Written by: Nikki G. and Nikki K. from Nikki and Nikki IBCLC.
It’s been on your mind for a while. You had an amazing breastfeeding experience. It wasn’t without its challenges, but you made it work for 2.5 years. You became known in your parenting circle as “the one that could”. You assumed the role of cheerleader for your friends, family, and co-workers. You felt somewhat qualified to help with the small things since you personally experienced it all: mastitis, low milk supply, slacker boob, and the infamous “itchy-nipple-I-think-it’s-yeast-but-who-knows”.
This narrative sounds familiar. We’ve heard a similar rendition in over 50% of the bios that we’ve read about our colleagues. Lactation consultants are so multi-dimensional and versatile. We come from all corners of the world and represent so many amazing journeys, yet many of our stories began the same. Maybe you were the one with the awful experience who is set on
changing the course for others. Whatever the journey that led you here, now you‘ve fallen in love with lactation and need to know how to tap into this world. We can help.
The lactation profession was founded on peer support. Ask anyone who has survived the IBCLC exam and they will tell you that the work begins and ends with support. Can you help your peers? Can you support another parent in your family or your community? You don’t have to go it alone. There are peer support organizations helping new parents all over the world. Maybe you’ve heard of La Leche League, Breastfeeding USA, or Chocolate Milk Cafe? Getting plugged into a local support organization may be the perfect toe into the field. You can get a sense of what you love about it while learning counseling skills and maybe even earning clinical hours for your IBCLC exam prerequisites.
Looking to make lactation support your profession? There are many different lactation support certifications that will allow you to earn an income from helping families. Certified Lactation Counselor, Certified Breastfeeding Specialist, and Certified Lactation Specialist are just a few options of the certifications that you can turn into extra pocket change or a steady income. If you are looking for a culturally-focused course check out the B.L.A.C.K. Course and Indigenous Lactation Counselor training. The courses are generally around 50 hours long and vary in format (online vs in person). In the end, learners should have a strong command of how to support families through common breast or chestfeeding challenges, and can even teach classes in their community. Some find employment in physicians’ offices or hospitals providing support to new parents, while others open private practices.
The lengthiest and most intense credential to pursue by far is International Board Certified Lactation Consultant (IBCLC). It is the most clinical in nature and involves managing common challenges to complex feeding issues well outside the scope of common. This certification is one that many use for a career in lactation support – either as a stand-alone credential or as a supplement to other related licenses and certifications. The prerequisites to IBCLC can take years to complete, and include 14 post-secondary courses in general sciences and other healthcare-specific topics, 95 hours of lactation education, and hundreds of hours of clinical hours spent supporting families.
No matter your end goal, there is an opportunity in lactation support for you! There will always be parents in need of your help, and ways to jump in to support. We recommend taking your time learning more about the options by getting plugged into the lactation support community around you and online. You’ll be happy to find “your people” as many are in your very same stage of exploration and ready to dip their toes into the waters of lactation support. You’ve got this!
By Jacquelyn Ordner BSN, RN, IBCLC, RLC
I had met my breastfeeding goals with three out of my four children, with the fourth still nursing once or twice a day. Number four was about 2.5 years old and had decided he only needed “milkies” at naptime and bedtime. I was comfortable with this, and we were moving through this transition happily. But, when my husband and I decided we were going to adopt, my thoughts around weaning began to change. What if my next child needs my milk too?
As we completed the international adoption application process and began the home study process, we really began to think about the little person who would be joining our family. We had told the agency that we’re open to parenting a child with significant medical needs. Our child could need a myriad of medical interventions, and I immediately began thinking that I needed to store breastmilk to help support him or her. I’m an RN and IBCLC, so that’s just how my mind works. I KNOW that just 15 ounces of breastmilk can provide up to:
29% of a toddler’s energy requirements
43% of their protein requirements
36% of their calcium requirements
76% of their folate requirements
75% of their vitamin A requirements
94% of their vitamin B12 requirements
And 60% of their vitamin C requirements (Dewey 2001).
Breastmilk does not suddenly become non-nutritious or suddenly lose its bioactive and immune boosting components at a certain age! So, in the waiting and through the mountains and mountains of paperwork, I could be working toward making more milk to save for our fifth child!
I began with the basics…..pumping! In an effort to store every ounce, I gently encouraged our current youngest to cut back to nursing just once a day. This was easy at first, and he didn’t even seem to mind me pumping. I was double pumping with the Spectra S2 just 3-4 times a day to start. Let me tell you, this wasn’t very encouraging! I was only yielding a total of 1-1.5 oz per DAY! That’s when I hit the first major setback….my toddler became jealous of my pump! He cried when he saw me pumping and asked for “milkies” multiple times per day. I felt so conflicted at this point because my natural instinct was to scoop him up and provide that loving comfort as we had done thousands of times before. However, I also knew my goal was to collect and store as much milk as possible before we brought kiddo #5 home. Knowing that an effectively nursing baby (or toddler in my case) was far more efficient at stimulating milk production than my pump, I allowed him to nurse up to three times per day while I continued to pump 3-4 times per day.
We were hitting our stride, and my pumping output was SLOWLY increasing, when we had another setback. My work schedule changed, and this put stress on the whole family. My little guy had to start a new daycare during at this time as well. So, I took a break from pumping for a couple of weeks. I could kick myself for this now, but I can’t go back to change it. That two week break set me all the way back to the beginning. Still, once we found our new rhythm, I was determined to get my production up. I began faithfully pumping 5-6 times per day and VERY SLOWLY started to see an increase! Over the course of 4 weeks, my pumping output went from 1-1.5 oz per day to 3 oz per day in addition to the milk I was providing to my nursing toddler. Though my output is small, I’m confident that I can continue to increase my supply with dedicated pumping. Re-lactation takes time! If you are considering starting the re-lactation process, there are a few things to keep in mind:
- Milk supply is easier to influence in the first 4-6 weeks postpartum.
- The amount of time and pumping needed to re-lactate depends on many factors such as how long you were nursing or pumping before stopping, how long it has been since you stopped nursing or pumping, and how much milk you were producing at the time you stopped.
- Pumping alone can be an effective way to stimulate re-lactation. The use of galactagogues should only be done so with the help of a knowledgeable practitioner.
- An effectively nursing baby is the MOST efficient way to stimulate milk production. If your baby will latch, this is very helpful to the re-lactation process. The use of an at-breast-supplementer can be significantly helpful as well.
- The knowledge and expertise of an International Board Certified Lactation Consultant, who has experience with re-lactation, can be extremely beneficial for a mother who is pursuing this goal!
Dewey KG. Nutrition, Growth, and Complementary Feeding of the Breastfed Infant. Pediatric Clinics of North American. February 2001;48(1).
By Dr. Rachel Goldman Ph.D., FTOS, Licensed Psychologist
Self-care. We have all heard about it and we know we “should” do it, but do we? Self-care is a broad term that encompasses just about anything that we do to be good to ourselves; it’s about being kind to ourselves. It doesn’t need to be going to a 5-star resort or having a spa day, although wouldn’t that be nice? I am talking about something we do more regularly, something you can do on a daily basis that is for YOU. You are probably thinking, how is that possible when I am a mom, have a baby to take care of, need to pump/breastfeed, change diapers, and keep this little human alive, but it’s not only possible, but it is actually necessary. Think about the instructions flight attendants give on an airplane- we need to put our oxygen mask on before we put anyone else’s on. Think about your cell phone- we don’t let our cell phone batteries run low, but we instead keep an eye on it and charge it when needed. Self-care is about knowing when your resources are running low and taking a step back to replenish and recharge.
You may be thinking this is a bit selfish to put yourself first, and especially with a baby at home, but I call it a “healthy selfishness”. When it comes to our health and wellbeing we have to be a little selfish. A “healthy selfishness” is knowing what you need to do (within reason) and allowing yourself to do it. If you think about everything we do for survival, such as sleeping and eating, those are examples of behaviors associated with a “healthy selfishness”. We need to participate in these behaviors in order to survive. We also need to participate in other behaviors to be healthy, both physically and emotionally, such as taking time out of our day for us, for “me time,” and to relax or de-stress. For some that may be going on a run or going to the gym, for others that may mean a quiet and relaxing bath. Whatever it is, it is needed to allow you to de-stress, refocus and be able to be productive and accomplish what you need to accomplish, which includes being a mom and being emotionally and physically available to take care of your little one. Without some of these behaviors and acts of “healthy selfishness” we will eventually burn out and not be productive in any aspect of our life. We may even start to feel regret, sadness, and anger, which is not uncommon feelings during the postpartum time, especially since your life has just drastically changed by having a new baby. These feelings are also signs that it is time to take a step back and to do something about it. We need to monitor and check-in with ourselves in order to see what we need in order to function to the best that we can at that given time. Keep in mind, what we need today may be different than what we need tomorrow. This may also look very different for different people and can change with different life circumstances.
So now what? Here are some things to think about to help YOU find the time YOU need to be the best YOU.
- Make Yourself a Priority- think of the instructions regarding putting on an oxygen mask on an airplane. Decide that you deserve self-care.
- What does ‘Me Time’ mean to YOU? This could be just a few minutes to yourself or can be an activity that you enjoy, so you will actually do it. We tend to make excuses for things we don’t enjoy doing, so think about activities that do not cause stress, but rather relaxes and recharges you. Besides the gym and running, I have made pumping be part of my self-care routine. I have my husband give our baby a pumped bottle while I pump, so I have some quiet time to relax and destress. This is also helpful as stress can affect our milk supply, so having this quiet time has been useful and works for me.
- Use Relaxation Techniques – relaxation techniques, including meditation, massage, yoga, imagery, and breathing are very effective at decreasing stress levels and helping you relax. It can be useful to practice these techniques while you are pumping as well to ensure you are calm and not stressed.
- Schedule – make sure you set aside time each day just for you (‘Me Time’). Consider this time like an appointment that you wouldn’t miss. Since I pump a minimum of 2 times per day (first thing in the morning and before I go to bed), this is already scheduled for me. I do schedule additional ‘Me Time’ though, including exercise and physical activity.
- Create a Daily Routine – make it something you look forward to and will become part of your lifestyle. Your daily routine should also include what I call the key health behaviors (water intake, nutrition, physical activity, and sleep). AND these are also all key behaviors to helping your milk supply!
- Be Assertive and Ask for Help – don’t say yes to everything. Learn to say no or to delegate responsibilities. For instance, my husband gives the morning bottle while I pump. I had to ask him to do this, but when I asked him and explained to him how it would help me (which would also help our baby), he was willing to do it. You don’t know until you ask ☺
- Find Support – get support from your family, friends, and colleagues. Talk to them about your stress, your ‘Me Time,’ and your plan. Also, find people going through similar things and support each other.
- Seek Professional Help – if stress and anxiety is impacting your daily functioning and is getting in the way of you fulfilling your responsibilities, there is help. Increased stress for prolonged periods of time can be bad for your physical and mental health, but can also impact your milk supply, and those around you, including your little one.
To YOU, taking care of YOU, YOUR health, and YOUR pumping and breastfeeding journey!
Connect with Dr. Rachel at www.DrRachelNYC.com
By Trill Paullin, Ph.D.
Co-Founder, Free to Feed ∘ Military Veteran ∘ Breastfeeding Mother of 2
Many parents struggle in their breastfeeding journey. We know breast milk does an amazing option for our babies – yet the support and guidance are lacking significantly. Another huge issue is the amount of misinformation regarding breastfeeding and newborn babies.
Why does society make it even harder on families by sharing misinformation?
This is more prevalent when infant food allergies are involved. The journey of parenthood is hard enough. Throw in baby food reactivity and your world just turned upside down.
Below we’ll debunk common lies breastfeeding parents are told. We will flip the script to empower everyone through their breastfeeding journey!
1) MYTH: The Food You Eat Does Not Transfer to Your Breast Milk
FACT: Many scientific publications, dating back before the 70s, show that this is false. Maternal food proteins can and do transfer to breast milk. This myth leads to mothers assuming that it must be their breast milk eliciting a response and they unnecessarily stop nursing.
When we stop nursing it can interfere with breastmilk supply and the baby returning to the breast. Your baby is not allergic to your breast milk! Reactivity to breast milk is incredibly rare and caught at the hospital immediately after birth due to the mass amounts of complications it creates. Instead, your baby is reacting to a specific type or types of protein source that is transferring to your breast milk.
Click here for a link to view a list of publications showing that specific portions of what we eat CAN and DO transfer to our breast through the circulatory system!
2) MYTH: Ingested Food Proteins Stay in Your Breast Milk for Weeks
FACT: Research shows that a serving of peanut, cow’s milk, wheat, egg, and more all peak around 2-4 hours post-ingestion and steadily decrease after that. This results in breast milk that is typically clear of reactivity-inducing protein concentrations after 24 hours.
This myth leads to the end of breastfeeding for many because their milk will “poison” their baby for weeks and any accidental exposures are incredibly stressful. It’s hard to know what to do because even some medical providers recommend women to stop breastfeeding to “clear” their system of food proteins.
This means, those who want to continue breastfeeding their baby with food allergies switch to formula and continue to pump to not lose their supply. Talk about adding a lot more to the parent’s plate – and for no reason!
We believe in science-based facts and this myth honestly drives us crazy because we know the truth. This leads to unnecessary stress on families who are trying to help their babies.
3) MYTH: Colic is Normal in Breastfeeding Babies
FACT: While some crying is normal for infants, continuous crying is a red flag that there is often an underlying issue.
Colic is generally defined as crying for 3 or more hours per day, at least 3 days a week, for at least 3 weeks. Many parents are told colic improves around 3-4 months of age.
But we’re breaking out of that outdated theory. Because we believe you know if something is wrong with your baby!
There is no definitive answer for why colic occurs in some babies and not others but the top possible contributing factors include:
Lip or Tongue-tie
Undeveloped digestive tract
Infant food reactivity
Imbalance of healthy bacteria in the digestive tract
Baby food allergies or intolerances made the list, yet many parents struggle to get answers or solutions for their babies with food allergies. You’ll also notice the trend of digestive issues behind colic. If you aren’t sure whether your baby’s stool is normal, definitely check out Free to Feed’s popular Diaper Decipher resource!
Colic is commonly not a diagnosis, but a symptom that should be investigated. This leads to infants being in unnecessary pain, leaving families exhausted and confused.
4) MYTH: Probiotics Are the Answer to Your Baby’s Gastrointestinal Issues
FACT: While probiotics can be powerful tools, they can often cause more problems than they solve for babies with food intolerances or allergies. There are many “unknowns” when it comes to probiotics.
First, as for supplements, they’re not regulated as strictly as food or medication which can lead to an increased possibility of hidden allergens such as cow’s milk protein (dairy) and soy. Not all babies react to “hidden” allergens (those from derivatives less likely to be clearly labeled) but for the ones that do – this can make your hard work of eliminating the food out of your diet go to waste.
Second, probiotics may mask actual food reactivity symptoms. Masking symptoms can lead to continued exposure to the trigger food when the best course of action is avoidance. You don’t want to put a bandaid on your breastfeeding baby with food allergies, you want to solve the problem.
5) MYTH: Formula Is the Only Option When Your Baby Has Food Allergies
FACT: Thousands continue to breastfeed through infant food allergies. Determining the trigger and continuing to breastfeed by eliminating that food is a viable option. It can be hard thinking your breastmilk is hurting your baby but you have to remember all – and we mean ALL the benefits of breastfeeding.
For many, formula is not an option. Babies may react to elemental formula, reject either bottles or the formula outright when trying to quickly switch from breast milk. Learn more about finding the right hypoallergenic formula in the Free to Feed blog.
Spectra S1 Plus Electric Breast Pump
If you are a busy mom on the go looking for outlet-free customized pumping sessions, then the Spectra S1 is the perfect pump for you! A favorite among exclusive pumpers, the Spectra S1 Plus is hospital strength and a closed system that allows for single or double pumping. Along with loads of customizable features, the Spectra S1 pump weighs in at only under 3lbs. The multi-phase “suckle” makes pumping with the S1 feel comfortable and natural. You’ll have 3 hours of battery life with the Spectra S1, delivering convenience that can make a pumping mom’s life easier! When you’re already juggling a thousand things, CONVENIENCE MATTERS! Unplugging this pump and going cordless doesn’t compromise suction like with some other battery-powered pumps. The rechargeable S1 is typically offered as an “upgrade” through health insurance plans. Countless moms have reported the additional cost of the S1 as being “worth every penny.” If a rechargeable pump with the customization of 12 vacuum levels, 5 Expression Cycles, and an adjustable Massage Mode sounds like a dream, then the S1 is for you!
The Spectra S1 Features include:
- Closed Pumping System
- Single or Double Pump capability
- Customizable Settings
- Rechargeable 3-hour battery life
- 270 mmHg
- Weighs only 3 lbs
- Built-in night-light
- LCD screen
- ( 2 ) Years Warranty on pump | 90 days on accessories.
The Spectra S1 Electric Breast Pump 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
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!
Check out the digital S1 Plus Manual for more information.
By Monica Auslander Moreno, MS, RDN
Food before the age of one provides supplemental nutrition to the majority of the infant’s intake — breastmilk and or formula. Most of the benefits of solids lie in developing motor, sensory, cognitive, and fine motor skills. Introducing the baby to the whole concept/atmosphere of solids is as, or more important, than the actual nutrients from the scant amount of food a six-month-old will eat. As time progresses, the ratio of solids to milk increases until age one, when the infant is ready to possibly wean off of breastmilk/formula and transition to cow’s milk (if no cow’s milk allergy is present.) Eating, for an infant, is about being with a caretaker, the sounds of the food being scraped about, watching the preparation of the food, or touching the food. They learn how to use utensils, use food as utensils (like a scooped zucchini stuffed with cottage cheese), and are noticing colors, shapes, textures, temperatures, seasonings, flavors, and scents. The food experience makes babies more aware of their surroundings like their chair, their clothes, and the adult reactions to their intake. They learn to drink water/milk from a cup sorting out taste preferences, and observe animals enjoy the fallen bits.
We recommend that babies meet three milestones before introducing solids:
1) That they can sit independently, and well, for several minutes at a time. This is great to minimize choking risk because if they aren’t focusing on staying upright, they’re less likely to choke.
2) That they lose their tongue thrust reflux.
3) That they show an interest in the food that adults around them are eating.
There is much debate about starting with purees versus “whole foods” (known as Baby-Led Weaning, or BLW). There are risks and benefits to both methods. Baby-led weaning may present a higher choking risk and can take longer but may advance eaters to “adult food” more quickly and may lead to more “intuitive” eating, as babies can probably better intuit their own fullness and satiety this way. They likely develop enhanced jaw strengthening with BLW, since it takes quite a lot of force to chew whole foods, even without teeth, although it’s prudent to remember that even babies fed with purees (you likely were!) rarely become kindergarteners who can’t chew. BLW is definitely messier! Spoon-feeding an infant tends to be cleaner, and you can control the amount on the spoon. However, an infant may zone out and overeat / ignore fullness cues. Purees can be time-consuming to prepare if you’re making them at home, and store-bought puree packets tend to have more sugar and be more fruit-based than we like (though there are now a few brands producing protein and veggie blends with very little sugar.) Both BLW and purees require significant precautions against choking and honoring safety protocols. All foods, even “safe” ones, need to be appropriately mashed/cooked/watered down to match your infant’s abilities. Never leave an infant unattended while eating. Always ensure they are sitting upright. Familiarize yourself with CPR and infant choking treatment techniques. Be aware that babies gag and recover when they eat — this is different from choking, where they cannot move air at all. Babies should be coached to chew and swallow at all times as caretakers mimic these actions themselves
Six-month-old infants should be taking at least 24 oz of milk per day. This drops to 20 oz per day at nine months and 16 oz per day at one year. It’s also a good idea to offer water at meals to familiarize your infant. In the realm of food behavior, maintaining a happy and joyous but neutral attitude towards food is best. Feed your baby when they are alert and happy, and not too hungry, and not too full. You can start with one “meal” a day (it may only be a teaspoon or two!) and progress to eventually three meals per day by nine to 11 months. Your baby will start to increase their portion sizes/demand for solids as time goes on, but be aware that sometimes it can even take weeks for a baby to figure out what to do in the highchair with food presented to him!
Nutritionally, the infant’s iron stores from pregnancy start to decrease around six months. Focusing on iron-rich foods is priority #1 with respect to the “nutrition” aspect of solids. Heme iron, that which comes from animals, is better absorbed than non-heme iron. (heme iron: beef, venison, bison, lamb, chicken, turkey, eggs. Non-heme iron: ground flax, chia, walnuts, fortified whole grains, hempseed, spinach, almonds, tofu — ensure appropriate consistency versus choking!) Both plants and animals should be introduced with solids. Always give iron-rich foods with a food rich in Vitamin C (a vegetable/fruit) to enhance absorption, and try to avoid giving iron-rich foods with calcium (a dairy product), as they inhibit each other’s absorption. Omega3 fatty acids are also a major macronutrient important to infant development. Offer wild, small, fatty fish (lower in mercury) like sardines, anchovies (bones removed, skin removed), salmon, mackerel, and herring. Eggs, which are rich in choline, are also a wonderful thing to introduce to babies (boiled and cut into appropriate slices, or pureed with breastmilk/water). By the way — you can always puree foods with breastmilk/formula/water!
Some ideas for first solid meals, whether you are practicing BLW or puree (remember appropriate chewing/choking/cooking precautions for appropriate texture!):
Steak + avocado + sweet potato
Beet + salmon + spinach
Raspberries + Green beans + chicken mashed with Greek yogurt
Carrot + squash + cottage cheese
Zucchini + kefir + chickpeas
Oat flour + seed butter + banana
If your child is at risk for food allergies, you should consider offering high-risk allergy foods in the presence of your pediatrician and consulting an immunologist for testing before starting solids.
An infant is considered high risk if they have a family history of food allergies, a documented allergy, and or have eczema. Early exposure to antibiotics may also raise the risk of food allergy. The American Academy of Pediatrics changed its position in 2008 about introducing high-risk allergenic foods because there was a lack of evidence that delaying the introduction of allergenic foods could prevent food allergies.
Over time, your baby will move from one little snack per day to three “square” meals, and then eventually auxiliary snacks. Babies should continue to include high-quality, full-fat dairy (like cow/goat/sheep milk [after the age of 1], yogurt, kefir, cottage cheese, and cheese) throughout their day after weaning from breastmilk/formula. All meals/snacks should include protein and plants (fruit/vegetables/legumes, etc.). Over time, you’ll raise a competent and confident eater (just like you!)
For more tips nutritional tips for you and your baby follow Monica at @eatlikemonica on IG
Note from a Spectra Baby USA, IBCLC:
Breastfeeding at this stage can look different for every mom. Are you pumping and nursing? Are you exclusively pumping? These factors can influence how often you should be pumping at this stage. You never ever want to stop pumping cold turkey. Some moms will be able to pump enough with only 4 pumping sessions per day while others will need to continue to pump 6-8 times per day. It all depends on your breastfeeding routine and how much milk you would like to have on reserve. Remember baby’s primary nutrition should still be breast milk so it’s important to continue to pump when baby receives a bottle whether you’re exclusively pumping or pumping when you are away from your baby. Continue to incorporate pumping sessions to keep providing enough breast milk to meet your baby’s nutritional needs. Our bodies are pretty amazing and will adjust easily to any new routine!
The information provided here is for general informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis, or treatment by a qualified medical professional. Any questions you may have concerning the diagnosis or treatment of a medical condition should be directed to your doctor or other qualified healthcare providers.
The copyright and other intellectual property rights in all material and content here, including the organization and layout of the site, is owned by Essence Nutrition, LLC and/or its licensors. Any reproduction of content or layout without explicit permission from Essence Nutrition, LLC is forbidden. Any rights not expressly granted in these terms are reserved.
By Jennifer Gaskill
As a first-time mother, I experienced both the demanding and rewarding sides of providing breast milk for my child. My breastfeeding journey was unique and challenging. Like many moms today, my expressed breast milk saved the day. Nowadays, exclusively pumping, once the territory of mostly NICU moms, has become the chosen feeding option for more women.
Some women turn to pumping after dealing with latch and supply issues and/or lack of support at the start of their breastfeeding journey. For these women, pumping is the one way to supply breast milk to their child. Moreover, working mothers must build up a milk bank before going back to work, helping make the transition easier for both mom and baby. It is essential that moms considering pumping choose an efficient pump.
Choose the right tool
Most experts state that quality, closed-valve, hospital-strength pumps work best. Exclusive pumpers must choose a pump that can endure five or more sessions per day throughout the breastfeeding experience. Here are some tips for choosing a pump:
- Choose a pump with 250 mmHg or higher vacuum strength (also known as a hospital strength). Spectra’s single-user pumps are among the hospital-strength pumps recommended to exclusive pumpers. Moms can customize their settings to personalize vacuum pressure and cycle speed.
- If you cannot purchase a pump, you can rent one or buy a used one. When using these options, always choose a pump labeled as ‘multi-user’. Otherwise, the motor may not be designed to endure multiple users and an exclusive pumping regiment. Always purchase new accessories/parts; rentals and second-hand pumps include pump and motor only.
- Most insurance companies provide coverage for hospital-strength pumps. You can call your insurance plan or go online to determine your breast pump coverage. Breast pumps are issued by “DMEs” (durable medical equipment) and you can find one that works with your insurance plan here.
Timing is everything
Initially, exclusive pumpers should pump as often as the average newborn baby nurses (about 8-12 times per day). Experts recommend pumping every two to three hours. The timing starts from the beginning of one session to the beginning of the next. To protect your supply, avoid going longer than three hours between pumping sessions.
Maintaining breast milk supply
When starting out, it’s normal to see as little as 2 oz. combined per sessions. As supply builds, average daily output peaks at 19-30 oz. Around four to six months, supply naturally starts to self-regulate and milk composition changes often to a higher fat content. A similar shift occurs around 8-12 months. Keeping pace with baby’s feeding schedule will ensure your supply continues to meet baby’s needs. To keep the pump performing at its optimum, you must replace the accessories/parts periodically.
Maintenance and back-ups are essential
Be sure to regularly inspect and replace parts, especially valves and membranes. Exclusively pumping mothers should look to replace these parts every 2 months and part-time pumping mothers every 3 months. Worn, damaged, or incorrect parts are often to blame for supply fluctuations. Furthermore, have at least one backup set of replacement parts/accessories available in case of emergency.
Support for exclusive pumping moms is out there. Whether it comes from a close-knit group of friends, a lactation consultant, or an internet community of like-minded moms. We all know providing breast milk for baby is a labor of love, and having the appropriate supplies and resources makes the journey so much easier. You can join our support community on Facebook here.
Melissa Portunato MPH, IBCLC, RLC
It’s hard enough to care for a newborn while you recover from childbirth; throw pumping in the mix, and it can be challenging to juggle it all. But we have good news on the horizon! Often, there are areas in your pumping schedule you can limit, rearrange or eliminate all together and still have a healthy milk supply. Read on to learn about my Top 3 Pumping Schedule Killers and how you can avoid them so you can make plenty of super milk for your baby and keep your sanity too!
Pumping Schedule Killers
1. Pumping more than 8x times per day
If exclusively pumping, the first 12 weeks aim for pumping every 2-3 hours, which is about 8x per day. Pumping more than that will be harder to manage your schedule plus can increase nipple soreness and pain. Pumping sessions should be 15-20 minutes. After 12 weeks is a great time to start scaling back on pumping to around 6x per day. As a general rule, exclusive pumpers need 120 minutes per day of quality breast stimulation with a hospital strength pump.
2. Everyday Power Pumping
Power Pumping is a technique that requires on/off pumping for one full hour. Talk about a time sucker! But, when used short term, it can help increase milk supply. But beware! Power pumping every single day for an hour is exhausting, draining, and not necessary. And worse! Your body will plateau and get used to pumping for the full hour, making shorter pumping sessions harder to achieve. Instead, keep Power Pumping limited to once a month and only for 3-4 consecutive days. This is a great way to stimulate the effects of a growth spurt or cluster feedings. Expect to see an increase in about a week. Learn more about Power Pumping here.
3. The Triple Feeding Nightmare
Ugh, Triple Feeding, just reading those words can be overwhelming. Nurse at the breast, bottle feed baby, then pump. Repeat over and over at EVERY feeding. This advice, in theory, makes sense but is it realistic? As an IBCLC, I speak to so many parents ready to quit their breastfeeding journey because they simply can’t keep up with the triple feeding schedule. Instead, single pump while doing skin to skin with baby. Practice nursing between feedings because we know a “hangry baby” will be more difficult to latch. Try using a supplemental nursing system at the breast, which can encourage more nursing and less bottle feeding. Work on a few nursing sessions a day instead of every feeding. This can ease your mind for a bit and give you some much-needed rest and downtime.
Sample Pumping Schedules
Set reminders, block off pumping times on your calendar, and aim for 8x per day 20 min each. Pump when baby eats can be an easy-to-follow schedule, especially during the newborn phase.
Newborn 8x per day
7am, 10am, 12pm, 3pm, 6pm, 9pm, 12am, and 4am
After 12 weeks, 6x per day
6am, 10am, 12pm, 3pm, 6pm, 10pm
Nursing and Pumping
The best time to pump will always be in the morning, 30 min or so after nursing your baby. In the morning, prolactin (milk-making hormone) peaks; take advantage of this time and pump. You can do single or double pumping. Expect to see between ½ – 2 oz combined. If you’re returning to work, start pumping more consistently about 2-3 weeks before your return. A few days before you head back, pump at times you will be pumping at work.
It’s OK if you don’t pump at the same time every day! Skipping a pumping session or going over in-between times occasionally shouldn’t have a drastic effect on your supply. Focus your energy on consistency and commitment! Don’t dwell on what happened in the past and push forward towards your pumping goals.
Need help managing your pump schedule? Our highly skilled Spectra IBCLCs can help! Schedule your complimentary consultation today.
By: Rue Khosa, MSN, FNP-BC, IBCLC
We recently had a chance to chat with Rue Khosa, a Board-Certified Family Nurse Practitioner, Lactation Consultant, and new momma of baby #3. She shares her expert advice on preparing for your delivery, planning for the return to work, and why Spectra Baby USA breast pumps are her top pick.
✔ Book a Prenatal Lactation Consult
I firmly believe every expectant couple should book a prenatal lactation consult. Getting a review of your medical history, a breast assessment, and help to select the right pump for you is vital. Knowing I was going back to work at just 6-weeks postpartum, I knew getting the perfect pump to establish my supply and build a frozen stash was critical to my successfully maintaining supply.
Find and book your prenatal consult with an IBCLC around 28-34 weeks.
✔ Order your Breast Pump
I was fortunate enough to receive the Spectra Synergy Gold pump to review! The Spectra Synergy Gold electric breast pump uses advanced technology with dual motors allowing you to adjust each side independently. Furthermore, it’s a hospital strength closed system making it effective and efficient to establish and maintain my supply despite my hectic schedule.
Before you deliver, you will want to order your pump, wash the pump parts, and get familiar with using it. There is nothing more stressful than trying to read a pump manual with a hangry newborn wailing next to you. Find out if your insurance covers a Spectra baby USA here.
✔ Establish your Supply
When it comes to breastfeeding, demand equals supply. The more you demand of your breasts by stimulating and emptying them frequently, the more milk you will make. Therefore, breastfeeding your newborn a minimum of 10-12 times a day or every 2hrs during the first couple of weeks is crucial. Equally important is making sure you are breastfeeding effectively. If your newborn is unable to latch and nurse effectively or at all, then you will need your breast pump to pick up the slack while you work with your IBCLC to assess and establish breastfeeding.
Prolactin, the hormone responsible for milk production, returns to pre-pregnancy levels in the first two weeks postpartum if there is inadequate breast stimulation. This makes it increasingly more challenging to restore and recover your milk supply the further postpartum you are.
✔ Build a Stash
The word stash can often sound intimidating, but it is essential to remember that the goal is to feed your baby, not the freezer. You want to store 2-4oz a day, helping build a 4-7 day reserve by the time you return to work at 12 weeks.
If you are not already pumping, you will want to start pumping around four weeks postpartum. This will allow you to take advantage of higher prolactin levels and corresponding higher milk supply in the immediate postpartum period. Pumping after the first and last feed of the day for 10-15mins is more than sufficient.
✔ Contact HR
Thanks to the Obama administration, not only do we have better lactation services insurance coverage, but employers have to provide pumping breaks and designated pumping rooms for new mothers. Contact your HR department 2-4 weeks before your expected return to make sure that they make appropriate accommodations for you.
On the Job
Now you are ready to go back to work. Know that most women are bound to experience a decrease in their supply as they return to the workforce. Many factors, including work stress, decreased hydration, decreased breast stimulation, as well as the natural regulation of your milk supply around the 12-week time frame, contribute to this decrease. If you have followed all of the above steps, you are less likely to experience a dramatic drop. Additionally, to maintain your supply, you will want to pump at least every 3hrs while at work. I recommend pumping right before you leave for work to give you time to settle in before you have to pump again. You also want to coordinate the last pump of the day and the baby’s first breastfeed when you get home. Ask whoever is caring for your little one to avoid bottle feeding 2hrs before you are due to return home and likewise avoid pumping during that same time frame. If schedules allow, this will save you a pump session and give you both a much-needed bonding experience after a long day apart.
To save time, Spectra has created the Simple Store Solution Kit, which allows you to pump, store and feed your baby all from the same bag.
Only 12% of women have access to paid maternity leave, and up to 25% of women have to return to work just two weeks after giving birth. Whether you are returning to work at two weeks or 12 weeks, the stress and anxiety around the transition can have devastating effects on your breastmilk supply. In a perfect world, we would all have the option of staying home with our little ones for as long as we desire. However, by following the above steps, you will have the next best thing, the best shot at being able to exclusively feed your baby breastmilk through the first year and beyond.
Good luck, mama, you got this!
Rue Khosa is a Board-Certified Family Nurse Practitioner and Lactation Consultant. She has dedicated her career to being a women’s health advocate supporting new and expectant parents to thrive through the parenting journey. Believing it takes a village to raise a child, she has created a global village of women centered around mutual respect, trust, and unconditional support. Follow her on Instagram @rue_theboobboss for all things Bumps, Babies, and Boobs.
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.
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
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!
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.
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.
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!
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.