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Healthy Eating and Breastfeeding

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Melissa Portunato MPH, IBCLC, RLC

Though it’s totally fine to indulge every once in a while, maintaining a balanced diet will give you energy, keep you satisfied longer, and can help your breast milk flow easier. Breastfeeding burns on average between 300-500 calories per day. It takes a ton of energy to produce your liquid gold; make sure you compensate with healthy milk-making foods. 

Read on to learn more about the best foods to eat while breastfeeding to keep you feeling happy and healthy as a new mom. 

What are the best foods to eat while breastfeeding?

The best breastfeeding foods offer a variety of macronutrients – protein, complex carbohydrates, and healthy fats. The World Health Organization recommends adding 25grams of protein for breastfeeding moms –  individual needs based on your weight and other factors. 

High-quality protein sources include eggs, red meat, and wild-caught salmon. These all have a  long list of health benefits, but the top of the list includes improving eye health, aiding in weight loss, and preventing disease. If you’re vegan or vegetarian, legumes are loaded with iron and protein too! Especially the dark ones! 

Leafy greens are nutrient-dense, low in calories and carbs, and packed with vitamins and minerals like Calcium, Vitamin K, Folic Acid, and Iron. Fresh fruit is a simple, nutritious snack! Blueberries are one of the most nutritious fruits globally, providing Vitamin C, Vitamin A, Vitamin E, and Antioxidants. Eating two servings a day of fresh fruit like berries can help amp up weight loss, decrease inflammation, and promote digestion which is beneficial to breastfeeding moms recovering from childbirth. 

Are “diets” OK when breastfeeding? 

Any diet that dramatically cuts calories can impact milk supply, especially within the first 6-8 weeks, as your body regulates how much milk is needed to keep your baby growing and thriving. However, low-carb diets like the Paleo diet are compatible with breastfeeding moms as long as they consume enough nutrients from a variety of lean proteins, fruits, and veggies. Research studies claim, aiming for at least 1800-2000 calories per day, breastfeeding moms can safely lose about 1 pound a week. 

Are protein shakes OK?

The short answer is YES! But not all protein shakes are created equal. Here are tips when choosing a protein shake. 

  • Making your own protein shake is always best! Packed with protein, calcium, magnesium, and iron, raw almond butter makes for an easy base for a clean protein shake made at home. 
  • Consider medications and supplements you are already taking to avoid exceeding recommended daily values of vitamins and minerals, which can be dangerous for you and your baby. 
  • Avoid protein shakes created for athletes which can have additives not intended for nursing mothers. 
  • Avoid shakes with added and artificial sugar, GMO’s, caffeine, and common allergens such as dairy, wheat, soy, etc. 
  • Most plant-based store-bought options are considered safe for nursing moms. Though some whey proteins may be safe, many often have additives that can be harmful. Always check with your doctor first before starting a new store-bought protein shake. 

Proper nutrition is required to feel well and care for your new baby! A healthy diet can also encourage plentiful milk production. Fuel your body right and be kind to yourself. Don’t forget to always check with your doctor before starting any weight loss or exercise plan. Have more questions? Please email us at ibclc@spectrababyusa.com. 

Sources:

Kominiarek, M. A., & Rajan, P. (2016). Nutrition Recommendations in Pregnancy and Lactation. The Medical clinics of North America, 100(6), 1199–1215. https://doi.org/10.1016/j.mcna.2016.06.004

Dewey et al. (1994). Effects of dieting and physical activity on pregnancy and lactation. Am J Clin Nutr, 59( Suppl 2), 446s-453s.

Lauwers, J. & Swisher, A. (2015). Counseling the Nursing Mother: A Lactation Consultants Guide. Burlington, MA: Jones & Bartlett Learning.

Neville et al. (2014). The relationship between breastfeeding and postpartum weight change—a systematic review and critical evaluation. International Journal of Obesity, 38, 577-590.

Breastfeeding Tips for Success

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

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

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

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

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

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

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

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

Good luck, mama, you got this!

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

Breastfeeding 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/. 

All About The Simple Store Milk Collection Kit

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Our new Spectra Simple Store Milk Collection Kit makes pumping, storing, and feeding as easy as 1-2-3! This innovative technology allows breastmilk to be pumped directly into BPA-free collection bags for simple storage and bottle feeding. Spectra’s easy-to-use breastmilk storage system is convenient for busy parents and prevents the exposure of germs that are often present when transferring milk from one storage solution to the next. Assembly is intuitive, clean, fast, and simple. Always keep your milk safe and ready to use with The Spectra Simple Store Milk Collection Kit.

What’s included? 

The Simple Store Milk Collection Kit includes one bottle connector and (10 ct) 200mL milk collection bags. The connector adapts to a Spectra flange when pumping, and seamlessly converts as a bottle with a wide neck cap and nipple (wide neck cap and nipple sold separately). If you are double breast pumping, you will need two Simple Store Milk Collection Kits. Replacement collection bags (30 ct) are available here.  

How does it all work? Easy as 1-2-3! 

Step 1 Pump 
First, remove and set aside the small plastic cap from the collection bag. Next, use the bottle connector included to attach your Spectra flange to the collection bag. Last, sit back, relax, and double breast pump for 15-20 minutes with a hands-free bra to save even more time! 

Step 2  Store
Seal the collection bag with the small plastic cap you set aside prior. Your milk is now ready to be frozen or refrigerated for later use. Learn more on milk storage guidelines here. Expert tip! Remove excess air by gently squeezing the collection bag and freeze flat to optimize space. Use a plastic bin or an empty soda can box to organize your frozen milk stash. 

Step 3 Feed
It’s simple! Feed your baby right from the collection bag. First, twist on the bottle connector. Then, connect the wide neck cap and nipple. All set and ready! Time for a feeding. 

All Spectra Milk Collection Bags are double lined and provide a strong seal ensuring leak-free insulation families can count on. Collection bags come with a built-in temperature sensor, displaying when breastmilk is perfect for your baby. 

Have more questions about The Simple Store Collection Kit? Email us at IBCLC@spectrababyusa.com.

Happy pumping! 

 

 

5 Quick Tips for Pumping at Work

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Melissa Portunato MPH, IBCLC, RLC

You’ve finally gotten into a sweet groove with breastfeeding and now it’s time to head back to the office. You can absolutely continue to breastfeed and maintain a healthy milk supply while away from your baby. It can seem overwhelming at first, but all you need are the right tools to help you get into a manageable routine. We know you can do it! We believe in you! 

Here are 5 quick tips to make pumping at work easier.

1) Make a Schedule 

Plan on pumping every 3-4 hours to maintain a healthy milk supply. Set those alarms and block off pumping time on your calendar to make sure you don’t go too long without pumping. Practice at home about a week before returning to work at the times you will be pumping. This will make you more comfortable and confident so you can smash your first day back! 

2) Have a backup plan 

Getting ready for work with a baby can take more time now than when you were flying solo. A checklist can help you make sure that you have everything you need when you leave the house. But even with a system, there’s a good chance that one day you’re going to be in a hurry and forget something crucial, like duckbill valves or your flanges. Keeping replacement parts at work can be a lifesaver. It’s also a good idea to have a handy manual pump in your car or office, just in case you forget your pump altogether. 

3) Go Hands-Free

If you’re pumping at work, getting a hands-free bra so that you can do other things besides holding your breast shields during the time you spend pumping can be a game-changer. It will also allow you to use Hands-on Pumping which can make pumping sessions more efficient. Skip the pumping bra and level up your pumping game with the Spectra Caracups. Pumping with the Spectra Caracups will make the whole process even easier AND discreet if you need to be on a virtual meeting or even in person with a client. 

4) Milk Storage and More 

The more you can leave at work, the lighter the load will be on your commute. If you will be traveling with your pump, choose a pumping bag that can store it all: Spectra pump, cooler case, water bottle, laptop, water bottle, snacks, and other personal items. Check out our new pump, store and feed system! The Spectra Simple Storage Kit uses innovative technology that will keep your milk clean, safe, and always ready to use. No more bottle washing either!  

It’s recommended that you wash all your pumping parts after every use. 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. 

5) Community and Support 

Let your managers and co-workers know in advance that you will be pumping milk for your baby. Make friends with other pumping moms in your office. If there are other women using the lactation room at your office, try to get to know them. Having pumping mommy friends can make your breastfeeding journey even more meaningful. Knowing you are not alone can get you through a rough day and help you press on. Connect with a virtual breastfeeding support group too! 

Can’t get a letdown? This is common when moms return to work. Try to relax. Throw a nursing cover over you, listen to music, or watch videos of your baby. Whatever you do, don’t watch the bottles! It can be stressful pumping on a time crunch and can take some time to get used to. With patience, practice, and support you can continue to meet your breastfeeding goals. 

Are you returning to work virtually from home? We got you covered. Check out our top tips to make the transition smooth and easy!  Need help returning to work at the office or virtual? Our IBCLCs can help with pumping schedules, flange sizing, and much more. Schedule your complimentary phone call or virtual consultation today. 

 

Spectra 9 Plus Electric Breast Pump

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mom holding 9 plus breast pump

The 9 Plus is Spectra’s smallest pump, weighing in at only ½ a pound!  This tiny, but mighty pump offers the ultimate in on-the-go single or double pumping.  The rechargeable battery allows for convenient pumping in almost any location.  Though this pump is small, it isn’t lacking in features!  It provides up to 260mmHg of suction and is still considered hospital strength. The 9 Plus also offers an adjustable Massage Mode along with 10 levels of vacuum in Expression Mode and a convenient timer. The backlit LCD screen is an added feature that moms love as well. Pair this little powerhouse with the hands-free CaraCups and you have a convenient hands-free pumping setup without sacrificing effectiveness! Like with all of Spectra Baby Electric Breast Pumps, this pocket-sized pump also comes with a 2-year warranty. 

The Spectra 9 Plus Features include: 

  • Single or Double Pump capability
  • Vacuum suction up to L10
  • 260 mmHg
  • Weighs only .5 pounds
  • LCD screen
  • ( 2 ) Years Warranty on pump | 90 days on accessories

The Spectra 9 Plus comes with everything you need to single and double pump.

  • Two (2) 24mm 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 9-Volt AC Power Adapter. Includes detachable power cord prongs

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! 

Starting Solids with Your Breastfed Baby

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Jacque Ordner BSN, RN, IBCLC, RLC 

You finally feel like you’ve gotten this breastfeeding thing figured out and your baby’s pediatrician mentions starting solids.  Like most parents, your mind is instantly filled with tons of questions.  When do I start?  How do I know she’s ready?  Do I need to offer foods in a certain order?  Do I start with baby cereal or baby-led weaning?  Will my baby still want my milk once he starts solids?  What about allergies?  HELP!!!  

We’ve got you covered with our quick guide to starting solids with your breastfed baby! 

How do I know my baby is ready? 

Current research and recommendations tell us that human milk is the only nutrition needed for healthy, full-term babies up to six months of age.  Breast milk is amazing because it changes in composition to meet baby’s unique needs as they grow. It’s not surprising that many babies begin to show signs of readiness for solids at around six months as well.  

Signs of readiness include: 

o   Can sit unsupported 

o   Has good head control 

o   Has lost the tongue thrust reflex and can move food from the front of the mouth to the throat 

o   Opens mouth when offered foods 

o   Can use pincer grasp to bring food to the mouth (essential for self-feeding) 

o   Has doubled birthweight 

 Which method is best? 

The goal of introducing solids is to help baby explore new skills, flavors, and textures while also introducing new sources of nutrition.  While trends may try to dictate a singular approach, it can be beneficial and even easier to use a combined approach.  For example, if you’re not keen on rice cereal because of the potential for arsenic, cadmium, and lead, opt for another fortified grain cereal like barley, oat, or amaranth.  Looking to keep things as whole as possible?  Consider cooking and mashing foods and mixing with breastmilk rather than purchasing pre-packaged options. Soft foods make good options for encouraging self-feeding.  Soft or cooked fruits and vegetables, shredded meats, flaky fish, and beans make great finger foods for little eaters.  Avocado packs a big nutritional punch and is often fun for baby to self-feed. When surveying pureed and prepackaged options, look for simple ingredient lists that don’t include sweeteners, thickeners, artificial preservatives or artificial colors and flavors. It’s ok to incorporate both purees and finger food options as baby needs practice with using a spoon and building dexterity in their hands! 

What about allergies? 

The most up to date recommendation is to introduce common allergen containing foods after 6 months and before 12 months for healthy, term infants.  The most common allergen foods are eggs, dairy, peanuts, tree nuts, wheat, seafood, soy, and sesame.  Another safety measure is to introduce only one new food at a time so that if an allergy occurs, it can be easily associated with its cause. Experts recommend peanut allergy testing (prior to introducing peanut containing foods) for babies who have severe eczema and/or have an allergy to eggs.  Allergy experts often recommend keeping common allergen foods as a regular part of baby’s diet provided there was no allergic reaction after introduction. 

How do we get started? 

Offer breastmilk first!  Breastmilk is still baby’s primary source of nutrition until 12 months.  Nurse or offer a bottle of breastmilk before moving to solids.  If baby is interested, it’s ok to give solids immediately after.  However, some babies prefer to wait a bit before taking in solid food after a nursing session or a bottle.  Solids should not replace breastmilk intake, but rather compliment it. Start small!  Occasionally parents will feel overwhelmed at the thought of getting an entire serving of baby-friendly food into their just-turned-six-month-old.  Keep in mind that introducing solids is meant to be a gradual process, so it’s ok if baby is only interested in a bite or two at first. As baby gets the hang of their new skills, they’ll naturally increase their solids intake.  Children learn through modeling, so consider feeding baby solids during your normal mealtimes.  There is no evidence that starting with fruits will make baby less likely to take vegetables or vice versa.  There is no specific order in which foods must be introduced.  If baby is completely resistant to starting solids, despite displaying signs of readiness, table the idea (no pun intended) for a week or two.  As with other developmental skills, not all babies are ready at the same time. 

Expect changes. 

It’s not uncommon for babies to experience a change in diaper habits. Introducing solids means more formed stools that often have a stronger odor as well.  Some babies may stool less often as well.  Introducing solids slowly can help reduce the risk of irritating baby’s digestive system.  Don’t forget that foods can influence the color of baby’s stool as well.  For example, beets turn stools an obvious red while peas often add a tinge of green.  Some parents report that stains from baby’s stool after starting solids are harder to remove than stains during exclusive breastfeeding.  

Does my baby need extra liquids? 

The short answer is NO.  As long as your little one is getting an adequate intake of breastmilk, no additional fluids are needed.  Breastmilk changes in composition to become more watery in hotter environments…..how amazing! It is still OK to offer a small amount (no more than 8oz. per day) of water once your baby reaches six months old. Many parents use a small amount of water to introduce a sippy or straw cup at this age.  Skip juice as it is high is sugar content and low in other nutritional value. Experts advise no juice for babies under 12 months, and only up to 4oz. of 100% fruit juice thereafter. 

Have more questions?  Need more details?  Check out these resources for additional information: 

Healthy Children.Org 

La Leche League 

CDC 

Looking for help creating a personalized plan for starting solids?  Schedule a FREE consultation with one of our specially train International Board Certified Lactation Consultants (IBCLCs) 

Sources 

Starting Solids. (2020, August 7). La Leche League International. https://www.llli.org/breastfeeding-info/starting-solids/ 

When, What, and How to Introduce Solid Foods. (2020, December 11). Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/InfantandToddlerNutrition/foods-and-drinks/when-to-introduce-solid-foods.html 

Working Together: Breastfeeding and Solid Foods. (2012). HealthyChildren.Org. https://healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Working-Together-Breastfeeding-and-Solid-Foods.aspx 

Child Care and the Breastfed Baby

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Melissa Portunato MPH, IBCLC, RLC

It’s likely that at some point, your breastfed baby will be cared for by someone else other than yourself. Sometimes it’s temporary while other times it can be long term like when returning to work. Child care options can vary from private stay at home nannies/family members, private home licensed child care, or commercial child care facilities. 

The process to find the perfect match for you and your baby doesn’t have to be stressful. Your breastfeeding relationship can absolutely continue and thrive with this new milestone. No matter who you choose to care for your baby, your breastfeeding goals should be supported and respected. Read on for tips on finding a caregiver for your breastfed baby including how to connect with local resources and how to share valuable education with your child care provider. 

Support and Communication 
Let’s start here. It’s OK if your child care provider isn’t a “breastfeeding expert” but they should be open and teachable when it comes to feeding mother’s milk to babies in their care. They should be willing and ready to accommodate your requests or accept breastfeeding-friendly education. An “open door” policy is one of the ways caregivers can be supportive of the breastfeeding dyad. Allowing mothers to drop in at any time without notice to pump or nurse their baby on demand protects breastfeeding. If your child care facility pushes back on your breastfeeding requests, then it’s probably not a good fit.

Knowledgeable Staff 
A child care provider whether in a private or commercial setting should have basic training on breastfed infant behavior, proper bottle-feeding techniques, and breastmilk storage handling.  All babies, breastfed or not, should be fed using The Paced Bottle Feeding Technique. This feeding method allows the baby to control the flow of milk, preventing overfeeding. Normal milk consumption for babies 1-6-month-old is 1- 1 ½ ounces per hour. Milk leftover from feedings should be discarded within 2 hours of initial use and proper breastmilk milk handling should be carefully followed. Download the handout here to share with your child care team. Breastfed babies should not be fed on strict schedules but rather monitored for hunger cues. For younger babies less than 3 months old this includes moving head from side to side (rooting), bringing fingers to mouth, and for older babies, actively moving arms and legs while gazing at the caregiver. 

Facility Accommodations 
Breastfeeding friendly accommodations on-site should include a designated area to pump or nurse your baby, other than a restroom. A fridge to store breastmilk and a sink to wash pump parts. You will need to label bottles and/or milk storage containers with the name of your baby and date with permanent, reusable, or personalized silicone labels. 

Additional tips for success:

???? Check with your local / state breastfeeding coalition to find breastfeeding-friendly centers here.

???? Take a tour with your prospective child care provider first before making a decision. 

???? Choose a child care provider nearby. You can hop into pump/nurse or simply check on baby anytime. 

???? A low child-adult ratio allows the caregiver to pay more attention to feeding cues and can prevent overfeeding. 

???? Long-standing caregivers provide added security your baby is in the care of an experienced professional. 

???? Send breastmilk in 1-2 ounce increments to prevent milk from being wasted. 

Always remember you are your baby’s advocate. No matter your breastfeeding goals, you should feel comfortable to easily keep an open conversation with your child care provider. 

Do you still have other questions about child care and breastfeeding? Email us at IBCLC@spectrababyusa.com anytime or schedule a complimentary consultation. Our International Board Certified Lactation Consultants are happy to assist you along your breastfeeding journey. 

We’re in this together and we support you! 

Sources

  1. How to choose a breastfeeding-friendly childcare provider. (2020, February 19). La Leche League USA. https://lllusa.org/choosing-a-childcare-provider/
  2. Proper Storage and Preparation of Breast Milk. (2020, January 22). Center For Disease Control. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  3. Anne Smith, IBCLC. (n.d.). Caregiver’s Guide to the Breastfed Baby. Breastfeeding Basics. Retrieved January 11, 2021, https://www.breastfeedingbasics.com/articles/caregivers-guide-to-the-breastfed-baby

Night Weaning

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Jacque Ordner BSN, RN, IBCLC, RLC 

Sleep is a sensitive and often sensationalized topic among so-called parenting gurus, authors, and creators of online sleep courses.  However, let me reassure you that if your baby nurses or takes a bottle to drift off and wakes to feed through the night, they are not broken….THEY ARE NORMAL!  In fact, research tells us that babies who sleep through the night at less than one year of age are closer to the exception than the rule.  New parents are often asked, “Is he a good sleeper?” or “Is she sleeping through the night yet?” when babies are barely out of the newborn stage. This helps perpetuate the myth that there is something wrong if babies under one are not yet giving their parents 6-8 hours of uninterrupted sleep.  Well-meaning advice givers often tell parents that their babies will magically stop waking if night feedings are cut-off.  In reality, early night weaning can lead to decreased milk supply and put baby at risk of receiving inadequate intake. At somewhere around six months of age,  you may begin to notice that your little one naturally stretches out the time between feedings and perhaps even stretches the time spent sleeping at night. While I recommend waiting until baby is closer to age one to start actively night weaning, there are some tips that parents can employ to encourage healthy sleep for their babies.  Since sleep is developmental, I recommend following your baby’s cues while eliminating obstacles to good sleep.  Find out more in our blog post, Newborn and Infant Sleep – What is Normal? 

While night weaning can help encourage an older baby or toddler to sleep longer at night, it’s not a guarantee of reduced night waking. This is because sleep is primarily developmental, and children wake for other reasons besides just hunger.  We, as parents, can help shape our children’s environment and behaviors to encourage sleep, but it is important to keep in mind that waking at night is normal even through toddlerhood.  Keep in mind that your child will eventually sleep through the night all on their own! 

Keep reading for our top tips for night weaning. 

Increase Daytime Intake 
When considering night weaning, it’s important to ensure your child is still receiving adequate calories.  Older babies and toddlers will often naturally shift to longer periods of sleep when their daytime intake increases.  Simply offering more nursing sessions or a greater volume of breastmilk via cup or bottle can be enough to encourage less need for night-time feedings.  Increasing solids is another way to get in more daytime calories.  Toddlers often do well with a bedtime “snack” that is nutritionally dense.  Foods that provide fiber, fat, and protein are often most satiating. 

Dream Feed Just Before Bed 
If your little one generally nods off before you’re ready to hit the sack, consider offering a dream feed to “top them off” just before you go to bed.  Babies will often rouse just enough to nurse or bottle feed without becoming fully awake.  This can give you a longer stretch before baby wakes for the next feed. 

Enlist Help 
If possible, ask your partner or another trusted caregiver to assist through the night during this transition.  This is especially helpful for nursing mothers.  If a non-lactating caregiver is present to comfort and soothe during night waking, baby may be less likely demand a feeding.  The old motto holds true…..Out of sight, out of mind! 

Increase Cuddles and Communication 
It’s not uncommon for toddlers to be anxious about weaning of any sort.  Reassure them with extra cuddles and clear communication about the night weaning process. Toddlers are perceptive and the often understand far more than we adults give them credit for!  Talk about night weaning during waking hours and let your child know when the process will start.  It’s ok to tell your toddler “no” when they ask for a night-time feeding, but follow it up by also letting them know when they can nurse again. For example, “We can’t nurse now, but we can nurse again when the sun is up”. Or “I’m just going to rock you for now, but we’ll get milkies when it’s time for breakfast”. Knowing when they will be allowed to nurse again, can bring an immense amount of peace to a worried toddler. 

Set Limits 
The counting method is often very effective with toddlers!  Let your little one know that they can nurse until you reach a certain number (whatever you are comfortable with).  For example, “You can nurse until Mommy gets to 20”.  Count out loud, going slowly for the first several nursing sessions.  After a few nights, begin to count a little faster.  As your toddler adjusts, you can reduce the number until there is no nursing.  If this approach is taken slowly and gently, it is not uncommon for toddlers to become uninterested in nursing at night. 

Don’t Be Afraid to Stop 
If you begin the night weaning process only to find that your baby or toddler is greatly distressed by it, don’t be afraid to stop and start again later.  If your child is hysterical each night and shows no signs of adjusting to night weaning, try again in a month or two.  There is no one-size-fits-all prescriptive timeline for any sort of weaning and it is rarely a linear process!  

Patience, reassurance, and planning are the keys to night weaning success! 

Tried all the tips and still struggling with night weaning?  You’re not alone!  Our International Board Certified Lactation Consultants (IBCLCs) have years of experience helping families navigate night weaning and many other sleep concerns.  We’re available 7 days a week for FREE CONSULTATIONS.  No matter where you are in your breastfeeding journey, we’re here to support you! 

 

Sources: 

Burnham, M., Goodlin-Jones, B., Gaylor, E., & Anders, T. (2002, September). Nighttime sleep-wake patterns and self-soothing from birth to one year of age: A longitudinal intervention study. Retrieved January 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201415/  

Galbally, M., Lewis, A. J., McEgan, K., Scalzo, K., & Islam, F. A. (2013). Breastfeeding and infant sleep patterns: an Australian population study. Journal of Paediatrics and Child Health, 49(2), E147–E152. https://doi.org/10.1111/jpc.12089 

Kent, J., Mitoulas, L., Cregan, M., Ramsay, D., Doherty, D., & Hartmann, P. (2006, March). Volume and           frequency of breastfeedings and fat content of breast milk throughout the day. Retrieved January 4,        2021, from https://www.ncbi.nlm.nih.gov/pubmed/16510619

Breastfeeding and Pregnancy

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mom on couch with breast pump

Melissa Portunato MPH, IBCLC, RLC

Did you just find out you’re expecting a new baby and you’re currently breastfeeding? So many emotions can begin to flood your mind when you start to process that a new little one will be joining your family in just a few short months…excitement, joy, anxiety and uncertainty. If you’re pregnant and breastfeeding, you could be asking yourself questions like “Will I need to stop breastfeeding since I’m pregnant? Can I harm my unborn baby by continuing to breastfeed throughout my pregnancy?” Take a deep breath! We got you covered! Read on to get evidence based answers to everything pregnancy and breastfeeding. 

First things first, is it safe?
Nipple stimulation triggers the release of the oxytocin hormone which can trigger contractions. Research tells us less oxytocin is released when a woman is pregnant making it generally safe for a healthy mom to continue nursing while pregnant but not always. If you are exclusively pumping, remember that is breastfeeding! We recommend scheduling a prenatal exam as soon as possible to thoroughly discuss your personal situation with your doctor. If you are considered a “high risk” pregnancy you may be advised to discontinue breastfeeding to ensure your pregnancy will be safe and smooth. The current data reflects breastfeeding and healthy term births are not only compatible but biologically normal.

Changes in Milk Supply and Composition
Hormonal changes in pregnancy can cause milk supply dips and fluctuations, as well as, increased nipple tenderness. Your nursling might want to breastfeed more frequently or become less interested. Supply and demand, won’t typically hold up even if breastfeeding has been increased. Some mothers do not experience a decrease in milk supply at all while others do. Everyone is different. Milk composition will begin to transition into colostrum during your third trimester. Increased sodium levels in breastmilk can change the taste of your breastmilk and this combined with less milk, could lead to natural weaning yet; some kiddos do not mind at all and continue to nurse. The AAP recommends breast milk as the primary source of food for the first year. Closely monitor your baby’s breastfeeding behavior at the breast, weight gain and diaper output to ensure they are growing and thriving. 

Tandem Nursing
Colostrum will be produced for your newborn during the first few days postpartum even if you have continued to breastfeed an older child throughout your pregnancy. Since colostrum is packed with immune properties and prepares the newborn gut for mature milk you want to make sure you are giving your newborn priority at the breast during the early days after delivery. Nursing both of your babies at the same time, called tandem nursing, can be a way to offer emotional security and extra attention to the sibling. Tandem nursing can also help lessen engorgement and create an adequate milk supply. If you decide to wean your older baby, gradual weaning is always best. Avoid being seen in your typical nursing areas, don’t offer the breast but don’t refuse either. Redirecting behavior when asked to nurse can help the weaning process too, like offering a snack or a favorite toy. 

Pumping To Induce Labor and Colostrum Harvesting 
If you haven’t been breastfeeding since the beginning of your pregnancy it’s not recommended to start now unless you are full term (over 38 weeks) and under the care of your medical practitioner. Pumping or hand expressing can be an effective way to kick start labor! If your doctor approves you can start with hand expression or pumping with your Spectra Baby USA breast pump for 10-15 minutes on a low 38 cycle and low suction strength, just a few times a day. Some mothers will even start to see some drops of precious colostrum. You can use sterile syringes to collect, store and freeze colostrum. This can be even extra important if you already know you will be separated from your baby after delivery. Always check with your doctor first when using pumping to induce labor. 

If you desire to continue to breastfeed while pregnant, you are not alone. Breastmilk continues to have benefits for your older child and many mothers safely breastfeed their older babies while pregnant. Work closely with your health care practitioner and surround yourself with support to ensure breastfeeding can continue safely. Spectra baby USA is here for you and we support your decision to breastfeed while pregnant. Schedule a prenatal consult with us and we can help you reach your personal breastfeeding goals. 

Sources:

Amico, J., and Finley, B., Breast stimulation in cycling women, pregnant women and a woman with induced lactation: pattern of release of oxytocin, prolactin and luteinizing hormone. Clinical Endocrinology, 1986 25:97-106.

Journal of Nursing Research, 20 (1) p 74-80. doi: 10.1097/JNR.0b013e31824777c1

Mohrbacher (2010) Breastfeeding Answers Made Simple, Hale Publishing, ISBN-10: 0984503900

Flower H. (2016) Breastfeeding during pregnancy and tandem nursing: is it safe? Recent research, Breastfeeding Today, 11 April 2016

Philippa Pearson-Glaze, Expressing Colostrum Antenatally, Breastfeeding Support, 24 August 2019, https://breastfeeding.support/expressing-colostrum-antenatally/ (accessed 9 September 2020).

 

The Over Achiever: When one breast produces more than the other

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By: Jacque Ordner BSN, RN, IBCLC 

Have you noticed that one of your breasts seems to consistently produce more milk?  If you’re pumping, this may be even more noticeable.  If your baby nurses, you may have noticed that he or she prefers one side or seems to finish nursing on one side much faster than the other.  Rest assured, this is normal!  One study of exclusively pumping mothers found that in 65.7% of pumping sessions observed, the right breast produced at least slightly more milk.  In another similar study, only 2.6% of the exclusively pumping mothers displayed equal pumping output from both breasts.  

Why does this happen? So, we know it’s normal for one breast to produce more or to have a greater pumping output, but WHY? Breasts aren’t typically symmetrical.  Like many other parts of the human body (eyes, hands, feet, ears, etc.) a degree of asymmetry is normal.  This can mean a difference in the amount of milk making tissue (alveoli) or even in the amount and size of milk ducts.  Many times, mothers can readily observe a difference in the size of their breasts and also notice that one commonly feels “fuller” than the other. Other less common reasons for this discrepancy include previous breast surgery and previous injury or trauma to the breast. Rarely, asymmetry is caused by a disorder known as Poland Syndrome.  This syndrome is evidenced by missing or underdeveloped muscle tissue on only one side of the body and often results in one breast being dramatically smaller and less developed than the other. In general, breast asymmetry is completely normal as is having one breast that produces more milk.  We like to call that breast the Over Achiever. 

We’ve compiled a few tips to help “even out” milk output: 

  • If you’re pumping, consider trying different settings to see if each breast responds differently to certain cycles/vacuums.  Once you determine which settings are best for each breast, determine a plan to incorporate these settings into your typical pump session.  For example, some woman report that one breast responds best to Massage Mode (cycle 70) while the other responds well to an Expression Mode cycle.  Moms often have great success with switching between the two modes like the example below: 

            -5 minutes at cycle 70 

            -5 minutes at cycle 54 

            -5 minutes at cycle 70 

            -5 minutes at cycle 38 

*Remember that higher vacuum doesn’t necessarily mean more milk!  We never recommend increasing the vacuum to an uncomfortable level. 

  • Consider adding more stimulation for the lower producing side. If you’re pumping, this can be as simple as starting or ending the pumping session with just a few extra minutes of single pumping on the lower producing side.  If you’re nursing, consider starting sessions on the lower producing breast or adding a few minutes of single pumping on that side after nursing. 
  • Do YOU have a preference? It’s not uncommon for mom to unknowingly develop a preference for feeding from one side over the other.  We often prefer to keep our dominant hand free, and therefore may feed more often or spend more time on the opposite side.  Keeping a simple log of feeding times for each side can help highlight any preferences you might not have noticed otherwise.  
  • Encourage better nursing and greater pumping output with your hands! If baby tends to stop nursing on the less preferred side sooner, consider incorporating breast compressions while nursing. This can help keep the flow a bit faster and more interesting for baby. It can also make milk removal easier. Similarly, Hands On Pumping is a technique that can help elevate your lower producer to Over Achiever status.  Check out this video from Stanford University: https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html 
  • Add in hand expression. One breast may give less output because it just doesn’t respond to pumping as well as the other.  Hand Expression is a technique that can help increase pumping output not only for the lower producing breast, but even for the Over Achiever breast as well!  A few ways to incorporate hand expression include in between pumping or nursing sessions, following pumping or nursing sessions, or when you’re running short on time and can’t fit a full pumping session in.  Here’s a link for a fantastic resource on the topic: https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html 

Keep in mind that it is normal for one breast to be the over achiever and it’s absolutely ok if you choose to do nothing to even out the supply.  Having a lesser producing breast doesn’t mean there is something wrong, it just means our bodies aren’t perfectly symmetrical! However, if baby consistently fully refuses one breast, if there is a noticeable change in size or shape of only one breast, if there is a lump that doesn’t go away or grows, or if there is a lump that doesn’t move with the breast tissue, reach out to your healthcare provider as soon as possible. Additionally, if baby seems uncomfortable turning toward one breast or always seems to turn his or her head in the same direction, reach out to your pediatrician for further evaluation for conditions such as torticollis.  Should you desire to bring both breasts to Over Achiever status, incorporating the tips above is a great place to start! 

Keep on keeping on, mamas!  We know you’re doing your very best to provide your babies with the best start and we support you! If you have questions about uneven milk supply or any other breastfeeding related topics, we can help! Our International Board Certified Lactation Consultants are available for free consultations at www.spectrababyusa.com/lactationservices.  You can also email us at ibclc@spectrababy.com  Happy pumping! 

References 

Engstrom, J. L., Meier, P. P., Jegier, B., Motykowski, J. E., & Zuleger, J. L. (2007). Comparison of Milk Output from the Right and Left Breasts During Simultaneous Pumping in Mothers of Very Low Birthweight Infants. Breastfeeding Medicine, 2(2), 83-91. doi:10.1089/bfm.2006.0019 

Hill, P. D., Aldag, J. C., Zinaman, M., & Chatterton, R. T. (2007). Comparison of Milk Output Between Breasts in Pump-Dependent Mothers. Journal of Human Lactation, 23(4), 333-337. doi:10.1177/0890334407307575