Pumping 101

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Melissa Portunato MPH, IBCLC, RLC

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

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

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

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

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

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

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

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

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

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

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

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

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

Happy pumping! 

 

Breastfeeding Basics

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By Jacque Ordner BSN, RN, IBCLC 

Breastfeeding is natural and the biological norm for feeding babies, but that doesn’t mean it’s easy! We’ve got you covered with top tips for getting started and avoiding common pitfalls. 

The human breast continues to develop milk-making glands, ducts, and other structures involved with lactation throughout pregnancy. For this reason, it is normal to experience breast changes including an increase in size, increased sensitivity, darkening of the areola and nipple, and even leaking of colostrum in late pregnancy. These are all great signs that your body is getting ready to feed your baby! 

After baby is born (more specifically, after the placenta is delivered) mom’s body experiences a hormone shift that triggers the production of breast milk.  For the first few days, women’s bodies make a thick, sticky liquid called colostrum.  Colostrum is a POWERHOUSE of nutrients and bioactive immune factors the help seal up your baby’s gut and protect him or her from illnesses.  Colostrum is small in volume but is just what baby needs in the early days.  Due to its thick, sticky consistency, colostrum can be difficult to express with a breast pump.  Many moms have more success using hand expression.  Here’s a great video with more information on hand expression in the early days:  https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html  Newborn tummies are tiny and are made to stretch as mom’s milk supply increases in the initial postpartum period. 

Placing baby skin to skin with mom and offering unlimited access to the breasts can have a huge impact on later breastfeeding success.  Latching baby within the first hour is ideal.  However, not latching in the first hour doesn’t mean breastfeeding will be unsuccessful!  Breastfeeding is a new sensation but shouldn’t be painful.  If you’re experiencing pain with latching or pumping, reach out for help from an IBCLC.  Frequent nursing helps mom’s milk supply increase faster.  Mothers make transitional milk (often somewhat yellow, very nutritious breastmilk) until about 6 weeks postpartum when transitional milk becomes mature milk (often whiter and more abundant breastmilk). If baby is unable to latch or is not nursing effectively, it is imperative that mom begin pumping with a high quality, hospital grade breast pump.  Studies show that 120 minutes/24 hours of good quality nipple/breast stimulation is needed to bring in and maintain a full milk supply. A full milk supply (after about 6 weeks postpartum) is between 750ml and 1035ml. 

Newborns nurse often!  We often hear that babies should nurse at least 8-12 times in 24 hours, but it is also normal for them to nurse even more.  If your newborn is producing 6-8 wet diapers in 24 hours and 3-4 dirty diapers in 24 hours, along with maintaining appropriate growth, then breastfeeding is likely going well! Remember, painful latching is a sign that something isn’t quite right even if baby is gaining weight well.   

If nursing is going well, there is no need to pump right away!  Many moms stress over when to add in pumping once they bring baby home.  In general, if nursing is going well, there is no need to add in pumping until around 4-6 weeks postpartum.  Pumping and nursing can lead to an oversupply of milk, and in-turn, increased risk of clogged ducts and mastitis.  However, many moms choose to introduce pumping as they anticipate returning to work soon after delivery.  If your baby requires a supplement, or if you are pumping milk for bottle feeding, Paced Bottle Feeding is key!  Check out this great demonstration for tips on avoiding overfeeding and helping baby transition from breast to bottle and back: https://www.youtube.com/watch?v=2K3O3grKusA 

Confidence is key!  Moms and babies are made to breastfeed!  If you are struggling with breastfeeding (pumping is breastfeeding too) or just need reassurance that things are going well, don’t hesitate to reach to an IBCLC for help!  Our IBCLCs are available to support you as well.  Email us at ibclc@spectrababyusa.com or set up a virtual consultation at www.spectrababyusa.com/lactationservices .   

 

Sources: 

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 

Nursing Positions To Try With Your Newborn

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Melissa Portunato MPH, IBCLC, RLC

Mothers and babies learn to breastfeed by breastfeeding. Exploring different nursing positions can help lessen nipple pain, improve milk transfer and allow you to get more rest. Read on to discover some of our favorite breastfeeding holds to try with your new baby. 

First things first, start every feeding with skin to skin. Remove all pillows, blankets, and comforters nearby; this can make latching more cumbersome and difficult. Baby should only have a diaper and bare chest for the parent. Skin to skin helps engage baby’s inborn feeding behaviors and reflexes while contributing to a powerful hormone feedback system between mom and baby. Skin to skin is powerful! 

Laid – back
Breastfeeding in a reclining or laid-back position relaxes and stimulates reflexes in both mother and baby. Research shows mothers and babies have innate physical responses that are triggered with laid-back breastfeeding. Interestingly, mothers were found to stroke their baby’s feet at just the right time during latching and feeding, which triggers the release of the lip and tongue for a deeper, more nutritive latch. Babies feed using their whole bodies, not just their heads and mouth. Your nurs-ling is looking for a place to anchor their chin, push with their toes, and feel the warmth of their natural environment – mommy’s chest! 

Side-lying 
Mastering the Side-Lying Breastfeeding position can help you recover from a difficult labor or cesarean delivery and can naturally improve blood circulation as you recover from childbirth. Start lying down side by side with your baby. You should be facing each other – belly to belly. Your baby’s mouth should be even with your nipple. Next, lift your arm under your head and, with your other arm, cradle your baby on the back of the neck to assist them to the breast if needed. Cradling your baby with the opposite arm can keep your newborn close, preventing turning and unlatching from the breast. Baby’s arm should always be hugging the breast. 

Football 
Cradle your baby by supporting the back of the neck with the same arm you will be latching to the breast. With the opposite hand, lift your breast to aim your nipple above the baby’s nose. Wait for your baby to “gape” or open wide and quickly bring your baby towards you. Pillows should be used only to support YOUR arms and back, not the baby. 

Koala
Feeding your newborn in an upright position can lessen reflux and manage an overactive or forceful letdown. Sometimes called the koala hold, your newborn will latch to your breast, sitting up while straddled on your thigh or knee. Baby’s spine and head should remain upright throughout the feeding. With proper support, this position can easily be done with newborns and can be a convenient way to nurse older babies too! 

Practice these four simple to-do nursing positions that will ensure your baby is growing and thriving from your super milk. Remember that breastfeeding doesn’t have to be “all or nothing.” No matter if you are nursing at the breast, exclusively pumping or supplementing with formula – it’s still breastfeeding! We’re here to support you and offer any help we can as you navigate your breastfeeding journey. 

Email us at ibclc@spectrababyusa.com or set up a free consultation with one of our IBCLCs at www.spectrababyusa.com/lactationservices. 

 

Sources

Milinco, M., Travan, L., Cattaneo, A. et al. Effectiveness of biological nurturing on early breastfeeding problems: a randomized controlled trial. Int Breastfeed J 15, 21 (2020). https://doi.org/10.1186/s13006-020-00261-4

Positioning. La Leche League International. (2020, August 6). https://www.llli.org/breastfeeding-info/positioning/. 

Unboxing the S1 and S2

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With so many breast pump options, it can be overwhelming to make a final choice to meet your specific breastfeeding needs. Before you decide on the perfect breast pump for you and your baby, you’ll need to consider a couple of factors like where and how often you will be pumping. No matter your breastfeeding journey, all Spectra baby USA Electric Breast Pumps offer high quality and amazing comfort. Read on to learn more about Spectra’s most popular breast pumps, the S1/S2 Plus! 

Spectra S2 Plus Electric Breast Pump

The Spectra S2 Plus is a hospital-strength, closed system pump that allows for single or double pumping. With a suction strength of 270mmHg, it has 12 adjustable expression vacuum levels and 5 cycle speed settings. Massage Mode is also customizable with up to 5 levels of vacuum suction to help effectively elicit let-down. The S2 Plus is the perfect pump for moms who regularly express their milk or exclusively pump.  The multi-phase “suckle” makes pumping with the S2 feel comfortable and stimulates a more natural milk flow. The Spectra S2 Plus is a top choice for many breastfeeding moms and is covered by most health insurance plans. 

The Spectra S2  Plus Features include: 

  • Closed Pumping System with Backflow Protection
  • Single or Double Pump capability
  • Customizable Dual-Phase Settings with Adjustable Suction 
  • Hospital Strength at 270 mmHg
  • Weighs 2.5 lbs
  • Soothing 2 level illumination light 
  • Touch screen LCD with timer control 
  • ( 2 ) Years Warranty

Spectra S1 Plus Electric Breast Pump 

A favorite among exclusive pumping moms, the Spectra S1 Plus includes all the features and functions of the S2 Plus in addition to a rechargeable battery!  The freedom of outlet-free pumping is often offered with a reasonable upgrade charge through health insurance plans.  Countless moms have reported the additional cost of the S1 as being “worth every penny!”  It’s no doubt that the 3-hour battery life delivers convenience that can make a pumping mom’s life easier, and when you’re already juggling a thousand things, convenience really does matter. Unplugging this pump doesn’t compromise suction like some other battery-powered pumps. You still get up to 270mmHg of suction, whether plugged or unplugged! If you want a portable and discreet pumping experience anywhere, the Spectra S1 Plus is the way to go! 

The Spectra S1 Plus Features include: 

  • Closed Pumping System with Backflow Protection
  • Single or Double Pump capability
  • Customizable Dual-Phase Settings with Adjustable Suction 
  • Hospital Strength 270 mmHg
  • Weighs 3 lbs
  • Soothing 2 level illumination light 
  • Touch screen LCD with timer control 
  • Rechargeable 3-hour battery life
  • ( 2 ) Years Warranty 

The Spectra S1 / S2 Plus Electric Breast Pump BPA Free Accessories:

  • Two (2) 24mm Spectra Breast Flanges
  • Two (2) 28mm Spectra Breast Flanges
  • Two (2) Spectra Tubing
  • Two (2) Spectra Duckbill Valves
  • Two (2) Spectra Backflow Protectors. Includes silicone membrane, uppercase, and lowercase for each Backflow Protector
  • Two (2) Spectra Wide Neck Storage Bottles. Includes nipple, cap, disc, and lid for each bottle
  • One (1) Spectra 12-Volt AC Power Adapter 

Does your health insurance plan cover a Spectra pump? Learn more here. Can’t decide on which Spectra Breast Pump is right for you? Schedule a complimentary virtual consultation with one of our International Board Certified Lactation Consultants today! We’re here for you and we support you! 

Milk Supply: What’s Normal?

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By Jacque Ordner BSN, RN, IBCLC, RLC 

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. 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. 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 

 

All About the Synergy Gold (SG)

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The Spectra Synergy Gold Dual Electric Breast Pump is a game-changer in the pumping world! The SG dual-motor advanced technology promotes more productive pumping sessions that can save time with comfort and ease. Double the motors mean more customizable features and pumping options. The Spectra Synergy Gold has 15 vacuum levels on expression mode and 5 on massage mode that can be independently adjusted at 0-270mmHg per breast. With so many variations to choose from, this pump has something for everyone – part-time and exclusive pumpers alike. Benefits to having a breast pump with dual motors includes increasing milk supply on lower producing breast, treating and preventing clogged ducts, and creating a healthy milk supply for premature infants. The Spectra Synergy Gold Dual Breast Pump maintains the same high standards as other Spectra models with its trusted closed system and 2-year warranty. 

Unique features of the Spectra Synergy:

  • First of its type in the USA
  • Newest technology, dual independent motors, hospital strength (270+) per breast 
  • Spectra true closed pumping system
  • All current model Spectra accessories are compatible, including CaraCups
  • 15 vacuum settings and 5 cycles for expression
  • 5 vacuum settings and 5 cycles for massage mode
  • Vacuum levels adjustable on each side
  • Quiet and discreet with mute button option
  • 3 level soothing nightlight feature
  • Comfortable carrying back handle 

No matter which Spectra breast pump you choose, flange size, settings, pumping environment and several other factors can make a huge difference in your pumping experience.  Our specially trained International Board Certified Lactation Consultants can optimize pumping!  Schedule your complimentary consultation today or email us at ibclc@spectrababyusa.com for more help. 

 

Storing Breastmilk: Tips and Guidelines

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Melissa Portunato MPH, IBCLC, RLC

Every breastfeeding journey is special and filled with love. For you, it might include occasional pumping or only pumping when at work. Others choose to exclusively express breastmilk around the clock. It’s all breastfeeding! No matter how often you express your milk, you always want to ensure your liquid gold is handled with care and stored properly. Following proper milk storage guidelines will guarantee your breastmilk continues to support your baby’s health, growth and development. 

Read below frequently asked questions, tips and guidelines on breast milk storage. 

Breastmilk Storage Guidelines
How long is breast milk really good for? Remember the RULE of 4! According to the CDC, breastmilk is optimal for 4 hours at room temp, 4 days in the fridge, and 4-6 months in the freezer. If you will be freezing your breastmilk, it’s best to freeze it right away. Refrigerated breast milk can be frozen within 4 days of expression. 

Keep your breast milk cool when a refrigerator is not available. Transport refrigerated/frozen milk by placing breastmilk in an insulated bag or cooler with a frozen cold pack. Milk should be refrigerated or frozen within 24 hours. 

Proper Storage Containers 
Breastmilk should be stored in clean food-grade containers such as BPA-free plastic, glass, or silicone as well as disposable milk storage bags. Never use regular disposable kitchen bags or plastic inserts made for bottle feeding because freezing may cause these to leak and break down. 

Looking for a quick and effective way to pump, store and feed your baby? Check out the new Spectra Simple Storage Kit! Keep your milk clean, safe, and always ready to use with this new line of Spectra Baby USA products that lets you pump, store, and feed all from the same bag. This innovative storage solution also features a temperature sensor to ensure that breastmilk is just the right temperature for feeding. 

Fresh or Frozen? What’s Best?
All breastmilk is best! Fresh breastmilk contains the highest concentration of anti-infective properties, next in line refrigerated milk and then frozen milk. Give your baby freshly pumped milk whenever available. Fresh, frozen, and refrigerated milk can be combined. It’s best to mix breast milk at the same temperature to keep the immunological properties intact. 

Breastmilk should never be microwaved because it can heat unevenly and hurt your baby. In addition, microwaving can destroy valuable bioactive components found only in human milk. Gentle thawing of breast milk is best to preserve the quality. Thawing can be done in the refrigerator overnight or placed in a bowl of warm water. 

The Pitcher Method
The Pitcher Method is a popular method of collecting pumped milk from several pumping sessions throughout the day into one container and then using that milk to prepare the next day’s bottles. So easy to do, The Pitcher Method can save space and valuable time for breastfeeding families! 

Learn more about The Pitcher Method here. 

Cleaning Pump Parts
It’s recommended that you wash all your pumping parts (except tubing) after every use in a designated basin with warm soapy water. The CDC recommends, sanitizing parts once daily for extra germ removal. If you know you won’t have access to a sink, bring enough sets of pump parts to get you through the day. Placing pumping parts in the refrigerator in between uses is not recommended. 

Expert Tips

✔ Remember to start every pumping session by washing your hands for 20 seconds. 

✔ Store breastmilk in 2-4 ounce increments to prevent milk from being wasted. 

✔ If using breastmilk storage bags, squeeze the air from the top before sealing tightly.

✔ Freeze breastmilk bags flat to save space.

✔ Once frozen breastmilk is defrosted, it’s good to use within 24 hours and shouldn’t be refrozen. 

✔ Use leftover breastmilk from a feeding within 2 hours of finishing. 

✔ Warm breastmilk first, then gently shake. This technique will mix the fat which may have separated. 

✔ Breastmilk can be given cool, warm or room temp to healthy full term babies. 

For more information on breastmilk storage and preparation, download a printable sheet here to share with your family and caregivers.

Do you have a question about breastmilk storage? Email us at IBCLC@spectrababyusa.com! Our International Board Certified Lactation Consultants are happy to assist you along your breastfeeding journey. 

Sources:

Proper Storage and Preparation of Breast Milk. (2020, January 22). Center For Disease Control. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm

Heating Human Milk. La Leche League International. (2020, August 6). https://www.llli.org/breastfeeding-info/heating-human-milk/. 

 

 

Do I Have Elastic Nipples?

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Do I Have Elastic Nipples

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! 

 

 

Getting Started with my Spectra Breast Pump

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Melissa Portunato MPH, IBCLC, RLC

The first few weeks after your baby finally arrives is the time to soak in those yummy newborn snuggles. You shouldn’t have to worry about pumping just yet. But when you are ready, you might pump for reasons like going back to work, a weekend get-a-away, low milk supply, special circumstances with baby, or simply “my nipples just really need a break.”  It’s best to wait until 4 to 6 weeks postpartum to start pumping. However, pumping can be a lifesaver when you want a freezer stash of milk for returning to work or important “mommy time” away from baby!  Depending on your personal needs, you might need to pump occasionally or around the clock. Regardless of your reasons, one thing is for sure: pumping will allow your baby to continue receiving all those valuable immunological benefits that breast milk provides. 

Below are 5 facts to help you get started with your Spectra breast pump! 

1.Choosing the right breast pump and flange size

There are a few basic types of pumps: manual pumps, battery-operated pumps, and electrical pumps. Each of these pumps extracts milk by providing a seal around your nipple and areola while it applies and releases suction as baby would do at the breast. Suction strength and cycle speed will vary depending on the type of breast pump and whether you are single pumping (one breast) or double pumping (both breasts at once). If you are returning to work or exclusively pumping, a double electric breast pump will yield the best results. You can learn more about finding the perfect Spectra Baby USA hospital strength breast pump here. 

Finding the right size flange is an important part of the pumping process.  A flange that doesn’t fit properly could leave you with nipple pain, redness, and full breasts. Yikes!  No worries, it’s easy to measure your nipples using this breast shield guide that you can print out. This will save you time and stress with wondering whether or not you have the correct flange fit. 

2. When should I start pumping? 

If baby is growing well and has unlimited access to the breast, there is no need to start pumping right away. Pumping can add another layer to your busy day, and if breastfeeding is going well, no need to hook up the pump just yet. Waiting 6-8 weeks is best. You could even start sooner if you are returning to work around 4 weeks after birth, but keep in mind the very early weeks are for establishing your milk supply, bonding and nursing, not pumping. These guidelines are for healthy full-term infants. There are instances where pumping will be necessary right from the start, like with preterm infants or when medical conditions have been presented. 

Start with pumping once a day at first and then gradually increase sessions according to your breastfeeding goals. Starting with a pumping session about 30 min after an early morning nursing session is a great time! If you are returning to work, you will have plenty of time to build a nice freezer stash for when you are away. Moms are often surprised at how much milk they can store in just a few short weeks! 

3. Now, Let’s Get Pumping! 

Wash your hands with warm soapy water, gather your pump and accessories, and find a comfy place to relax. Don’t watch the collection bottles slowly fill up drop by drop! Instead, watch a video of your baby or listen to music! This can help you feel more at ease and allow your milk to start flowing freely. Research shows moms can yield about double the amount of 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. It’s recommended to pump for a total of 15-20 min.

Try these settings:

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

4. How much milk should I be pumping?

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

5. Clean. Store. Prepare.

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 baby by adhering to the CDC guidelines for storing and preparing expressed breast milk. 

Between breastfeeding, changing diapers, building baby gear, and managing all the visitors wanting to get a glimpse of your fresh bundle of joy (but seriously have a plan in place on handling visitors), you will have a full plate. Pumping really doesn’t have to be an additional item on your to-do list. During those sacred early weeks, concentrate on skin-to-skin and directly feeding your baby at the breast as much as possible.

Have more questions on how to get started with your Spectra Baby USA breast pump? Schedule a complimentary consultation with us here. 

We’re here for you and we support you!

HypnoBirthing for Childbirth, Breastfeeding & Beyond

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By Patty M. Castellanos, LMHC, CHT, HBCE

You’ve heard the stories from your mother, sister, friend, or even that mom you don’t know, but she’s in a Facebook group you’re a part of. You’ve seen the movies; Hollywood loves dramatic birth scenes. Your provider may have even talked to you about what birth is like. Perhaps you have even had a birth experience yourself, which left you wondering if pregnancy and birthing could be different.

Mothers have been conditioned to believe that excruciating pain is associated with labor, and because of this, women often hold a deeply rooted fear of giving birth. This intense fear may cause their bodies to become tense, and that tension prohibits their bodies from quickly allowing the body to function as it is intended to. This leads to what many fear most – long, painful birthing, unnecessary interventions, and feelings of failure or inadequacy.

I became a HypnoBirthing educator after experiencing an empowering birth experience with my daughter, as a  Vaginal Birth After a Cesarean. This led me to believe that our bodies were designed to release, heal, relax, focus, surrender, and trust that my baby and body work together in harmony for birth.

HypnoBirthing is a childbirth education method that emphasizes the use of self-hypnosis,  guided imagery, and relaxation techniques to reduce fear, anxiety, and childbirth discomfort. HypnoBirthing is a method for all mothers and birthing couples, those seeking the calm confidence to give birth as calmly, safely, and gently as possible, in a hospital, a birthing center, or at home. This method is beneficial for mothers seeking natural unmedicated birth, medicated birth, cesarean section birth, or elective or non-elective. Mothers of all walks of life, birthing alone or with a birth companion, benefit from dispelling deeply rooted myths of birthing and discovering that they are capable of giving birth in a very different and empowered way. From healthy, low-risk women to women who need medical assistance or interventions due to particular circumstances, they learn to eliminate the fear-based stories, myths, and the words of well-intentioned people, and they are guided to see birth as normal, learn to trust that their bodies how to birth in a calm and gentle way.

 So now you may be wondering what this really looks like in practice:

 ✔ Confidence-building classes are hosted in a series of five, 2.5-hour classes, once a week, providing a thorough yet simple to follow program of guided relaxations, hypnosis, and education.

 ✔ The five-week series includes a HypnoBirthing® the Marie Mongan Method book, Spiral Workbook, Relaxation Audios, and everything you need to know to create an amazing birthing experience.

✔  When giving birth with HypnoBirthing, just as with the practice, a mother is not in a trance or asleep but instead in a state of deep focused relaxation—awake, aware, and fully in control, as she impacts her subconscious mind towards release and trust.

 ✔  Mothers and birth companions learn through a process of special breathing, relaxation, visualization, deep intentional bonding practice, attention to nutrition, and positive body awareness. Through this, it encourages communication, mutual respect, and understanding for the mother, the birthing family, and the care provider. This, in turn, allows the mother to remain in complete trust and confidence.

✔  Mothers and the birth companion are encouraged to bond with their babies. For some, this time is the first time in their pregnancy that they deeply connect and communicate with their baby and a team.

 ✔ Mothers learn what makes labor hurt, or what’s called the cycle of Fear-Pain-Tension, but more importantly, they learn the reasons behind why labor doesn’t have to hurt and what they can do about it.

 ✔ Mothers and their birth companions learn how past learning, programming, fear, and anxiety affect their mindset and how it affects the body’s physical and chemical processes. In other words, we break down the fight, flight, or freeze response and replace it with calm, confident relaxation.

✔ The HypnoBirthing techniques are practiced in class. Then they continue the practice in what I call the white space of change between classes, where the deep transformation and mindset shifts occur. As they listen to the Affirmations and Relaxations, their subconscious mind shifts limiting beliefs or negative thinking to thinking that is calm, confident, and surrendering to the breath and purpose of birth.

This mindset and practice extends to breastfeeding and the bond of a mother and child through their feeding relationship. Mothers receive basic breastfeeding education and are guided to understand how relaxation supports milk production and a mother’s bond to her baby using the same calm breathing exercises they learned for birthing combined with Breastfeeding Affirmations.

The overall effect of practicing the HypnoBirthing techniques is that the birthing mother and others supporting her can better appreciate the benefits of calm, gentle birthing, clear open communication, and instinctive bonding. HypnoBirthing can make the childbirth experience a more trusting, relaxed, and joyful one for mother, baby, and others involved—benefits that can last a lifetime. 

You are Greater than your Story…

Connect with Patty at www.theexpressioncenter.com to inquire about HypnoBirthing virtual classes and to learn more on how this affirming relaxation technique can support your individual goals for birth and journey through motherhood. 

Source:

Victoria J. Madden, BSc, Daniel S. Harvie, PhD, Romy Parker, PhD, Karin B. Jensen, PhD, Johan W.S. Vlaeyen, PhD, G. Lorimer Moseley, PhD, Tasha R. Stanton, PhD, Can Pain or Hyperalgesia Be a Classically Conditioned Response in Humans? A Systematic Review and Meta-Analysis, Pain Medicine, Volume 17, Issue 6, June 2016, Pages 1094–1111, https://doi.org/10.1093/pm/pnv044

Hands on Pumping

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Melissa Portunato MPH, IBCLC, RLC

“Hands on Pumping” is a technique that uses breast massage to drain the breast better and stimulate healthy milk production. 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! Benefits of Hands on Pumping is higher milk volumes, increased fat content, less time pumping, preventing and treating clogged ducts. Every breastfeeding mom should use Hands on Pumping because it’s simple to do and maximizes pumping sessions!

Check out this easy to follow routine to get started with Hands on Pumping:

Step 1
Start with hand massage and expression! Use two fingers to gently massage around each breast in a circular motion for 3-5 min. This will begin to stimulate your first letdown.

Step 2
Wear a hands-free bra and double breast pump for 15 – 20 minutes. As you’re pumping, apply pressure on both breasts. Position your hands above the flanges. Move your hands around the breast throughout your pumping session, concentrating on areas that feel full. Cup your hands and apply pressure under the breast and on the sides of your breasts with the traditional “C” hold.

Step 3
Finish with hand expression or single pumping for 3-5 minutes on each breast.

Spectra IBCLC Bonus Tip – Start with the letdown mode (three-wave button) for 5 min. When milk slows down, press the three-wave button and switch to the expression mode—swapping modes when milk flow decreases is called Cycle Pumping. These settings closely mimic a newborn’s feeding pattern and can be an effective tool to make pumping more productive. Keep suction set to your comfort level. Higher suction DOES NOT mean more milk!

Instead of only relying on the pump for milk removal, use your hands in combination for more productive pumping sessions! To learn more, check out these videos on Hands on Pumping. Watch it while pumping for the best results! 

Hands on Pumping: https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html

Hand Expression: https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html

Source

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

Top Breastfeeding Challenges and How to Overcome Them

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By Melissa Portunato MPH, IBCLC, RLC

You had envisioned yourself latching your beautiful new baby to your breast, and it would instantly be magical. Pure bliss! But breastfeeding didn’t come as easy as you thought it would, and it feels far from magical. Instead, you feel frustrated, disappointed, and feel like giving up. The truth is, for most of us, breastfeeding is not what we thought it would be like at all. Just like with anything worthwhile in life, breastfeeding takes hard work and commitment. Let us help you get past those pesky common challenges so you can begin to truly bond with your baby.

Here are the Top 10 most common breastfeeding challenges and solutions to get you through those tough times and into a happy place with breastfeeding. 

#1 Painful Latch

Every time you know feeding time is coming around, your toes curl, and you start to get major anxiety because it hurts to latch your baby to your breast! Most likely, it’s because your nipple is rubbing on the roof of your baby’s mouth, causing discomfort. So how can you work on perfecting the latch to get rid of this dreadful feeling? Adjust your body, adjust your baby, and adjust your breast to what feels comfortable and relieves tension. Do this by practicing  “natural breastfeeding,” or also called “laid-back breastfeeding.” If you are using a traditional hold like the cradle or football hold, start the feeding with your nipple above baby’s nose, wait for baby to open wide, and then bring baby quickly (chin first) towards you. This technique can help aim your nipple deeper into your baby’s mouth. When done correctly, you should instantly feel a difference. Phew!

#2 Sleepy Baby at Breast

You changed baby’s diaper, tickled their toes, got them all undressed, and still can’t seem to wake baby from dreamland. A newborn baby should be nursing a minimum of 8 to 12 times per day. If baby is still not at their birth weight, they most definitely need to be woken up to feed throughout the night. For the first six weeks, try NOT to swaddle baby or offer a pacifier. This can interfere with nursing cues and cause baby to feel full and cozy and not want to nurse. Hand express for a few minutes before offering the breast to soften the breast, allowing for baby to latch easier. Sometimes, just a few drops of breastmilk on a sleepy baby’s lips will get them to want to nurse. Use breast compressions while you nurse. This can help keep your baby stay awake because of the steady flow of milk.

If your chubster is already back up at their birth weight, talk to your pediatrician. It’s most likely OK to hit the snooze button on that alarm. Finally rest!

#3 Cluster Feeding 

You feel your baby is practically attached to you morning, noon, and night. You can’t catch a break and you’re tapped out! Cluster feeding is when baby bunches nursing sessions close together about every 45-60 minutes. This feeding pattern is typical for young babies and coincides with growth development, but cluster feeding can be exhausting. Wearing your baby in a wrap or sling will allow you to be hands-free and get work done around the house or on the go! Check out more tips on our baby-wearing blog post here. 

We promise, there is hope! These marathon feedings will increase your milk supply and are typically followed by long sleeping stretches for baby. Sit back, relax, and scroll through your favorite newsfeed. Sleep is on the horizon. 

#4 Baby Refusing the Breast

If your baby was nursing and suddenly refuses the breast, you could be experiencing a nursing strike. Nursing strikes will typically last from just a few short days to over a week. They can be caused by various factors like an illness, teething, significant changes in routine, or long periods of separation from your baby.

Take it back to the basics! Dim the lights and do skin to skin with baby on your bare chest with only a diaper. Offer the breast frequently but, don’t ever force baby! It should be a gentle “wooing” back. You can even have baby gently wake up next to your bare breast. Often, babies will be more willing to nurse when just waking up. Limit bottles as much as possible and offer the breast first. Don’t wait until baby is too hungry. Try to have someone else give the bottle besides mommy.

#5 Sore Nipples

Your nipple is elastic, and as it begins to stretch, you can experience soreness. Soreness in the first few weeks is normal but should subside after about two weeks. Continued soreness, pain, cracking, and bleeding are not normal. It’s best to work closely with an International Board Certified Lactation Consultant to ensure baby is latched on properly. The best way to treat sore nipples is with your very own breast milk! Yep, pretty incredible, huh? Studies show the antibacterial properties in breastmilk make it the perfect substance to heal nipples and keep them healthy. Hand express breast milk on your nipples after every feeding and apply a cool hydrogel. Make sure you are changing your breast pads frequently. This will help prevent any infection and allow your nipples to heal faster. Your nipples will be feeling better in no time! 

#6 Engorgement

It’s been a few days, and your milk has officially made its grand entrance. HELLO! Engorgement can make it difficult for baby to latch. To help, you can apply a warm cloth and softly massage your breasts a few minutes before nursing. It’s crucial during this time to nurse frequently! Offer the breast often and use Reverse Pressure Softening, a technique that moves swelling upward and into the breast, providing relief from engorgement. If after nursing or pumping you still feel engorged, fill up a large basin with warm water and lean over it to let gravity naturally drain any excess milk from your breasts. After you’re done, you can ice or use a cold compress for 10 min to help bring down any swelling.

Call your healthcare practitioner if you have redness on your breasts; they feel hot to the touch; you have a fever or chills because it could sign an infection.

#7 Clogged Ducts

Ouch! Clogged ducts can be extremely painful but completely treatable. How did you even get them in the first place? A blocked duct can be caused by various reasons, from prolonged time without milk removal, shallow latch, restrictive clothing, or even stress. The fastest way to treat clogged ducts is by frequently nursing or pumping. Try nursing in the “dangling feed” position or “dangle pumping.” Practice massaging your breasts while nursing or pumping, no matter what position you use each time. You want to start massaging above where you feel the clog and gently move towards the nipple. You can use a warm compress before you nurse or pump to help with milk removal.

Alternate heat and cold on the area affected. If you find you have a milk blister or bleb, avoid trying to squeeze because it can make things worse. The milk blister or bleb will naturally draw out as the clog subsides.

The most important thing to remember with clogged ducts is that they should progressively get better, not worse. Most clogged ducts subside within 48 hours. If pain continues or other symptoms appear, give your doctor a call.

#8 Tongue Tie

You’ve spent countless hours looking under your baby’s tongue and upper lip, comparing it to pictures you found on the internet to try and assess. A tongue-tie is when the connective tissue under your baby’s tongue is too tight, too thick, or both. A tongue-tie is commonly accompanied by a lip tie – the upper lip tissue connecting to the gum can be tight or too thick. Both tongue and lip ties can restrict mobility in oral function, causing issues with breastfeeding.

Unfortunately, ties often go undiagnosed. Signs of a tongue or lip tie can include loud clicking when baby is nursing, baby is not gaining weight, has reflux, or you continue to experience nipple soreness. A specialist such as an International Board Certified Lactation Consultant or a Pediatric Dentist can evaluate your baby and provide effective treatment to ensure the breastfeeding relationship can continue. 

#9 Thrush

Stabbing nipple pain, itchiness, and shiny or flaky skin on the nipple or areola can all be signs of thrush. Thrush is a common fungal infection caused by the overgrowth of yeast or “candida.” Candida can be found in its natural environment pretty much all over the human body, but when it starts to multiply, it can cause an infection. Thrush can be a side effect of antibiotics too!  Talk to your doctor if you are experiencing any of the above symptoms and suspect you have thrush. Both you and the baby will need to be treated. Ask about starting probiotics for the both of you, which can help replenish the healthy bacteria in the gut for a quicker recovery and, most importantly, prevent thrush from recurring. 

Rinsing your nipples with a vinegar and water solution (1 tablespoon apple cider vinegar preferred to 1 cup water) or baking soda in water (1 tablespoon per cup) can help stop the spread. Use a fresh cotton ball for each application and mix a new solution every day. Limiting sugar can also help! Make sure you wash and sanitize your pumping parts after every use. 

#10 Mastitis

Last but not least, you think you might have the most dreaded condition in the whole breastfeeding universe; Mastitis. Mastitis is an inflammation of the breast tissue. Symptoms of mastitis include redness of the breast, hard lumps, hot to the touch, and feeling like you’re catching a nasty flu bug. If symptoms persist or get worse after a few days, call your doctor to ensure infection is not brewing. 

There are many causes of mastitis, including lack of breastmilk removal, worsening clogged ducts, change in breastfeeding patterns, and even a tight bra! It’s essential to continue to breastfeed during this time and keep your milk flowing. Make sure you REST and get plenty of fluids, as this often can occur due to a suppressed immune system. You need to take care of yourself so that you can take care of your little one!

Tips for relief are the same as when treating a clogged duct. See tip #7.

If you are experiencing any one of these common breastfeeding issues and still can’t seem to find relief, trust your mommy instincts and seek professional help from an International Board Certified Lactation Consultant. Never quit on your worst day! Always remember why you wanted to breastfeed in the first place. Surrounding yourself with breastfeeding support will make a world of difference. Join our online community on Facebook and connect yourself with other moms who will meet you exactly where you are on your breastfeeding journey. You’re not alone in your struggles, and you’re doing the very best you can!

 

Sources:

Colson, S. D., Meek, J. H., & Hawdon, J. M. (2008). Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Human Development, 84(7), 441-449.

Newman, J., & Newman, J. (n.d.). Are you worried your baby’s not getting enough breastmilk? International BreastFeeding Centre. https://ibconline.ca/breastcompression/. 

Thrush. La Leche League International. (2020, August 6). https://www.llli.org/breastfeeding-info/thrush/#:~:text=Rinsing%20your%20nipples%20with%20a,Wash%20your%20hands%20thoroughly. 

 

 

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