than only responding to the consistent flow of the bottle over which they have no control.  This is especially important for newborns (particularly pre-term newborns) who require supplementation early.  Allowing newborns to develop natural feeding cues and skills can be instrumental in helping them return to the breast or to transition from breast to bottle and back.   
  • Babies often develop a preference for the fast and continuous flow from the bottle. In the past, this might have been labeled as “nipple confusion”, but we now call it flow preference.  We now know that when baby prefers the bottle over the breast, it’s almost always due to the preference and ease associated with the faster flow of the bottle.  Babies are smart, and once they learn that they don’t have to wait for milk from the bottle they may start to refuse or become frustrated at the breast. Paced Bottle Feeding helps to mimic the slower and non-continuous flow of milk that occurs during nursing.  
  • Paced bottle feeding allows time for baby’s satiation signals to be recognized.  Most of us know the experience of scarfing down a big holiday meal in 10 minutes or less only to realize we’re painfully full.  Similarly, a baby can often take copious amounts from the bottle, due to its rapid and persistent flow, before the brain has had a chance to realize the belly is full.  This can lead to a gassy, fussy, spitty baby. Over time, baby’s tummy can come to expect those large feeds even if the volume isn’t necessary for baby’s complete nutrition.  Additionally, the same large study mentioned above found that caregivers often encourage baby to finish a bottle even when they’re displaying signs of satiety. Caregiver pressure to empty the bottle is another contributing factor to overfeeding. This can also lead mom to believe her supply is inadequate when baby is actually being overfed. 

 What are the principles of Paced Bottle Feeding? 

  • Feed on demand following baby’s hunger cues (rooting, sucking on fists, smacking lips, restlessness, etc.) Remember crying is a LATE sign of hunger.  
  • Choose a slow flow nipple.  Not all slow flow nipples are as slow as they claim.  Click HERE for to check the flow rate of many popular brands.  
  • Feed baby in a nearly upright position. 
  • Allow baby to “latch” onto the nipple rather than inserting it into his or her mouth. 
  • Hold the bottle parallel to the ground so that milk just enters the nipple. 
  • Provide frequent breaks by tipping the bottom of bottle down or completely removing the nipple from baby’s mouth. This is especially important if baby begins to gulp. Watch baby’s cues! 
  • Switch sides halfway through the feeding to mimic a nursing session. This also provides cross-connectivity in the brain. 
  •  Feedings should take 15-30 minutes.  
  • Don’t force baby to finish the bottle.  Allow baby to determine when he or she is full rather than encouraging them to finish a specific amount.  

*These techniques are appropriate for babies under 6 months of age.  

Click HERE for a video demonstration of Paced Bottle Feeding. 

Paced Bottle Feeding helps protect the nursing relationship, reduces the risk of overfeeding, and gives baby control of their feedings.  Have concerns about bottle feeding?  We can help!  Our Board Certified Lactation Consultants can develop a plan to help you introduce or manage bottle feeding.  Click HERE to schedule your free virtual consultation or email us at ibclc@spectrababyusa.com.  We’re here to support you! 

References 

 Arenz, S., Ruckerl, R., Koletzko, B., & von Kries, R. (2004). Breast-feeding and childhood obesity–a systematic review. International Journal of Obesity and Related Metabolic Disorders, 28(10), 1247-1256. 

 Dewey, K. G. (2009). Infant feeding and growth. In G. Goldberg, A. Prentice, P. A., S. Filteau & K. Simondon (Eds.), Breast-Feeding: Early influences on later health (pp. 57-66). New York, NY: Springer. 

Kramer, M. S., Guo, T., Platt, R. W., Vanilovich, I., Sevkovskaya, Z., Dzikovich, I., et al. (2004). Feeding effects on growth during infancy. Journal of Pediatrics, 145(5), 600-605. 

Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. (2006). Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics, 117(3), e387-395. 

Li, R., Fein, S. B., & Grummer-Strawn, L. M. (2008). Association of breastfeeding intensity and bottle-emptying behaviors at early infancy with infants’ risk for excess weight at late infancy. Pediatrics, 122 Suppl 2, S77-84. 

Doneray, H., Orbak, Z., & Yildiz, L. (2009). The relationship between breast milk leptin and neonatal weight gain. Acta Paediatrica, 98(4), 643-647.

What Do I Really Need to Buy for Breastfeeding?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

It’s no secret that having a baby is expensive!  With all the buzz around certain products, we thought it would be helpful to break down what is a must-have and what might not be necessary (at least at first). 

 Must Haves: 

  1. A good quality, hospital strength, double electric breast pump- It’s true not every breastfeeding mom needs a pump, but it is estimated that 85% of breastfeeding mothers use a pump at some point in their breastfeeding journey. Even if you don’t plan to be separated from your baby for work, you may desire a night out or have to be separated due to other circumstances.  If your baby has trouble latching or you need to boost your supply, already having your pump will help prevent added stress. 
  2. An extra set of pump accessories- Duckbill valves, backflow protectors, flanges, tubes, and collection bottles are essential to your pump’s function. Having an extra set can save you or your partner from a midnight run to Target if one of your pieces gets lost or broken.
  3. Hands-free pumping bra – If you plan to pump, even just occasionally, a hands-free bra can be a game-changer!  Going hands-free gives you more freedom and allows for hands-on pumping to help increase pumping output.  
  4. Nursing bras – Many moms find the support of a nursing bra to be comfortable once their milk production ramps up.  The convenience of fold-down flaps can lead to reduced frustration when trying to get little one to latch.
  5. Hydrogel Pads – Your own breastmilk can be helpful for soothing and healing sore nipples, but hydrogel pads offer an added soothing coolness that many moms love.  Even if you don’t experience cracked nipples, hydrogel pads can be great to keep on hand for any nipple soreness that might occur. 
  6. A FEW milk storage containers/bags– While it’s tempting to stock up when those nesting urges hit, we recommend only purchasing a few milk storage containers or bags.  This gives you the opportunity to try different brands to find what you like before purchasing in bulk.  
  7. Bottles – Breastfed babies can be finicky when it comes to bottles.  For this reason, we recommend purchasing only a few to have on hand until you know what works best for your little one.  Registering for one of each of a few different brands is a great way to have a few to try when the time comes. 
  8. Water bottle – Staying hydrated is key when making milk!  Having a cute water bottle that you enjoy drinking from can be extra helpful when you’re stuck on the couch nursing or pumping. Have a water bottle that you like also encourages you to take it with you to get your water in on the go! 

While there are hundreds of products marketed to breastfeeding moms, the above list focuses on the basics to help get you started.  With this list, you can avoid expensive purchases that end up going unused.  If you find you desire extras like nursing tops, a pumping cart, breast massager, etc, there will be plenty of time to shop online while you’re nursing or pumping for your sweet bundle of joy!  
 
Have pumping or breastfeeding questions?  Schedule a free consultation with one of our 
Spectra Baby USA IBCLCs HERE.  

Milk Supply: What’s Normal?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

The number one concern I hear from breastfeeding moms is worry over not making “enough”.  Moms want what is best for their babies and are often concerned they won’t make adequate milk throughout the breastfeeding process.  Couple that concern with daily social media posts about huge freezer stashes and 10+ oz. pumping sessions and moms can get full on anxiety about whether their production is “normal”.  Don’t worry mamas!  We’re here to let you know what a full milk supply looks like and to hopefully calm your fears about just how much milk you’re likely going to need. 

THE AVERAGE BREASTMILK INTAKE FOR A BABY FROM 1 MONTH TO 6 MONTHS IS 25oz. PER DAY.  Research tells us that the range is from about 19oz to 30oz. per day.  Milk production usually peaks at around 40 days postpartum as well. Medically speaking, a full milk supply ranges from 750ml –1035ml per day. It’s also normal for this amount to fluctuate from day to day.  It’s normal to see pumping output fluctuate from session to session as well.  

FOR MOMS WHO ARE PRIMARILY DIRECTLY NURSING THEIR INFANTS, TYPICAL PUMPING OUTPUT CAN RANGE FROM 0.5 oz to 2 oz. PER SESSION. We talk to so many moms whose babies have been growing and thriving while nursing at the breast, but then mom becomes concerned when her first pumping session only yields about an ounce from both breasts combined.  We can literally hear the relief in their voices when we tell them that THIS IS NORMAL!  Mamas, you don’t have to be pumping 5-10 oz per session to be successful at breastfeeding!  The amount you can pump is not necessarily an indicator of the amount your body is making.  Pumping is a learned skill that takes time to develop for many moms.  If you’re conditioned to letting down to your warm, squishy baby, it can take a while to train your body to let down to the cold, plastic pump. Take cues from your baby….if they’re growing well and making adequate wet and dirty diapers, chances are you’re making the perfect amount of milk for them.   

EXCLUSIVELY PUMPING MOMS TYPICALLY SEE A PUMPING OUTPUT OF 2oz. – 4oz. EVERY 2-3 HOURS. As I mentioned before, pumping is a learned skill and can take some time to get used to.  The above output range is for moms whose supply is established (after 40 days postpartum).  Unfortunately, some moms have been told that exclusive pumping will not allow them to make a full milk supply.  This is just not true, mamas!  With a high quality, hospital strength pump, a consistent pumping schedule, and well fitted flanges, moms can make a full milk supply (and more) with exclusive pumping. 

While it’s true that most women can make a full milk supply, it’s also true that a small percentage cannot.  If you suspect you have low milk supply or just need reassurance that things are going well, don’t hesitate to reach out to an IBCLC. Our Spectra Baby USA IBCLCs are here to help with free virtual consultations.  Click HERE to schedule. We can also help via email at ibclc@spectrababyusa.com  Happy pumping, mamas! 

 

Sources: 

Bonyata, K. (2018, January 02). Exclusive Pumping • KellyMom.com. Retrieved July 27, 2020, from https://kellymom.com/mother2mother/exclusive-pumping/ 

Bonyata, K. (2018, January 16). I’m not pumping enough milk. What can I do? • KellyMom.com. Retrieved July 27, 2020, from https://kellymom.com/hot-topics/pumping_decrease/ 

Lawrence, R. A., & Lawrence, R. M. (2016). Breastfeeding: A guide for the medical profession. Philadelphia, PA: Elsevier. 

Mohrbacher, N. (2012, November 27). How Much Milk Should You Expect to Pump? Retrieved July 27, 2020, from http://www.nancymohrbacher.com/articles/2012/11/27/how-much-milk-should-you-expect-to-pump.html 

 

Latch Tips and Tricks

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baby latching on mom

By Jacque Ordner BSN, RN, IBCLC, RLC 

As an IBCLC people are constantly asking me for insights to make breastfeeding easier.  Today, I’ve got my top tips and tricks to make latching easier and more comfortable!  

This advice isn’t original to me, and isn’t original to any other IBCLC or breastfeeding professional.  It’s been around as long as breastfeeding has, but it hasn’t been readily passed from mother to mother in recent years the same way it likely was centuries ago.  

#1 ALLOW BABY’S HEAD TO TILT BACK Let’s start with a little exercise.  Tilt your chin down as if you’re looking at your toes.  Can you open your mouth very wide in this position? Now, imagine taking a drink…..can you drink easily and efficiently?  Not so easy is it?  Let’s try another exercise.  This time, look up at that wall about 6’-8’ high.  Your head should be slightly tilted back and you should be able to easily open your mouth nice and wide.  Imagine raising a glass to your lips in this position.  Could you drink well like this?  Of course you can!  These same principles apply when our babies are nursing! Allowing baby to tilt his or her head back, while supporting it with your hand just at the base of the neck, will make getting those deep latches much easier! To make latching even easier, make sure baby’s chin touches the breast while the nose remains free. Sometimes, this is referred to as the asymmetrical latch technique.  Click HERE for more information! 

#2 CHECK BABY’S BODY POSITION We also want to make sure the rest of baby’s body is in an appropriate position to support a good latch.  Just as we imagined drinking while staring at our toes, now let’s imagine drinking while looking over our shoulders.  Difficult isn’t it?  We want to avoid putting baby in a position where she might have to drink while looking over her shoulder as well.  The best way to do this is to align the ear lobe, shoulder, and hip and place baby belly to belly with mom (or belly to side for football hold).  This puts baby in a comfortable, well-aligned drinking posture.   

#3 SUPPORT THE BREAST AT THE APPROPRIATE LEVEL Supporting mom’s breast can also make latching easier for both mom and baby.  This is especially true for women with larger breasts.  Young babies do not yet have the strength and motor function to hold a heavy breast at the appropriate height for latching or to maintain that height once they have latched.  It can be especially helpful for mom to maintain support of the breast for the duration of the nursing session.  We all know moms are great multi-taskers and one way to free up a hand is to use a rolled hand towel under the breast to support it during feedings.  Mom can even use the freed hand to help shape her breast to make it easier for baby to latch onto.   

The overall takeaway is that the number one tip for a good latch is to think about what makes up good drinking posture.  Look at your baby’s neck, shoulders, and hips.  Are they in a position that makes it easy and comfortable for your baby to open wide and latch on?  What about your breast?  Does baby have to turn his head to find the nipple or is the breast supported at the appropriate level?  Taking the time to assess and adjust can make for a much easier and more comfortable nursing session! You got this, mamas! 

Need additional help getting into the right position?  Is pumping uncomfortable?  Our IBCLC’s can help!  Schedule your virtual CONSULTATION today or email questions to ibclc@spectrababyusa.com.  

 

Summertime With Your New Baby

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Summertime With Your New Baby
Melissa Portunato MPH, IBCLC, RLC

Summer is finally here! Time to hit the road, spark up the grill or hit the beach with the family for some fun in the sun. Check out our best advice on keeping baby happy and healthy while enjoying the outdoors this summer. 

Will I need to bring along drinking water to give my baby?
Did you know that breastmilk is 80% water? Yep! It’s not necessary to give an exclusively breastfed baby water as long as mama is hydrated and they have free access to the breast or breast milk. Your baby will get all the hydration they need just from your breast milk! Infants less than 6 months should receive their nutrition exclusively from breastmilk, which means no other fluids should be given even in hot climates. 

Can I put sunblock on my baby? 
Your best defense will be to keep your baby in the shade and covered up. The general recommendation is to wait until your baby is 6 months before lathering them up in sunscreen. There are some sunscreens that are safe for younger babies. Check with your pediatrician before you’re ready to be in the summer sun with your baby. The majority of sunscreens on the market have toxic chemicals that are harmful to your baby and the environment. Look for a baby sunscreen with the active mineral ingredients of zinc oxide and titanium dioxide, these are ingredients the FDA recognizes as safe. 

What about bug repellent? Is it safe for my baby? 
The skin of a baby is so tender. It can be scary spraying it with bug spray and wondering if the ingredients are safe or will cause an allergic reaction. Most insect repellents are safe for babies over 2 months old. The American of Pediatrics recommends not to use DEET (N, N-diethyl-3-methylbenzamide) on babies less than 2 months old and not to use more than 10% DEET on a child of any age. It’s best to spray first on your hand and then on your baby. Natural repellents that contain essential oils from plants like citronella and lemongrass can be quite effective and will be the safest route to keep your little one bite free. You might want to consider mosquito netting around your baby’s stroller or bassinet to help keep those blood suckers out too! 

Keep You and Your Breastmilk Cool
You will get extra thirsty breastfeeding, caring for your baby, and lugging around all the outdoor props. Remember to stay hydrated mama! Carry a refillable water bottle with you and drink to thirst. If you are pumping on the go, keep your milk cool up to 24 hours with our pretty pink cooler. Check out the CDC guidelines for milk storage guidelines here. 

Hitting the road this summer with your baby? Do you have questions about pumping on the road? Schedule a one on one consultation with a Spectra IBCLC today. We can help you better plan! Less stress means more summer fun with your baby. 

Sources:

Academy of Breastfeeding Medicine Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med. 2017;12(3). DOI: 10.1089/bfm.2017.29038.ajk

https://www.fda.gov/drugs/understanding-over-counter-medicines/sunscreen-how-help-protect-your-skin-sun?gclid=EAIaIQobChMI0JO4l7KY6gIVCbSzCh17DgLzEAAYASAAEgJJhfD_BwE

American Academy of Pediatrics: Choosing an Insect Repellent for Your Child, July 2018.

Do I Have Elastic Nipples?

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blog photo 67

By: Melissa Portunato MPH, IBCLC, RLC

There’s been quite the buzz on “elastic nipples” lately. Whether you’re on social media or part of a virtual mommy group you’ve likely heard the term. It’s probably left you wondering if YOU have elastic nipples and if you’re even using the correct flange size. Don’t worry mama! We’ve got you covered. Read on to get the real 411 on elastic nipples. 

Here’s the deal. The skin on and around your nipple (areola) was intended to be stretched by breastfeeding. The nipple stretching is actually a good thing! Moms with truly inverted nipples or skin that is less elastic, are at an increased likelihood to experience issues with low milk supply, soreness, and nipple discomfort. Now if nipple elasticity is associated with low milk supply, pain, redness, or discomfort then it definitely needs to be addressed. Pumping shouldn’t hurt.

But how much should the nipple stretch when pumping to be experiencing “elastic nipples?” For the most part, the nipple should stretch a little less than half way down the flange when pumping. If it’s way past that – like hitting the backflow protector or end of the flange and you’re experiencing pain or low milk output, then it’s time to troubleshoot. Otherwise, elasticity itself is no cause for concern. 

Check out these 4 tips on how to get relief if you have “elastic nipples” and pain when pumping:

#1) Lower The Vacuum Strength

Please don’t think you have to work up your nipple tolerance to level 12 vacuum. Vacuum strength should always be set to comfort. Moms are surprised to see they pump the same amount whether pumping on a high suction or medium / low suction. Every mom is different. Keeping the cycle steady and lowering suction strength can help lessen the elasticity of the nipple. Pumping with your S1/S2 steady on the expression cycle 54 vacuum between 5-6 for 15-20 min can help minimize discomfort. 

#2) Check Your Flange Size

This part could be tricky. Typically a flange that’s too big will cause the areola to be pulled farther into the tunnel but if a flange is restrictive the nipple will rub inside the tunnel and stretch it farther too. That’s why it’s important to work directly with an International Board Certified Lactation Consultant. It’s normal for nipple size to fluctuate. Measure to know your nipple diameter. But this only tells us a piece of the story. Some moms will benefit from going up a size or changing sizes throughout their breastfeeding journey. 

#3) Lubricating Before Pumping 

Hand express a few minutes before pumping and squeeze a few drops of breastmilk to lubricate the inside of the tunnel. This can help keep your nipple in place and help with soreness too. You can do this with lanolin or a few drops of olive oil too! Reposition your flanges every few minutes while pumping if needed. Hand express for a few minutes after pumping and let breastmilk air dry on them to help heal and keep them healthy. Bonus – hand expressing before and after pumping can trigger more milk production. 

#4) Silicone Inserts / Massagers 

A massager or silicone insert can offer relief sometimes but not always. Spending a ton of cash on accessories that either don’t work or fit properly can be frustrating.Too often moms find these products can actually decrease suction and they find them hard to keep in place. If you’d like to try one of these, go for it! But it’s best to look for an insert that offers a money back guarantee or can send you multiple sizes to find the best fit. If you do find it hard to keep an insert in place, try moistening it with a few drops of water or breastmilk. Moisture can help create a better seal. 

Correct flange sizing and lower suction can usually be a quick fix to get relief from elastic nipples. But what if you’ve tried it all. You have the correct size, low suction and still have your nipple stretching way past the halfway mark but don’t have any pain? Then you’re good mama! Pump on! Your body is doing exactly what it was intended to do. 

Schedule a virtual consultation with us and we can help with tips to manage pain and discomfort associated with elastic nipples. We can help with flange sizing and troubleshoot your pump too. You’re doing really great at breastfeeding mama. We’re proud of you! 

 

 

Cesarean Delivery and Breastfeeding

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blog photo 66

By Jacque Ordner BSN, RN, IBCLC, RLC

Most moms don’t anticipate having a cesarean delivery, but for some it is unavoidable. In fact, the U.S. c-section rate is a staggering 31.9%.  We know that birth interventions can also have a correlation with increased breastfeeding difficulties, and cesarean deliveries are a BIG intervention.  However, the correlation might surprise you! As many as 41% of women who experience emergency cesarean delivery have a higher proportion of breastfeeding difficulties.  Studies also tell us that women who deliver via planned c-section are less likely to continue breastfeeding beyond 12 weeks postpartum compared to those who deliver vaginally.  How can you help improve your chances of breastfeeding success despite the challenges of cesarean delivery? Read on for our best tips!

  1. Be prepared – Take a breastfeeding class, preferably taught by an IBCLC, and make sure you  learn as much as you can about breastfeeding before you ever deliver.
  1. Know your resources – Identify local breastfeeding experts in your community.  Find a breastfeeding support group locally or online. Call on friends and family who have had breastfeeding success because their support will be invaluable!
  1. Get a pump – Having a hospital strength pump and being familiar with it can be a saving grace if directly nursing is difficult.  Our S1 and 9+ models have a rechargeable battery, so we recommend having them all charged up in preparation for baby’s arrival as well!
  1. Latch baby soon after delivery if possible – The first hour after delivery is often called the “Golden Hour” because nursing within this time frame can help lead to nursing success later on.  If mom and baby are stable, nursing right in the operating room can even be a possibility!
  1. Skin to skin – This super cozy practice can have big payoffs when it comes to baby’s temperature and blood sugar stability, but it is also a great way to encourage breastfeeding and abundant breastmilk production.
  1. Wake baby if needed – Some anesthesia/pain medications related to cesarean deliveries can cause sleepiness in baby.  For this reason, it is recommended to wake baby every 2-3 hours for feeds if they’re not waking up on their own.
  1. Nursing Positions – Get familiar with c-section friendly nursing positions such as side-lying, laid back, and the football hold. The right position can help make nursing more comfortable for mom and more effective for baby!
  1. Make your wishes known – If nursing is high on your priority list, let the hospital staff and your support people know that you wish to avoid supplements unless they are truly medically necessary.  Avoiding pacifiers and bottles in the early days and weeks can help increase breastfeeding success.

With the right preparation and support, moms can reach their breastfeeding goals no matter they type of delivery they experience! We’re here to help as well…..schedule a FREE pumping consultation with one of our IBCLCs to help prepare before baby arrives or at any time during your breastfeeding journey.  www.spectrababyusa.com/lactationservices

Sources

FastStats – Births – Method of Delivery. (2017, January 20). Retrieved March 31, 2020, from https://www.cdc.gov/nchs/fastats/delivery.htm

Hobbs, A. J., Mannion, C. A., McDonald, S. W., Brockway, M., & Tough, S. C. (2016). The impact of caesarean section on breastfeeding initiation, duration, and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth, 16(90). Retrieved from    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847344 

Prior, E., Santhakumaran, S., Gale, C., Philipps, L. H., Modi, N., & Hyde, M. J. (2012). Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. The American Journal of Clinical Nutrition, 95(5), 1113–1135. doi: 10.3945/ajcn.111.030254

Yan, Y., Gao, X., & Xiang, S. (2020). Effects of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study. Journal of Human Lactation, 34(11). doi: 10.1177/0890334417741434

 

 

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!

What’s in Breastmilk Anyway?

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mom holding breast milk bottle

By Jacquelyn Ordner BSN, RN, IBCLC, RLC

Breastmilk contains over 200 components, and that’s just what scientists have discovered so far! It is no surprise that breastmilk is the optimal food for babies, but what exactly is in it anyway?  With macronutrients, micronutrients, trace minerals, bioactive components and more, breastmilk truly is a living food!

Macronutrients

Macronutrients are nutrients that our bodies require in large amounts, typically measured in grams. Here’s a look at the average concentrations of macronutrients in 1 ounce of mature human milk. 

Carbohydrates 2.1 grams/oz
Protein 0.39 grams/oz
Fat 1.2 grams/oz
Calories (kcal) 22/ oz

Micronutrients, Vitamins, and Minerals

Micronutrients and minerals are essential for human growth and development.  It is important to note that some of these components of breastmilk can be influenced by mom’s dietary intake. Below is a list of just some of the micronutrients and minerals present, on average, in mature human milk.

Iron 23 mcg/ oz
Sodium 4.5 mg/oz
Phosphorus 4.5 mg/oz
Vitamin C 1.2 mg/oz
Vitamin A 18.2 mcg/ oz
Calcium 10.6 mg/ oz

*Note the above table is certainly not a comprehensive list of all micronutrients and minerals contained in breastmilk.

Additional Components 

Breastmilk not only contains amazing nutritional components, but also digestive enzymes, hormones, growth and development factors, antimicrobial components, and immune modulating components.  These non-nutritional agents make breast milk ideal for babies and toddlers! Here’s a brief look into some of these breastmilk super components:

Macrophages Protect against infection by seeking and engulfing potential immune threats
Stem Cells Essential for regeneration and repair
Secretory IgA Most prevalent immunoglobulin in breastmilk. Anti-microbial and anti-inflammatory
Cytokines Help modulate immune response and play a huge role in gut health.  Help protect against NEC (necrotizing enterocolitis)
Lactoferrin 2nd most abundant protein in breast milk, anti-inflammatory and antioxidant, aids in iron homeostasis, helps reduce instance of sepsis and NEC (necrotizing enterocolitis) in pre-term infants

Wow!  It’s obvious that breastmilk is truly amazing and can’t be duplicated!  How incredible is it that women’s bodies can create this incredible living food for their babies!  So, nurse or pump on mamas……you’re providing the best food on the planet, and every drop counts!

Sources

  • American Academy of Pediatrics, Policy Statement. Breastfeeding and the use of human milk. Pediatrics 2005; 115:496-506.
  • ESPGHAN Committee on Nutrition; Agostoni C, Braegger C, Decsi T, et al. Breast-feeding: A Commentary by the ESPGHAN Committee on Nutrition. Journal of Pediatric Gastroenterology and Nutrition 2009; 49:112-125.
  •  Ochoa, T. J., & Sizonenko, S. V. Lactoferrin and prematurity: a promising milk protein?. Biochemistry and cell biology = Biochimie et biologie cellulaire 2017, 95(1), 22–30. doi:10.1139/bcb-2016-0066
  • Walker A. Breast milk as the gold standard for protective nutrients. Journal of Pediatrics 2010; 156(2):Suppl. 1.
  • World Health Organization http://www.who.int/topics/breastfeeding/en/

 

How Birth Affects Breastfeeding

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Whether you’re in the process of growing a tiny human or you’ve already given birth, you know that nature is amazing.  Somehow our bodies know exactly what to do throughout the pregnancy process to create a beautiful new baby. It shouldn’t come as a surprise that breastfeeding is also a part of this natural process.  Breast milk production starts with preparation during pregnancy and ultimately begins with the birth of your baby.

How our bodies prepare for breastfeeding during pregnancy.

During pregnancy, you will notice changes in your breasts as time progresses.  How dramatic these changes depend on each individual mama.  Pregnancy hormones will promote milk duct growth and get breast tissue ready for milk production.  This makes the breasts feel heavier and look fuller. The areolas (the darker skin around your nipples) will typically get larger and darker as well.  By the third trimester, your body is ready to produce milk!

How the birthing process initiates breastfeeding.

When labor is initiated, the hormone oxytocin promotes powerful uterine contractions and signals to the body that it will soon initiate breastfeeding.  Throughout labor, hormones are released to help keep mom and baby energized and strong.  Typically once born, your baby will immediately look for your nipple to start breastfeeding.  This is their natural instinct. It will promote further oxytocin release to help expel the placenta in the final stages of labor.  Birthing the placenta is what truly initiates breast milk production with the release of the hormone prolactin. Once the birthing process is complete, the focus for breastfeeding turns to making sure baby is able to latch and feed well.  Ideally, this should be initiated within 30 minutes to one hour after birth. This will ensure further stimulation of breast milk production.    

How modern birth interventions can affect breastfeeding. 

In the U.S. only 2% of women give birth without any medical interventions.  These interventions are now a common part of labor and delivery and they, unfortunately, can affect the initiation of milk production for breastfeeding.  This can include interventions like induction, epidural, and/or cesarean birth. It has been found that undergoing any medical interventions makes a mother six times more likely to have a C-section!  No matter what specific procedure, it has been found that they affect the normal cascade of labor and milk producing hormones.  It can also leave baby and mama feeling lethargic making it hard to promote adequate breast stimulation when everyone just wants to sleep.  Of course, mothers and baby can still successfully breastfeed with the right support and education no matter what their birth experience entails. 

Strategies to optimize your success with breastfeeding after birth.  

  • Avoid unnecessary interventions.  Be well informed and if baby is healthy, try to wait for labor to start naturally.  
  • Get as much skin to skin contact as possible to promote adequate hormone balance for breast milk production.
  • Respond quickly to baby’s hunger cues and feed them often to establish good milk production and build baby’s trust in the feeding process.
  • Get proper support.  If you’re feeling unsure, ask for help immediately from a certified lactation consultant  (IBCLC) to maximize your breastfeeding journey.  Ask for help from family and friends as well to allow you to focus on breastfeeding, rest, and healing. 

Breastfeeding is the natural next step to caring for your beautiful new baby after birth.  With the right care, you should feel empowered to decide how your baby feeds and thrives! 

Clever Ways To Store Your Breastmilk

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You’re on top of your breast pumping game.  You have part of the fridge and a freezer full of milk. You are rich with liquid goal for your baby, hooray!  As your freezer gets fuller, you may be starting to wonder where it all will go. Before you take up more space in your home with a new deep freezer or feel like you’re losing your mind due to disorganization, try these genius storage tricks for your breast milk.

General storage tips.

  1.       You can store milk in bottles or storage bags.  Storage bags are ideal for space saving. Some can be directly attached to your breast shields on your pump and self-stand for easy filling and storing.
  2.       Once expressed milk is in the container you plan to store it in, always label it so you can keep track of where it needs to go (see options below).
  3.       Use your breast shield as a funnel when transferring in milk to decrease risk of spillage.

Organization for the fridge. 

  1.       If milk is in the fridge and you plan to use it within the 4 day limit, you can opt for convenience and keep it in a bottle if you have the space. 
  2.       Keep your breast milk organized in one area of the fridge.  Try using a designated tub or box always keeping what will be used next at the front for convenience. First in, first out.
  3.       Use a labeling system to keep track of when bottles were put in the fridge.  This can be as simple as post it notes or can become fancy with charms labels with days of the week (or dates) on them.

Organization for the freezer.

  1.       When trying to freeze large amounts of milk, space saving techniques are key to maximize your storage capacity.  This means using storage bags and freezing them lying flat (at least until frozen) so that they aren’t bulky and can be easily stacked. Sandwiching the freezer bags between two cookie sheets can help freeze them even thinner saving more space! 
  2.       Try using boxes made into “dispensers” by cutting a storage bag sized hole in the bottom.  Google DIY breast milk dispensers and prepare to be amazed! You can easily recycle things like gift bags and shipping boxes for this purpose (boxes may be easier to stack for optimal space saving). 
  3.       Keep track of how old your milk is in batches so it’s easier to organize and find via color-coding or labeling. This is where using gift bags can be fun!
  4.       **Writer’s Favorite** To minimize time rummaging through the back of the freezer, try a left to right system.  Always put the newest milk on the left and then shifting your storage containers to the right as you add. So simple it’s genius!   

Storage while traveling or at work.

  1.       Use a cooler with ice to keep milk fresh for up to 24 hours. 
  2.       When flying, ask for ice at a coffee shop at the terminal or while on the plane.  For more travel tips check here.
  3.       At work, keep ice packs in the company freezer (don’t forget those labels to avoid confusion!) to use for the commute home.
  4.       For more guidelines on how long milk can be stored at different temperature check out this great resource here. For other general tips on milk storage look here.

 Making your fridge or freezer pretty and organized can give you peace of mind.  Then you can focus on all the fun parts of raising your baby!

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