Pumping 101

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Melissa Portunato, IBCLC

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, but this really depends on your breastfeeding goals and when you will begin to be separated from your baby. If you are returning to work at 12 weeks, you can start pumping at 3-4 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. The best time to pump will be about 30 minutes after nursing your baby. Pump 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. 

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 – 30 ounces per day. Depending on if you are pumping for a missed feeding or pumping in between feedings, you can expect to pump roughly 2 – 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 Synergy Pumps come with two sets of flanges – 24mm and 28mm.  Spectra Baby USA flanges come in 16, 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 before pumping, it should only have a few millimeters (2-3) 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 2-3mm 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? At Spectra Baby USA, we understand the need for support, schedule a complimentary consultation with us here or email us at ibclc@spectrababyusa.com. 

We wish you all the best on your pumping journey and are here to support you every step of the way.

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.  

 

Cluster Feeding: Manage Breastfeeding Like a Pro

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Are you feeling like your little one is practically glued to you day in and day out? You’re not alone! Many new parents experience what’s known as cluster feeding, where your baby seems to want to nurse non-stop, leaving you feeling tapped out and exhausted. But fear not, there’s a science behind this feeding pattern, and with a few tips, you can manage it like a pro.

Cluster feeding, characterized by frequent nursing sessions spaced closely together, typically every 45-60 minutes, is completely normal behavior for young babies. This pattern often coincides with growth spurts and developmental milestones, indicating that your baby is growing and thriving. While it can be exhausting for parents, understanding why it’s happening can help alleviate some of the stress.

The most reassuring aspect of cluster feeding is knowing that it’s actually beneficial for both you and your baby. These marathon nursing sessions serve a crucial purpose in stimulating milk production and increasing your supply to meet your baby’s growing needs. The more your baby nurses, the more signals your body receives to produce milk, ensuring that your supply remains healthy and abundant. So, while it may feel like your baby is draining you dry, rest assured that they’re actually helping to boost your milk production for the long haul.

Additionally, it’s important to remember that cluster feeding is often followed by longer sleeping stretches for your baby. So, while those late-night nursing sessions may leave you feeling exhausted at the moment, they’re often a precursor to more extended periods of rest for both you and your little one. This natural rhythm of feeding and sleeping helps regulate your baby’s circadian rhythms and contributes to overall better sleep patterns as they grow.

One key tip for managing cluster feeding is to embrace baby-wearing. Using a wrap or sling allows you to keep your baby close while still being hands-free to tackle tasks around the house or even run errands. Not only does baby-wearing promote bonding between you and your little one, but it also allows you the freedom to move about without feeling strapped to a chair during marathon nursing sessions. Check out our baby-wearing blog for more tips on how to make the most of this practical and effective breastfeeding hack.

In conclusion, while cluster feeding may initially seem overwhelming, it’s important to recognize that it’s a normal and beneficial behavior for young babies. By understanding the science behind it and implementing practical strategies like baby-wearing, you can navigate this phase with confidence and positivity. Sit back, relax, and embrace the opportunity to bond with your baby while knowing that you’re nurturing them in the best possible way. And remember, sleep is on the horizon!

Source:

Hernández-Aguilar, Maria-Teresa, et al. “ABM Clinical Protocol #7: Model Maternity policy supportive of breastfeeding.” Breastfeeding Medicine, vol. 13, no. 9, Nov. 2018, pp. 559–574, https://doi.org/10.1089/bfm.2018.29110.mha

Do I Have Elastic Nipples?

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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! 

 

 

Breastfeeding: The First Week

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By: Chrisie Rosenthal, IBCLC
The Lactation Network

Breastfeeding: The First Week

Your little one is here! The first week of your baby’s life is sure to bring big emotions, special memories and a few challenging moments as well. When it comes to breastfeeding, knowing what to expect can make the tough times much easier.

Day 1: When your baby is born, they will be looking to eat right away! Take advantage of their instincts in this “golden hour” by bringing your baby to your chest and latching immediately after birth. Studies tell us that latching in the first hour helps ensure long-term breastfeeding success! However, if you aren’t able to breastfeed in the “golden hour”, don’t worry – breastfeed your baby as soon as you’re together and if you’re separated for more than four hours, it’s important to start pumping to let your body know that you are breastfeeding. If you delivered your baby in the hospital, ask the nurses to assist you. You may also see an in-patient IBCLC during your stay. You are surrounded by a team of people who are there to support you!

It’s a myth that breastfeeding should “just come naturally”! Breastfeeding is a learned skill, for the parent and for the baby. It takes time and practice. Babies need to eat a minimum of 8-12 times every 24 hours, and in the early weeks, it’s common for babies to eat 10-12 times every 24 hours. In fact, in the first few days, Pediatricians generally recommend that you feed your baby every 2-3 hours around the clock, measured from the start of one feed to the start of the next.

Output is also important. On day 1, your baby should have at least one wet diaper and one stool. After that, the number of wet diapers should increase by one for the first 4 days i.e. a minimum of 2 wet diapers on day 2, a minimum of 3 wet on day 3, and 4+ wet diapers on day 4. Stool frequency varies greatly, but you’ll notice that your baby first passes meconium, a thick, dark, sticky stool. Over the next couple of days, it will transition to a light brown or green, and by day 3-5 you’ll finally see “breastmilk stools” which are loose and a yellow/mustard color.

Day 2: If your support team at the hospital has been helping you latch, today is a great day to start latching your baby yourself, and asking them to observe and give you tips. If you have a partner with you, they can help by making note of the tips and techniques you’re learning.

Night 2 may bring baby’s first growth spurt! Growth spurts are marked by frequent feeding, gassiness, a cranky baby, and lots of wet diapers. Baby may feed more veraciously, your nipples may become more sore. Expect this growth spurt to last a couple of days.

It’s a myth that breastfeeding is “just painful, and you have to push through it.” Although you may feel tugging when your baby is latched deeply at the breast, it shouldn’t hurt. If it hurts, an IBCLC (an expert Lactation Consultant) can work with you to create a plan to feed the baby and make it more comfortable for you. Studies support that applying breastmilk to your nipples is one of the most effective healing measures.

Day 3-5: You may already be or may be heading home soon and if you’re feeling overwhelmed by this transition, know that those feelings are very common. Now is the perfect time to request a consultant with your Lactation Consultant, create a plan for breastfeeding at home and troubleshoot any concerns you’re having.

Sometime during days 3-5, you will also experience your milk transitioning from colostrum and increasing in volume. If you become uncomfortably full, cold compresses applied to your breast tissue (in addition to feeding your baby) can help to provide relief.

This is also when most parents have their first outpatient Pediatrician appointment. Your Pediatrician will ask about feeding, diaper output and take your baby’s weight and measurements. They may also tell you that at this point, your baby is allowed one longer stretch between feeds once a day.

It’s a myth that by “doing the right things, you can coach a newborn baby to sleep long stretches at night.” Babies tend to be nocturnal for the first few weeks of their life. Sleep deprivation can be a real challenge! If you have a partner, work together so you both have a chance to rest every day. If you don’t have a partner, lean on your support network at this time and ask for help. The good news is that baby’s sleep generally improves around six weeks.

Day 6-7: You’re nearing the end of baby’s first week, and you’re probably feeling like you’ve found a little bit of a rhythm by now. If your nipples were tender from the first few days of breastfeeding, you should be feeling some relief at this point. You should also be gaining more confidence in latching. If you’ve been using one breastfeeding position (most likely cross-cradle), this is a great time to switch it up and experiment with other positions (consider football or side-lying).

It’s also not uncommon to be feeling big swings in emotions. (Hormones!) Although “baby blues” are common, familiarize yourself with the signs of postpartum depression and postpartum anxiety. Your OB, MD and Lactation Consultant can provide resources if you need them!

It’s a myth that breastfeeding “is all or nothing”. Or that there’s only “one way” to breastfeed. Some parents choose to feed their baby exclusively at breast, or exclusively pump and bottle feed. Most introduce the bottle in the early weeks and feed both at breast and with a bottle. Your feeding journey is unique to you and your baby, but you’re not alone. If you need support, Lactation Consultants can help you reach your goals. You’ve got this!

Did you know that your breast pump and lactation consultations are often covered under your insurance? The Lactation Network is a great resource and can help connect you to an IBCLC in your area.

Source:

How often to breastfeed. HealthyChildren.org. (n.d.). Retrieved November 28, 2022, from https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/How-Often-to-Breastfeed.aspx?_ga=2.190306667.199690818.1668731164-1827075293.1652815044&_gl=1%2A1xjwh9v%2A_ga%2AMTgyNzA3NTI5My4xNjUyODE1MDQ0%2A_ga_FD9D3XZVQQ%2AMTY2ODczMTE2NC40MC4wLjE2Njg3MzExNjQuMC4wLjA

GOODLIN-JONES, B. E. T. H. L., BURNHAM, M. E. L. I. S. S. A. M., GAYLOR, E. R. I. K. A. E., & ANDERS, T. H. O. M. A. S. F. (2001). Night waking, sleep-wake organization, and self-soothing in the first year of life. Journal of Developmental & Behavioral Pediatrics, 22(4), 226–233. https://doi.org/10.1097/00004703-200108000-00003

AAP schedule of well-child care visits. HealthyChildren.org. (n.d.). Retrieved November 28, 2022, from https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx

Working From Home and Breastfeeding

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By Melissa Portunato MPH, IBCLC, RLC

Your maternity leave might be coming to an end soon and instead of doing your typical trek to the office you now find yourself prepping for a new normal...working from home. Will your baby be home while you’re working? Will you be pumping during your work day? No matter your situation, with some flexibility and planning you can continue to meet your breastfeeding goals. 

Childcare
Let’s start with the most important question. Who will be caring for your baby? Will you be home alone and caring for your baby while you work? Will your baby be going to daycare? Depending on your childcare options pumping and nursing can look a little different. If baby will be home with you and nursing at the breast has been going well so far, holding off on a pumping schedule all together may be your best bet! If nursing at the breast is not an option, double pumping every 2-3 hours while you are working is going to help keep up your milk supply to meet the needs of your growing baby. 

Prioritize Your Pumping Schedule 
Juggling back to work and mommy-ing can be hard at first but it’s all about routine! Make sure to plan your pumping breaks. Set alarms and block out times on your calendar to allot for pumping. It can be tempting to tame the laundry monster during breaks but stay focused and reserve this time for ONLY pumping. Keep a pretty nursing cover nearby, so if you do need to take a virtual call or meeting while pumping you’re ready to go! Our pumps are quiet and discreet. Your co-workers will never know you are multitasking. 

Setup a Mobile Pumping Station
If you will be pumping from home during your work day, creating a mobile pumping station can help you stay organized and make pumping a lot easier to squeeze into your busy day! An art cart or portable plastic drawers will work well. Load up your mobile station with all your pumping essentials: Spectra baby USA pump, parts and accessories, milk storage bags, and even a small cooler kit to temporarily store your pumped milk. Add yummy dry snacks and remember to stay hydrated. Creating a mobile pumping station will save you time and allow you the mobility to move around the house to find a quiet place to help you relax while you pump. It especially comes in handy if you have others working from home or in virtual school, where space is sometimes limited and working areas can change throughout the day. 

Caring For Your Accessories 
Take advantage of your clean personal pumping space! It will be pretty sweet to not worry about where to clean your pump accessories or having to store your milk in a stinky work fridge. CDC recommends washing all pump parts that come into contact with your breast milk in warm soapy water after every use. It will be easy to keep them squeaky clean and ready for your next pumping sesh! Keep extra accessories on hand especially duckbills and backflow protectors. We recommend replacing these accessories every 6-8 weeks depending how often you are pumping. Bonus tip: Assembling your accessories in advance can save you precious time!

Communication 
During these strange pandemic times, something positive that has surfaced is employer flexibility. Companies have had to adapt to unlikely conditions like employees virtually schooling and caring for children at home while working. Employers are now more likely to accommodate flexible and even non traditional working hours. Start the communication now with your employer if you think a different schedule will make you more focused and productive. You’re a valuable asset to your organization mama! Speak up! You might be pleasantly surprised at the response. 

Staying Connected 
Working from home definitely has its perks and can help make the transition back to work easier but it can be lonely at times. Be kind to yourself and care for your physical, mental and emotional well being. Ask for help if you need it mamas and if you need breastfeeding advice reach out to our team of Spectra baby IBCLCs. Join our virtual support groups on Facebook and keep yourself engaged with other breastfeeding mamas just like you! 

We believe in you and we know you are totally going to rock working from home and breastfeeding! 

 

Breastfeeding Must-Haves

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Melissa Portunato, IBCLC

If we’re being honest the only thing you really need to “breastfeed” is your baby and your boobs. But sometimes, things don’t go as smoothly in the early days or maybe you’ve already decided to pump for your baby exclusively – pumping is breastfeeding! With so many new devices, gadgets, and tools on the market to choose from, it can be overwhelming to decide what you will really need. We break it down below into the absolute must-haves you should grab for your breastfeeding journey.

Grab It!

✅ Hospital strength pump

If nursing is going well, you won’t need to introduce pumping right away, 3-4 weeks is a great time. You can start with once a day in the early morning about 30 minutes after you nurse your baby. If exclusively pumping, the first 12 weeks aim for pumping every 2-3 hours, which is about 8x per day. Pumping sessions should be 15-20 minutes. No matter if you are triple feeding to increase milk supply, returning to work, or exclusively pumping quality breast stimulation with a Spectra Baby USA hospital strength pump will express milk efficiently and comfortably.

✅ Nursing / Pumping Bra

Choose a bra that is supportive and not loose or too restrictive. Measure your back size in your last trimester and go up a size. You should be easily able to unclip the strap to bring your baby to your breast. “Hands-on Pumping ” is a technique that uses breast massage to drain the breast better and stimulate healthy milk production. With a well-fitted pumping bra, you will be able to massage and compress without breaking the flange seal. Studies tell us combining hand expression and breast massage can increase milk volume by 48%. That’s a considerable amount of more liquid gold to store or give fresh to your baby!

✅ Storage Milk Bags

Milk storage bags are a super must when going back to work. You can pump directly inside the bags, transport them easily, and store them flat in your freezer to maximize space. Whether in the fridge or freezer, breast milk should be stored in clean food-grade containers such as BPA-free plastic, glass, or silicone as well as disposable milk storage bags. Spectra Baby USA’s quality high-standard milk bags won’t leak or tear like most bags on the market.

✅ Extra Accessories

Load up on accessories! Duckbills should be changed every 4-6 weeks depending on how often you will be pumping. Most insurance providers are covering the cost of replacement parts. Check our insurance look-up tool here for more info.

✅ IBCLC Support

This is the most important breastfeeding must-have! Never underestimate the importance of quality skilled lactation care. Connecting with local lactation support prenatally and after you deliver your baby is critical to your breastfeeding success. An International Board Certified Lactation Consultant, IBCLC will provide evidence-based information, counseling, and support to continue to meet your breastfeeding goals. In addition, surround yourself with like-minded families that encourage breastfeeding.

DITCH IT!

🗑️ Breastfeeding Pillow

Babies nurse with their entire body, not just their head and mouth. They are looking for a place to anchor their chin and push off with their tiny feet which are called the Babinski Reflex. This newborn reflex creates brain development and assists your baby to pull themselves upwards in a crawling motion to latch to your breast completely on their own! Breastfeeding pillows are great to support your arms, legs, or back but should not be used to support your baby. They can interfere with the latch, proper positioning, and adequate milk transfer.

🗑️ Nipple Shields

Far too often, nipple shields are used to mask breastfeeding issues without getting to the root cause. Truth is, most moms do not need them at all. Nipple shields essentially create a barrier between you and your baby. They are infamous for low weight gain, clogged ducts, low milk supply, and a ton of other breastfeeding challenges. Some newer research tells us temporary use of nipple shields could possibly salvage a breastfeeding relationship if it’s combined with skilled lactation support early on. Proceed with caution and under the discretion of an IBCLC.

🗑️ Pacifiers

All major baby experts agree parents should wait to introduce a pacifier until breastfeeding has been well established. Baby should have gained back their birth weight and be gaining weight appropriately (around 3-4 weeks). Avoid supplementing with a pacifier if the baby is hungry. When using a pacifier, limiting to naptime and bedtime is best.

At Spectra Baby USA, we believe breastmilk is the perfect composition for your baby and every mother should have access to support. Connect with us directly at ibclc@spectrababyusa.com.

We believe in breastfeeding and we believe in YOU!

Sources:
Holmes, A. V., McLeod, A. Y., & Bunik, M. (2013). ABM Clinical Protocol #5: Peripartum Breastfeeding Management for the Healthy Mother and Infant at Term, Revision 2013. Breastfeeding Medicine, 8(6), 469–473. https://doi.org/10.1089/bfm.2013.9979

Widström, A. M., Lilja, G., Aaltomaa-Michalias, P., Dahllöf, A., Lintula, M., & Nissen, E. (2010, September 14). Newborn behavior to locate the breast when skin-to-skin: a possible method for enabling early self-regulation. Acta Paediatrica, 100(1), 79–85. https://doi.org/10.1111/j.1651-2227.2010.01983.x

Combining hand techniques with electric pumping increases milk production in mothers of pre-term infants. J Morton, JY Hall, RJ Wong, L Thairu, WE Benitz, and WD Rhine: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA: Journal of Perinatology (2009) 29 757-764

What Is Breast Gymnastics?

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By: Melissa Portunato, IBCLC

Breast Gymnastics is a gentle massage technique that can bring pain relief and easier milk flow for mothers experiencing engorgement, clogged ducts, and other common breastfeeding conditions. Maya Bolman, IBCLC and leading researcher in Therapeutic Breast Massage coined the phrase “breast gymnastics” to teach breastfeeding families and lactation health care professionals the benefits of gentle stretching and movement of the breast. Breast gymnastics triggers drainage of the lymphatic system creating milk to flow freely improving the quality of breast milk and decreasing swelling. Used in combination with hand expression, breast gymnastics effectively alleviate breast pain making nursing and pumping a more enjoyable experience.

THE BENEFITS OF BREAST GYMNASTICS

Breast pain is a leading cause of premature weaning and breast gymnastics can help resolve common ailments associated with early breastfeeding. Often relief is immediate, and breastfeeding can continue with no interruptions.

Chronic Breastfeeding Pain
If you are experiencing chronic breast pain, practicing breast gymnastics can bring relief. Chronic pain in the breast can sometimes be caused by a bacterial infection. It’s important to monitor your symptoms and check with your doctor if your symptoms are not improving.

Engorgement
Also known as “milk stasis”, engorgement comes from built-up milk in the ducts which can cause painful swelling, firmness, and sensitivity of the nipples and breast. Engorgement is most common among first-time mothers but can also happen when weaning from breastfeeding.

Clogged Ducts
A “plugged” or “clogged duct” occurs when a milk duct that leads to the nipple gets blocked. The onset is often fast and can be associated with a hard, often painful lump. Some causes of a blocked duct are prolonged time without milk removal, shallow latch, restrictive clothing, or even stress. With proper care, most clogged ducts subside within 2-3 days.

Mastitis
Mastitis can be infectious or non-infectious, and symptoms of both include fever, pain, swelling, redness of the breast, hard lumps, hot to the touch, and feeling flu-like symptoms. If you suspect you may have mastitis, make an appointment with your doctor. Breast Gymnastics can aid recovery, but you may also need medications to clear up the infection.

Latching Baby To Breast
Breast Gymnastics can soften the breast to allow your baby to latch on to your breast. The gentle movement and circulation with hand expression can protrude the nipple and your baby will be able to latch deeper for more nutritive feedings at the breast. You can move and stretch your breasts while simultaneously feeding your baby for more productive nursing sessions.

HOW TO DO BREAST GYMNASTICS

Step 1
Cup both hands under one breast

Step 2
Lift breast up and down

Step 3
Move your breast softly to the left and then right

Step 4
Move your breast gently all the way around in a circular motion – clockwise and then counterclockwise

Step 5
Repeat on the other breast

If your baby cannot nurse, protect your milk supply by breast pumping every 2-3 hours with a hospital-strength breast pump. If you are experiencing breast pain, connect with an International Board Certified Lactation Consultant, IBCLC for evidence-based information, counseling, and support to continue to meet your breastfeeding goals.

Source:

Mothers Value and Utilize Early Outpatient Education on Breast Massage and Hand Expression in Their Self-Management of Engorgement. Witt AM, Bolman M, Kredit S, Breastfeed Medicine 2016 Nov; 11:433-439.

Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts and Mastitis. Witt AM, Bolman M, Vanic A, Kredit S, J Hum Lact 0890334415619439, first published on December 7, 2015.

Recapturing the Art of Therapeutic Breast Massage During Breastfeeding. Bolman M, Saju L, Oganesyan K, Kondrashova T, Witt AM. J Hum Lact. 2013 Aug;29(3):328-31.

Finding a Breastfeeding Friendly Pediatrician

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Melissa Portunato MPH, IBCLC, RLC

Breastmilk is a living substance loaded with nutrients, antibodies, and vitamins, providing the perfect nutrition composition for your growing baby. Experts recommend breastfeeding exclusively for the first 6 months and continued breastfeeding for 2 years or as long as the mother and baby desire. Some mothers exclusively express breastmilk for their babies, while others prefer to nurse directly at the breast. No matter how you decide to provide breastmilk for your baby, you will give them the very best start by feeding them your precious breastmilk. 

The pediatrician you choose for your baby will significantly impact your breastfeeding journey. Some pediatricians are more knowledgeable about breastfeeding than others, and it’s recommended for expectant parents to interview candidates for their baby’s doctor during pregnancy. Read on for questions you can ask and the answers you should look to receive. 

What percentage of babies are breastfed in your office?

The national breastfeeding rates published by the CDC depict that 45% of infants are exclusively breastfed at 3 months, and about 25% are fed only breastmilk at 6 months. Your pediatrician’s practice should have a high breastfeeding rate, but don’t be discouraged if they don’t know the current national breastfeeding statistics. However, they should know the average of breastfed infants in their office and be willing to listen and support you on your breastfeeding goals. 

Do you work with an International Board Certified Lactation Consultant (IBCLC) should any problems arise?

The IBCLC credential is the gold standard in lactation care, providing skilled, evidence-based breastfeeding support. Access to an IBCLC at your pediatrician’s office will make a big difference. It tells the pediatrician understands your concerns and values specialized lactation care for their patients. 

How much breastmilk should my newborn consume daily?

Breastfed babies consume between 25-30 ounces per day. The amount your baby will consume stays consistent for the first 6 months. If you are exclusively pumping, aim for that total, and if you are nursing and pumping about half (12-15 ounces). 

What growth charts do you use in your practice? 

Breastfed babies should not be compared to formula-fed babies. Research shows breastfed babies are leaner over time and grow in different patterns than their formula counterparts. Breastfed babies should be measured on the WHO growth charts, NOT the CDC growth charts. You can download a free WHO growth chart here. Remember, percentiles are just a comparison with your baby among 100 other babies. If your baby is not growing as quickly as their peers, it doesn’t necessarily mean feeding is an issue. Genetics should be considered, and seeking advice from an IBCLC. 

When is supplementation medically necessary, and how should it be given?

On average, your baby should not lose over 10% of their birth weight and be back at their birth weight at 2 weeks. If your baby requires supplementation, your pediatrician’s first advice should be to breast pump and provide breastmilk as a supplementation in addition to nursing directly at the breast. Alternative feeding techniques like a cup, spoon, or syringe should be suggested instead of bottle feeding. If bottle feeding is preferred, the paced bottle technique is the best way to feed your newborn with a bottle. 

When do you recommend introducing solids?

AAP recommends exclusive breastfeeding for the first 6 months, introducing solids at 6 months, and continued breastfeeding for 2 years or as long as mother and baby desire. Your baby does not need any other food, water, or juice – only breastmilk for the first 6 months. 

When do you recommend weaning from breastfeeding?

The answer here should be until mother and baby desire. There is no specific timeline for weaning, and every family should make a personal decision on when to discontinue breastfeeding. Studies show there are benefits to breastfeeding at one year and beyond. Breastmilk continues to be a source of nutrients, antibodies, and vitamins through toddlerhood and early childhood. 

Be prepared and educate yourself before you begin breastfeeding. Finding a pediatrician that supports your decision to breastfeed is important and can influence the achievement of your breastfeeding goals. If your pediatrician is not supportive of breastfeeding, you can always opt for a second opinion. You are your baby’s advocate. 

Need help getting started with breastfeeding? Schedule a complimentary consultation with a Spectra Baby USA IBCLC here. 

We’re here for you, and we support YOU! 

Source:

Kellams, A., Harrel, C., Omage, S., Gregory, C., & Rosen-Carole, C. (2017). ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeeding Medicine, 12(4), 188–198. https://doi.org/10.1089/bfm.2017.29038.ajk

Everything You Need To Know About Biting and Breastfeeding

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Melissa Portunato MPH, IBCLC, RLC

Not all babies bite and the ones that do learn pretty quickly that mama does not like it and stop. If you’re part of the lucky few that does have a baby shark don’t worry mamas! Biting down at the breast is almost always temporary. With patience, time and support your breastfeeding journey doesn’t have to come to an end. Check out our expert tips to keep your baby from chomping down and get you back on track with breastfeeding pain free! 

Why does my baby bite down when nursing? 

Teething 
Every baby is different, but generally babies will start to cut their first tooth between 3 months and 12 months. During this time, baby’s gums can get sore and the pressure of biting down can bring them relief. Freeze a washcloth dipped in breastmilk and before nursing let baby chew on it. Breastmilk triggers the production of endorphins, a natural pain numbing effect. The anti inflammatory properties in breastmilk may also help reduce soreness and pain. Wrap your finger around the cold washcloth and softly massage the gums providing counter pressure before nursing. Massaging the cheeks and ears from the outside can also help soothe pain. These techniques can relax baby before nursing and they will be less likely to bite down. 

Sometimes teething can result in a shallow latch which overtime can make nipples tender. Try “breast shaping” and compression when nursing to better position the baby on the nipple. Using lying back breastfeeding and dangle feeding can help your nipple go deeper into the baby’s mouth. 

Baby not feeling well 
Other reasons babies might bite down when nursing could be because of a sickness like a cold, ear infection, sinus pressure, headache, or a stuffy nose. If baby has nasal congestion, use a mucous removal tool, like a nasal bulb or the NoseFrida, to clear baby’s nasal passage before nursing. Use breastmilk or saline water to moisten the inside of the nostrils before suctioning to make the process less irritating. Nursing your baby in an upright position, straddled on your lap, or using a sling or carrier can help make the airway stay clear and make breathing easier.

Oral Restriction
Sometimes newborns will clamp down when nursing at the breast. It doesn’t always mean there are oral restrictions but it could be an indicator. Oral restrictions can vary and can come in the form of a tongue tie, lip tie, and buccal tie (these ties can be found on the inside of the cheek). The shape of the palette and tongue can also influence how a baby will nurse at the breast. If your baby continues to clamp down when nursing, work closely with your pediatrician and connect with your local International Board Certified Lactation Consultant, IBCLC for a thorough breastfeeding consultation to determine the cause of the issue and develop a plan for resolution. 

Forceful Letdown 
If mom has a forceful letdown this can also cause a baby to clench down on the nipple. Using nursing positions that are counter gravity can slow the overactive letdown and baby will be able to manage milk flow easier. Nursing lying back with baby’s body flat directly over you or sitting baby upright to nurse can slow the flow, allowing baby the rhythmic suck and swallow necessary for nutritive feeding. In addition, hand expressing first or pumping for 5 min prior to nursing sessions can help baby latch on easier and slow forceful letdown too! 

What else can I do to make baby stop biting? 

No matter the reason for biting it can be painful. Try not to scream! Instead, put your baby down in a safe place and leave the room. It’s important to know a baby that is actively nursing can not physically bite down on the breast. Babies tend to bite down towards the end of a feeding, when distracted, or not interested. Watch your baby closely when nursing and end the nursing session before baby has the opportunity to bite down. Babies are pretty keen at sensing our body language and behavior. Talk to your baby often when nursing. Tell your baby things like “we don’t bite mama” or “biting hurts mama, outchy.” Babies look for facial expressions to communicate. Be expressive with your emotions when you talk to your baby. Smile and positively reassure your baby when latch on happens carefully and smoothly. 

Managing Nipple Pain and Milk Supply
If baby’s biting has your nipples sore, caused abrasions, or cuts be sure to treat them to prevent infection. Air dry as much as possible and wash with non antibacterial soap in the shower. Applying a cool hydrogel can soothe sore nipples and keep them healthy. For deeper cuts and abrasions temporarily applying a mupirocin, prescribed by your doctor, can help speed up healing and avoid infection. Small amounts on the nipples do not need to be wiped away before nursing. Always remember mamas! Your doctor is always a quick call away if something doesn’t seem right. 

If nursing directly at the breast has become too painful, pump to maintain your milk supply. Use the slow 38 cycle steady with the Spectra breast pump S1/S2 and lubricate the tunnel well with breastmilk or olive oil to prevent friction and further discomfort. Be gentle on your breasts and nipples. Use massage and compression to stimulate more effective letdowns allowing for less time on the pump. 

Remember you and your baby are a dyad. You are one. Your baby will learn quickly biting hurts mama and they will stop. Your baby loves you and doesn’t want to knowingly hurt you! You’re an amazing mom and your baby thinks so too.

References

Nishitani S, Miyamura T, Tagawa M. et al. The calming effect of a maternal breast milk odor on the human newborn infant. Neurosci Res (2009) 63(1): 66-71

In: Drugs and Lactation Database (LactMed). Bethesda (MD): National Library of Medicine (US); 2018 Oct 31.

http://www.nancymohrbacher.com/breastfeeding-resources-1/2016/6/10/your-breastfeeding-baby-is-biting-you

The American Academy of Pediatrics (AAP) Issues Updated Breastfeeding Guidelines

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By Melissa Portunato MPH, IBCLC, RLC

On June 27, 2022, The American Academy of Pediatrics updated its existing policy statement on breastfeeding. The revision has come at a controversial time amidst the current formula crisis, failed legislation, and the recent Supreme Court ruling on reproductive health rights. Read on for the full breakdown and what this means for public health in the US. 

What’s NEW?
The previous AAP policy recommended breastfeeding for the infant’s first year and has now been updated to 2 years and beyond. The policy now states, 

“ The AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond.” 

This wasn’t the only change that came with the revised policy. Social and cultural calls for action were also at the center of the guideline revisions to support parents who want to meet the new recommendation. The official statement includes the need for paid maternity leave and more support in public, child care, and workplace facilities. In addition, maternity care practices were urged to improve breastfeeding initiation, duration, and exclusivity. The organization also acknowledges that babies born to gender-diverse families may not have equal access to human milk, and clinical support may be more challenging. Overall, the AAP calls for clinicians to equip themselves to provide evidence-based quality medical care to ensure all families best meet their personalized breastfeeding goals. 

Why Now?
As the formula crisis rages on, parents may be asking themselves, why now? The truth is this has been a long time coming, but the formula shortages did help to revive the conversation. Significant research has long backed up the nutritional and immunological benefits of human milk feeding past one year. The extensive studies are not limited to the above benefits; instead, they reveal psychological advantages when the young child continues to nurse directly at the breast and boast benefits for the mother as well. It’s important to note that the new revision is now in line with the World Health Organization’s long-standing breastfeeding recommendations for 2 years or beyond. 

Now What?
We all know exclusive breastfeeding is the goal, but that can seem far-fetched or unattainable for families struggling to make enough milk, experiencing latching difficulties, or simply lacking breastfeeding education or support. Nevertheless, many experts still agree the revision to the AAP policy is a step in the right direction. It will likely prompt the availability of more community resources for pre/post-natal education, diversity of lactation clinicians, and easier access to low-cost breastfeeding support platforms, i.e., telehealth.

Unfortunately, the Pump For Nursing Mothers Act which would extend breastfeeding mothers pumping rights to 2 years, was denied in the wake of the AAP’s updated guidelines. The failed legislation covered salaried breastfeeding individuals that were not covered under the Affordable Care Act. Another bill already introduced to the Senate, the Pregnant Workers Fairness Act, prohibits employers from discriminating based on pregnancy, childbirth, and related medical conditions. This bill appears ready to pass soon and is set to protect working breastfeeding families similarly. Good news! 

How can Spectra Help?
Breastfeeding for 2 years or beyond may not be realistic for all families, yet there are ways Spectra baby USA is making it easier for parents that decide to breastfeed past one year. All Spectra Baby USA’s high-quality electric breast pumps have a 2-year product warranty. Complimentary virtual consultations with a Certified Lactation Consultant (IBCLC) are available with the purchase of any Spectra baby USA breast pump. No matter the amount of breastmilk you can provide or the length of time, breastfeeding is an accomplishment, and human milk provides irreplaceable health benefits to your baby. If you have questions about achieving your breastfeeding goals, message us at ibclc@spectrababyusa. In addition, we always recommend connecting with your local International Board Certified Lactation Consultant for evidence-based advice and community support. 

Sources:

American Academy of Pediatrics calls for more support for breastfeeding mothers within updated policy recommendations. Home. (n.d.). Retrieved July 5, 2022, from https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-calls-for-more-support-for-breastfeeding-mothers-within-updated-policy-recommendations/ 

Text – H.R.3110 – 117th Congress (2021-2022): Pump for Nursing Mothers act. (n.d.). Retrieved July 5, 2022, from https://www.congress.gov/bill/117th-congress/house-bill/3110/text 

Bonyata, K. (2018, January 15). Breastfeeding your toddler: What to expect • kellymom.com. KellyMom.com. Retrieved July 5, 2022, from https://kellymom.com/ages/older-infant/toddlernursing/ 

 

Should I Introduce A Pacifier to My Baby?

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Melissa Portunato MPH, IBCLC, RLC

Babies are born with a strong innate sucking reflex necessary for survival. When combined with the rooting reflex, a newborn baby can find the breast, suck and swallow milk. Sucking can also bring soothing comfort to a newborn baby, and parents often run to a binkie for a quick fix. Read on to learn the pros, cons, and helpful tips about introducing a pacifier to your breastfed baby. 

When Can I Introduce a Pacifier? 
All major baby experts agree parents should wait to introduce a pacifier until breastfeeding has been well established. Baby should have gained back their birth weight and be gaining weight appropriately (around 3-4 weeks). Avoid supplementing with a pacifier if baby is hungry. Limiting the pacifier for naptime and bedtime is best. After the initial first weeks, a pacifier can be considered and has some evidence-based benefits too!

Which Type of Pacifier is Best?
Pacifiers were created to mimic a breastfeeding mother’s nipple and first debuted in the early 1900s. Originally they were mostly made from natural rubber, later latex, and most recently BPA-free silicone. 

Choosing a pacifier with a rounded tip better encourages nursing at the breast. In addition, the silicone material is soft and smooth, which resembles a mother’s nipple. If baby doesn’t seem interested in the pacifier offered, you can try a different one to discover the baby’s preference. 

Pros & Cons

✔ In the first 6 months, decreased risk of Sudden Infant Death Syndrom when given at the onset of sleep 

✔ Suck training and shorter hospital stays for premature infants. 

✔ A distraction for car rides and airplane travel, especially during take-off. 

✔ Pain management for minor procedures. 

✔ Provides comfort if the mother is not nearby to nurse. It should not replace a feeding but rather temporarily soothe a fussy baby. 

✖ Early pacifier introduction has been linked to a shorter duration of breastfeeding, sore nipples, and engorgement. 

✖ Prolonged use can increase the risk of ear infections and thrush. 

✖ Pacifier use is associated with poor dental development if continued after 2 years old.

✖ Overuse and prolonged use may interfere with language development.

✖ It can be tough to break the pacifier habit, and weaning can be difficult. It’s recommended to ditch the paci before baby’s first birthday.  

Helpful Binkie Tips

★ Clean often and sanitize pacifiers daily 

★ Replace if torn or broken 

★ Wean baby before one year

★ Limit to bedtime and naptime

★ Never use a pacifier with a clip or strap, which can pose a hazard 

★ If baby is happy and content no need to introduce a paci 

★ Don’t push pacifier back in if baby refuses

More to Consider 
Interaction with your baby is vital for language and social development. Your baby will be less likely to coo or try to communicate while sucking on a pacifier. Moderation is key. Many breastfeeding families temporarily introduce a pacifier and continue to meet their breastfeeding goals. 

For guidance and support anytime, connect with a Spectra IBCLC at ibclc@spectrababyusa.com.

Sexton, S., & Natale, R. (2009, April 15). Risks and benefits of pacifiers. American Family Physician. Retrieved June 27, 2022, from https://www.aafp.org/pubs/afp/issues/2009/0415/p681.html#:~:text=Early%20breast%20weaning-,AAP%20recommends%20pacifier%20use%20in%20infants%20up%20to%20six%20months,procedures%20in%20the%20emergency%20department.&text=AAP%20suggests%20offering%20pacifiers%20to,reduce%20the%20risk%20of%20SIDS.